EACH YEAR SINCE 2001, Contact Lens Spectrum has presented an overview of international contact lens prescribing. The work is conducted by an ad hoc group of national coordinators—colleagues from the contact lens industry, universities, and optometric practices—who organize for contact lens prescribing practitioners (optometrists, ophthalmologists, or opticians, as appropriate) in their countries to provide information on paper or online about the contact lens fits that they perform.
Many countries have consistently provided data to this work for long periods and indeed, five markets have contributed data every year since the first Contact Lens Spectrum publication: Australia, Canada, the Netherlands, Norway, and the United Kingdom. The United States has been included since 2002, and, in total, 71 countries have provided data since the start of the century.
The purpose of the work is to provide information for different sectors of the contact lens industry; to allow optometrists and other eyecare professionals to compare the prescribing habits of their peers to their own; for researchers to have a sense of the market relevance of their work; and for the industry to see ongoing prescribing trends around the world.
Information about contact lens prescribing is collected proactively, with respondents providing data about 10 contact lens fits conducted after the start of the survey period. In addition to the age and gender of the patients fitted, information is collected about lens material, design, replacement frequency, wearing modality, anticipated weekly usage, and care system prescribed. By examining the dates of the reported lens fits, a weighting system is employed to reflect the volume of fits undertaken by each respondent.
KEY WEARER INFORMATION
For 2022, information for at least 100 fits was collected for 22 markets and is included in this report (Table 1). Six other countries supplied fitting data, but the lower response rates prevented inclusion here. In total, 13,136 fits were reported. The mean age of patients at fitting was 33.7 ± 15.9 (mean ± standard deviation) years with the average age ranging from lower than 30 years in Israel to greater than 40 years in Denmark and Sweden.
| COUNTRY | TOTAL FITS | MEAN (± SD) AGE | % FEMALE | % NEW FITS | % PART TIME (≤ 3 DAYS) |
| Argentina (AR) | 282 | 33.9 ± 15.5 | 70% | 42% | 6% |
| Austria (AT) | 121 | 39.0 ± 15.9 | 57% | 46% | 6% |
| Australia (AU) | 509 | 37.2 ± 18.1 | 66% | 49% | 24% |
| Bulgaria (BG) | 323 | 31.5 ± 11.9 | 63% | 43% | 8% |
| Canada (CA) | 1,897 | 35.6 ± 17.5 | 66% | 35% | 24% |
| Colombia (CO) | 349 | 30.0 ± 13.1 | 62% | 53% | 5% |
| Denmark (DK) | 248 | 40.5 ± 16.1 | 68% | 28% | 1% |
| Spain (ES) | 682 | 33.2 ± 16.2 | 59% | 52% | 11% |
| France (FR) | 380 | 39.3 ± 17.8 | 69% | 37% | 4% |
| Greece (GR) | 762 | 30.2 ± 9.9 | 62% | 30% | 2% |
| Israel (IL) | 320 | 29.4 ± 12.0 | 56% | 30% | 3% |
| Italy (IT) | 570 | 33.3 ± 17.1 | 59% | 60% | 16% |
| Japan (JP) | 3,037 | 32.1 ± 16.4 | 65% | 43% | 13% |
| Lithuania (LT) | 519 | 30.8 ± 10.9 | 66% | 16% | 18% |
| Netherlands (NL) | 288 | 39.1 ± 18.2 | 62% | 37% | 4% |
| Philippines (PH) | 957 | 30.4 ± 12.1 | 71% | 31% | 8% |
| Portugal (PT) | 294 | 35.6 ± 16.1 | 63% | 50% | 10% |
| Sweden (SE) | 155 | 43.2 ± 16.3 | 64% | 14% | 11% |
| Taiwan (TW) | 449 | 30.8 ± 10.2 | 84% | 48% | 0% |
| United Kingdom (UK) | 687 | 37.4 ± 18.0 | 65% | 56% | 29% |
| United States (US) | 207 | 37.8 ± 17.2 | 71% | 32% | 3% |
| Uruguay (UY) | 100 | 31.2 ± 14.5 | 59% | 57% | 12% |
| OVERALL | 13,136 | 33.7 ± 15.9 | 65% | 39% | 13% |
| *Data for retail outlets only are shown. | |||||
In line with previous years, around two-thirds (65%) of fits were to female patients and 39% were defined as “new fits” (i.e., the prescribing of contact lenses to people with no recent wearing experience). Most patients (87%) were prescribed contact lenses on a full-time basis (defined as four days per week or more in this analysis).
