INTERNATIONAL PRESCRIBING

International Contact Lens Prescribing in 2011

This year, we analyzed data from more than 22,000 prospective contact lens fits in 29 countries.

By Philip B. Morgan, PhD, MCOptom, FAAO, FBCLA; Craig A. Woods, PhD, MCOptom, DipCLP, FAAO; Ioannis G. Tranoudis, DO, MSc, PhD, FIACLE, FBCLA; Magne Helland, BSc, MScOptom, FIACLE; Nathan Efron, PhD, DSc, FAAO (DipCCLRT); Christina N. Grupcheva, MD, PhD, FEBO, FICO (Hon); Deborah Jones, BSc, FCOptom, DipCLP, FAAO; Kah-Ooi Tan, BOptom (Hons), PhD, MBA; Alice Pesinova, BSc; Ole Ravn; Jacinto Santodomingo, OD(EC), MSc, PhD, MCOptom, FBCLA, FAAO; Florence Malet, MD; Mihály Végh, MD; Nir Erdinest, BOptom, MSc; Hreinn Ingi Hreinsson; Prema Chande, MOptom, DBM, FIACLE; Giancarlo Montani, FIACLE, FBCLA; Motozumi Itoi, MD, PhD; Byoung Sun Chu, MOptom, PhD, FIACLE, FAAO; Jolanta Bendoriene, MD, PhD; Eef van der Worp, BOptom, PhD, FAAO, FIACLE, FBCLA; Suresh Awasthi, MPhil; Wanda Lam, OD, BSc; José Manuel González-Méijome, OD, PhD, FIACLE; Edgar Davila-Garcia, OD, NCLEAC; Simona Radu, MD, FIACLE; Vadim Belousov; Oskar Johansson, BSc; Mirna Stabuc Silih, MD, PhD; John Hsiao, BA, OD, FIACLE; & Jason J. Nichols, OD, MPH, PhD, FAAO

This is the 11th annual report of contact lens prescribing trends that we have prepared for Contact Lens Spectrum. Each year, we capture current modes of contact lens practice by asking practitioners in each market (optometrists, opticians or ophthalmologists, as appropriate) to provide information about the first 10 lens fits undertaken after receiving our paper or electronic survey form. In 2011, we captured information about 22,362 fits in 29 countries.

Lens Wearer Demographics

Women continue to represent the majority of patients attending for contact lens fitting (Table 1). Sixty-seven percent of fits were to women, with minimal variations in this measure between countries, ranging from 56 percent in Slovenia to 77 percent in Taiwan (Figure 1). For both sexes across all nations, the average age at fitting was 31.2 years, ranging from 23 years in Nepal to 37 years in Sweden. In a number of mature contact lens markets, the mean fitting age is edging toward 40 years. For example, in the United Kingdom, New Zealand, Sweden, Australia and Denmark, the average age is greater than 35 years. The oldest patient reported this year was a 100-year-old man, who was fitted with extended-wear soft lenses.

To download a PDF of the Tables as it appears in print, please click here

Figure 1. Age and gender for patients receiving contact lenses.

GP Lenses

Overall, GP lenses have maintained their recent level at about 10 percent of fits (8 percent conventional and 2 percent orthokeratology) (Table 2). Table 3 shows a detailed analysis for the 10 countries providing information for 35 or more GP lens patients. GP lenses account for 18 percent or more of lens fits in France, Japan, the Netherlands, New Zealand and Slovenia. Most markets report little or no orthokeratology, but this lens type accounted for 5 percent or more of fits in Australia, Italy, the Netherlands and Taiwan. High-Dk materials were preferred (65 percent of fits in major GP lens markets).

Soft Lenses

Soft lenses accounted for 90 percent of lens fits (Table 4). Silicone hydrogel materials continue to increase in popularity and now represent 70 percent or more of daily wear fits in Australia, Canada, Czech Republic, France, Hungary, Romania and Slovenia. Worldwide, 47 percent of fits were with this material.

Toric lenses accounted for 23 percent of lens fits. This figure rises to 29 percent if monovision, multifocal and cosmetically tinted lenses are excluded.

More than half of patients with presbyopia are prescribed multifocal lenses (41 percent) or monovision (12 percent). In Italy and France, patients who are 45 years old or older receive the highest proportion of presbyopia-correcting lenses (Figure 2).

Figure 2: Soft lenses prescribed for presbyopia.

We continue to see a great difference in lens replacement frequencies around the world. Daily disposables are prescribed for 56 percent of soft lens fits in Norway, but only 2 percent in Bulgaria (Figure 3). In general, however, about 90 percent of lenses are replaced monthly or more frequently. Only in South Korea are more than half of soft lens fits prescribed on a less frequent replacement schedule.

Figure 3: Worldwide prescribing of daily disposable lenses.

Overall, 90 percent of lenses are prescribed with multipurpose solutions.

Extended wear lenses have maintained their recent level at about 10 percent of soft lens fits; 74 percent of fits for extended wear are with silicone hydrogel lenses.

Puerto Rico

This year, for the first time, we analyzed data from Puerto Rico. We received data for 489 contact lens fits. Age and sex distributions were in line with other markets; 5 percent of lenses were GP, which is lower than the global average but not dissimilar to many other markets. Fewer daily disposables were prescribed than in most countries, and most soft lenses were replaced on a monthly basis. The proportions of toric, multifocal and extended-wear lenses were similar to world averages.

Lens types fitted in Puerto Rico (outside) compared to the global average (inside).

Anti-myopia Lenses

For the first time, we included “anti-myopia” as a lens design category to capture lens fits specifically designed to arrest the progression of myopia. Five percent of GP lens fits and 0.1 percent of soft lens fits were given this designation. This data set serves as a useful baseline for the possible growth in this area of contact lens practice in the coming years. CLS

This survey was funded by the sponsors of Eurolens Research at the University of Manchester: Bausch + Lomb Inc.; Ciba Vision (UK) Ltd.; CooperVision Ltd.; Johnson & Johnson Vision Care; Menicon Co. Ltd.; and Sauflon Pharmaceuticals Ltd.

Additional funding and/or assistance was provided for the following: Bulgaria, Israel, Romania, Slovenia, Hungary, Czech Republic—Johnson & Johnson Vision Care; ustralia—Optometrists Association Australia; China—Ciba Vision Shanghai; Korea—Korean Optometric Association; Norway—Norwegian Association of Optometry; the Netherlands—Bausch + Lomb Benelux; Puerto Rico—Johnson & Johnson Vision Care and The Puerto Rico College of Optometrists; Spain—Spanish General Council of the Colleges of Opticians-Optometrists; Sweden—Swedish Optometry Association and the Swedish Contact Lens Association.

The authors acknowledge the kind administrative support of the Centre for Contact Lens Research at the University of Waterloo, Canada.