Each month, Contact Lens Spectrum broadcasts a livestream series called CLS Live! during which the host sits down with leaders in the world of contact lenses to discuss new and future products, the latest research, and worldwide trends in prescribing—and even brings viewers up to date live from the floor of CLS conferences such as the Global Specialty Lens Symposium.

>> Each CLS Live! episode airs on the CLS Facebook and LinkedIn pages plus the CLS YouTube channel.

In this episode, which originally aired on Sept. 16, the hosting baton was passed from Jason Jedlicka, OD, (clinical professor at Indiana University School of Optometry and chief of the school’s Cornea and Contact Lens Service) to Philip Morgan, PhD, MCOptom (professor of optometry, head of optometry, deputy head of the division of pharmacy, and director of Eurolens Research at The University of Manchester). Dr. Morgan is also president of both the International Association of Contact Lens Educators and the Manchester Statistical Society and a past president of the International Society for Contact Lens Research.

This episode launches a new series that looks at contact lenses around the world. Here, Dr. Morgan and Dr. Jedlicka discuss the North American contact lens market.

Q: Jason Jedlicka, OD: Why did you get into contact lenses, and why do you find it interesting?

A: Phil Morgan, PhD, MCOptom: Contact lenses offer what is a scientifically and clinically fascinating form of vision correction. I’m very passionate about the benefits of contact lenses to our patients, and I think we can do a better job than we do currently considering the uptake of contact lenses worldwide.

Q: Dr. Jedlicka: Why might it be helpful for someone in the U.S. to have a perspective on how contact lens prescribing works in other countries around the world?

A: Dr. Morgan: In the mid-’90s, I was at The University of Manchester working with professor Nathan Efron. We were doing a lot of work on daily disposables…and we didn’t really know how popular these lenses were. We had a sense that they were starting to take off. We decided to initiate a survey of contact lens prescribing that we actually ran just in the U.K. in 1996. Since then, we run the same type of survey annually to try to answer this question: What sorts of contact lens products are being prescribed by practitioners here and around the world?

We’ve now collected data in more than 70 countries worldwide. The U.S. came on board in 2002, and we’ve actually got five markets now where we have 20 years of continuous information, and another five or so where we’ve got 15 years. We feel it’s important to share this information and we publish [a summary] each year in the January issue of Contact Lens Spectrum.

It might be useful to look at what’s happening with colleagues in your country, and if you find you’re fitting much more or less than average, then that perhaps informs you about your practice. It certainly has a use for educators and manufacturers as well. They can be informed [about] what their professional services people should be doing.

Q: Dr. Morgan: Let me turn the table on you and talk about what’s happening in the U.S. Why are contact lenses so successful in the U.S.?

A: Dr. Jedlicka: In the U.S., people spend time investing in their health by being active and exercising, and contact lenses fit well into that. Perhaps we also have more disposable income than in other parts of the world as well, and to spend money on contact lenses as opposed to just a pair of glasses might be preferable to a lot of people here who can afford it.

Q: Dr. Morgan: How contact lenses are prescribed and who is licensed to prescribe them is another area in which contact lens use varies around the world. If I’m a –2D myope and I’m living in Chicago, how am I going to go and get contact lenses?

A: Dr. Jedlicka: Really, all you need in the U.S. is a prescription. Now, how you obtain that prescription can be done in a variety of different ways. In the U.S., contact lenses are pretty regulated as medical devices, so you can’t just walk up to a vending machine and buy them like you can in other parts of the world. That doesn’t mean that there aren’t alternative ways to get them, of course.

As far as getting that prescription, it varies: someone can have a comprehensive eye exam and a thorough fitting, with measurements of the eye shape and lenses applied and evaluated, and then followed up for outcome prior to prescribing. On the other end of that spectrum, you could theoretically walk into a practice that does a very cursory exam and simply writes you a prescription for lenses at the end of it.

We think that it’s important that contact lenses are fitted properly and cared for properly because we have all seen the consequences of bad fits and contact lens abuse. It’s the hope that everybody would have a complete eye examination first, and as part of that, there would be measurements and prescriptions of appropriately fitting lenses and appropriately correcting lenses, with proper instruction of care and handling. That can happen through ophthalmology practices, optometry practices, and, depending on the state, in optical settings as well.

Q: Dr. Morgan: What are your thoughts on the current state of internet supply to patients who hopefully have a prescription?

A: Dr. Jedlicka: This takes me back to your initial question about why the U.S. has more wearers. I’d like to think maybe the fact that we do a better job of regulating them and fitting them at a higher level keeps our patients happy with their lenses and keeps them wearing them as opposed to getting them randomly from a machine and they don’t fit and so the patients have a bad experience and quit.

Certainly, alternative channels are there, but I don’t feel that internet sales are necessarily climbing at a significant rate compared to where they might have been five or 10 years ago. Our job is to prescribe proper-fitting lenses and we should be charging for our services. Beyond that, if the patient chooses to obtain their lenses from another route, as long as they’re getting the ones that I prescribed, I guess that’s OK.

Q: Dr. Morgan: When I look at the data from the U.S., it’s always been surprising to find daily disposable lenses are a little bit below average. That’s picked up in recent years, but still perhaps below the average of the countries that we survey worldwide. Do you have thoughts on why?

A: Dr. Jedlicka: Culturally, some groups pride themselves on quality, and cost is really not important. Other populations are focused on, “Let’s get the best deal.” The U.S. population has been the type that says, “I would like a lot, but I don’t want to spend a lot for it.” Or, maybe practitioners think that their patients think that way so they prejudge them, and they’re often wrong.

Another difference is that early daily disposables were not the best quality lenses. They were made inexpensively and the materials and the way they were manufactured weren’t as good as the lenses that were available in a two-week or monthly modality. While you were gaining the daily disposability, you were losing something in terms of quality of material. I think that’s changed now.

Q: Dr. Morgan: What part of contact lens practice do you think isn’t receiving the attention it deserves?

A: Dr. Jedlicka: There’s been a bit of controversy about this over the years. With the increased utilization of daily disposable lenses, you see it becoming less of a factor, but I think there’s more to lens material and solution compatibility than we want to admit. Many of us think all solutions work just as well with all materials, and I don’t think that’s true.

There are differences, and I don’t know that we want to explore them deeply enough because nobody wants to lose sales of their solutions and lenses. It’s all about preventing the dropouts, and I think that solution-material combination is probably more of a factor in dropouts than we probably want to admit. CLS

CATCH CLS LIVE! Watch this livestream’s full interview—and catch past and future episodes in the series via the online version of Contact Lens Spectrum at clspectrum.com or our Facebook or LinkedIn pages. Additionally, you can subscribe to Contact Lens Spectrum’s YouTube channel (bit.ly/clsyoutube22 ) to view this and other past interviews and to receive notifications for upcoming ones.