Table 2 provides a breakdown of lens fits into seven lens categories for the 22 reported markets. Soft lenses accounted for 86% of fits worldwide with similar numbers of daily wear fits for daily disposables (39%) and reusables (42%). Soft lens extended wear was reported for 6% of fits. High levels of rigid lens prescribing were once again noted for the Netherlands (36%) in particular.
| COUNTRY | RIGID (NON-OK) | OK | DD HYDROGEL | DD SI-HY | REUSABLE HYDROGEL | REUSABLE SI-HY | SOFT EW |
| AR | 4% | 0% | 1% | 1% | 33% | 61% | 2% |
| AT | 20% | 4% | 3% | 17% | 14% | 41% | 2% |
| AU | 18% | 5% | 2% | 39% | 3% | 30% | 4% |
| BG | 19% | 0% | 3% | 10% | 8% | 50% | 10% |
| CA | 10% | 1% | 7% | 40% | 5% | 35% | 3% |
| CO | 29% | 1% | 0% | 3% | 2% | 61% | 4% |
| DK | 13% | 0% | 32% | 14% | 2% | 34% | 4% |
| ES | 12% | 14% | 6% | 17% | 10% | 39% | 1% |
| FR | 32% | 11% | 2% | 16% | 1% | 38% | 0% |
| GR | 0% | 0% | 2% | 9% | 29% | 58% | 1% |
| IL | 3% | 1% | 25% | 29% | 9% | 32% | 0% |
| IT | 14% | 2% | 17% | 29% | 10% | 28% | 1% |
| JP | 12% | 0% | 24% | 29% | 10% | 26% | 0% |
| LT | 0% | 0% | 3% | 32% | 1% | 33% | 31% |
| NL | 31% | 5% | 10% | 9% | 6% | 38% | 1% |
| PH | 3% | 0% | 11% | 10% | 6% | 44% | 27% |
| PT | 24% | 0% | 6% | 25% | 6% | 38% | 1% |
| SE | 4% | 1% | 14% | 21% | 4% | 45% | 10% |
| TW | 8% | 0% | 43% | 12% | 27% | 11% | 0% |
| UK | 6% | 0% | 15% | 54% | 3% | 21% | 1% |
| US | 11% | 1% | 4% | 33% | 6% | 38% | 8% |
| UY | 25% | 0% | 8% | 3% | 26% | 38% | 0% |
| OVERALL | 12% | 2% | 12% | 27% | 8% | 34% | 6% |
| See Table 1 for country abbreviations. OK = orthokeratology DD = daily disposable EW = extended wear | |||||||
Figure 1 shows the trends for these seven categories of contact lenses since the start of these annual surveys. The number of rigid lenses decreased in the first decade of this work but have remained constant for the past 12 years. Orthokeratology has accounted for 2% to 3% of fits in recent years.
Daily disposable hydrogel lenses have also remained relatively stable at between 12% and 20% of fits over this study period, whereas daily disposable silicone hydrogels have increased to 28% of fits worldwide (in 2022) since their introduction in 2006. Similarly, silicone hydrogels now dominate the market for reusable soft lenses, accounting for 1 in 3 of all contact lens fits, with reusable hydrogels making up 8% of fits.
RIGID CORNEAL AND SCLERAL LENSES
Details for rigid lenses are shown for the 12 markets reporting at least 35 rigid lens fits in Table 3. Scleral lenses are growing in popularity within the overall rigid lens segment, accounting for about one-quarter of reported fits. Of rigid corneal lenses, spherical design lenses account for 38% of fits with more specialized lenses such as torics, multifocals, and orthokeratology lenses making up more than half of fits.
| AU | BG | CA | CO | ES | FR | IT | JP | NL | PT | TW | UK | OVERALL | ||
| Rigid lenses for new fits | 19% | 22% | 14% | 32% | 31% | 53% | 13% | 5% | 17% | 29% | 7% | 3% | 14% | |
| Rigid lenses for refits | 28% | 20% | 9% | 29% | 22% | 38% | 20% | 17% | 47% | 18% | 9% | 11% | 14% | |
| TYPES/MATERIALS | Scleral | 41% | 0% | 52% | 23% | 19% | 23% | 17% | 0% | 34% | 82% | 0% | 19% | 23% |
| PMMA | 0% | 3% | 7% | 2% | 2% | 3% | 0% | 0% | 1% | 0% | 0% | 2% | 2% | |
| Low Dk (< 40) | 0% | 14% | 1% | 0% | 4% | 0% | 1% | 9% | 2% | 0% | 0% | 1% | 3% | |
| Mid Dk (40-90) | 7% | 12% | 8% | 9% | 52% | 5% | 33% | 24% | 38% | 6% | 20% | 22% | 19% | |
| High Dk (> 90) | 52% | 71% | 32% | 66% | 24% | 70% | 49% | 67% | 24% | 12% | 80% | 55% | 54% | |
| DESIGN | Sphere | 23% | 67% | 25% | 70% | 15% | 27% | 29% | 75% | 23% | 52% | 77% | 68% | 38% |
| Toric | 41% | 22% | 27% | 20% | 15% | 14% | 27% | 1% | 43% | 40% | 23% | 13% | 20% | |
| Multifocal | 6% | 9% | 16% | 5% | 8% | 12% | 15% | 16% | 7% | 3% | 0% | 1% | 11% | |
| Monovision | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 1% | 2% | 0% | 0% | 0% | 2% | |
| Orthokeratology | 21% | 0% | 10% | 4% | 54% | 39% | 10% | 0% | 21% | 0% | 0% | 0% | 20% | |
| Myopia control | 8% | 0% | 13% | 0% | 5% | 0% | 9% | 1% | 4% | 3% | 0% | 16% | 5% | |
| Other | 2% | 0% | 9% | 1% | 2% | 8% | 9% | 6% | 1% | 3% | 0% | 1% | 5% | |
| Planned replacement | 12% | 100% | 35% | 98% | 81% | 90% | 74% | 24% | 38% | 92% | 91% | 47% | 64% | |
| Extended wear | 21% | 10% | 16% | 5% | 36% | 1% | 15% | 0% | 12% | 3% | 0% | 1% | 8% | |
| See Table 1 for country abbreviations. Data presented for countries reporting > 35 rigid lens fits. PMMA = polymethyl methacrylate. | ||||||||||||||
SOFT LENSES
As in 2021, soft lenses accounted for 86% of all lens fits in 2022 (Table 4). Silicone hydrogels were prescribed to 76% of patients receiving soft lenses. There was some variation here, with some markets reporting more than 90% of soft lens fits with this material type (e.g., Australia, Colombia, France, and Lithuania) and others noting a significantly lower use (e.g., Taiwan with 25% of soft lens fits).
| AR | AU | BG | CA | CO | DK | ES | FR | GR | IL | IT | JP | LT | NL | PH | PT | SE | TW | UK | US | OVERALL | ||
| Soft lenses for new fits | 97% | 81% | 78% | 86% | 68% | 94% | 69% | 47% | 100% | 96% | 87% | 95% | 100% | 78% | 95% | 71% | 96% | 93% | 97% | 84% | 86% | |
| Soft lenses for refits | 96% | 72% | 80% | 91% | 71% | 87% | 78% | 62% | 100% | 95% | 80% | 83% | 100% | 53% | 98% | 82% | 94% | 91% | 89% | 91% | 86% | |
| MATERIALS | Low water content (< 40%) | 3% | 1% | 0% | 2% | 0% | 0% | 5% | 1% | 3% | 1% | 4% | 7% | 0% | 4% | 15% | 0% | 0% | 54% | 1% | 1% | 5% |
| Mid water content (40-60%) | 32% | 4% | 3% | 6% | 2% | 15% | 10% | 0% | 23% | 29% | 17% | 25% | 4% | 15% | 2% | 3% | 6% | 21% | 13% | 8% | 13% | |
| High water content (> 60%) | 0% | 2% | 13% | 5% | 1% | 26% | 7% | 3% | 6% | 6% | 11% | 7% | 2% | 8% | 8% | 13% | 15% | 0% | 5% | 3% | 6% | |
| Silicone hydrogel | 65% | 94% | 84% | 87% | 97% | 58% | 78% | 95% | 68% | 64% | 68% | 61% | 94% | 74% | 76% | 84% | 79% | 25% | 81% | 88% | 76% | |
| DESIGN | Sphere | 73% | 27% | 53% | 41% | 42% | 48% | 38% | 24% | 56% | 39% | 24% | 70% | 78% | 35% | 47% | 33% | 32% | 75% | 31% | 36% | 48% |
| Toric | 20% | 25% | 17% | 34% | 35% | 26% | 32% | 24% | 34% | 41% | 37% | 20% | 14% | 26% | 29% | 36% | 29% | 16% | 39% | 35% | 28% | |
| Cosmetic tint | 0% | 3% | 2% | 1% | 3% | 0% | 1% | 0% | 1% | 2% | 2% | 2% | 1% | 1% | 1% | 1% | 2% | 0% | 2% | 0% | 1% | |
| Multifocal | 5% | 35% | 25% | 19% | 18% | 25% | 22% | 48% | 8% | 11% | 25% | 8% | 6% | 33% | 19% | 21% | 30% | 8% | 23% | 13% | 18% | |
| Monovision | 0% | 8% | 1% | 4% | 1% | 0% | 1% | 0% | 0% | 5% | 0% | 0% | 0% | 3% | 4% | 1% | 6% | 0% | 4% | 14% | 3% | |
| Myopia control | 0% | 2% | 2% | 2% | 1% | 1% | 6% | 3% | 0% | 2% | 12% | 0% | 1% | 1% | 0% | 9% | 0% | 0% | 1% | 0% | 2% | |
| Other | 1% | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 1% | 0% | 0% | 1% | 0% | 0% | 0% | 0% | 0% | 1% | 0% | |
| REPLACEMENT | Daily | 1% | 56% | 18% | 54% | 4% | 57% | 32% | 32% | 11% | 57% | 55% | 60% | 50% | 31% | 30% | 41% | 42% | 59% | 74% | 45% | 48% |
| 1-2 weekly | 14% | 8% | 11% | 5% | 1% | 8% | 1% | 14% | 41% | 17% | 6% | 39% | 8% | 6% | 1% | 2% | 4% | 3% | 3% | 12% | 15% | |
| Monthly | 79% | 34% | 67% | 40% | 65% | 34% | 62% | 50% | 46% | 25% | 31% | 1% | 42% | 60% | 63% | 56% | 52% | 35% | 23% | 38% | 34% | |
| 3-6 monthly | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 1% | 0% | 0% | 0% | 0% | 0% | |
| Annually | 2% | 0% | 3% | 0% | 25% | 1% | 4% | 3% | 1% | 0% | 7% | 0% | 0% | 3% | 7% | 0% | 0% | 0% | 0% | 3% | 2% | |
| Unplanned | 4% | 2% | 0% | 0% | 4% | 0% | 1% | 1% | 0% | 0% | 1% | 0% | 0% | 0% | 0% | 1% | 2% | 2% | 0% | 2% | 1% | |
| Extended wear (EW) | 2% | 5% | 12% | 3% | 6% | 5% | 2% | 0% | 1% | 0% | 1% | 0% | 31% | 1% | 27% | 1% | 11% | 0% | 1% | 9% | 7% | |
| EW with silicone hydrogels | 100% | 100% | 45% | 98% | 97% | 95% | 100% | • | 83% | • | 100% | 50% | 98% | 45% | 79% | 100% | 0% | • | 97% | 87% | 91% | |
| MPS solutions | 96% | 97% | 98% | 82% | 99% | 95% | 93% | 81% | 98% | 60% | 81% | 80% | 86% | 91% | 95% | 87% | 89% | 86% | 97% | 89% | 88% | |
| Presbyopes multi/mono | 18%/0% | 61%/17% | 61%/6% | 52%/12% | 46%/8% | 45%/3% | 70%/2% | 73%/0% | 80%/0% | 62%/18% | 69%/1% | 32%/1% | 31%/0% | 68%/8% | 77%/1% | 64%/0% | 52%/9% | 55%/0% | 55%/9% | 30%/31% | 53%/7% | |
| See Table 1 for country abbreviations. | ||||||||||||||||||||||
Of all soft lenses, toric designs account for 28% of fits. This number rises to 37% when only standard single-vision fits are considered (i.e., ignoring multifocal, monovision, cosmetic tint, and myopia control fits). This value has almost doubled since the start of the century, presumably due to greater availability of toric lens parameters, improved lens quality and reproducibility, and increased practitioner confidence (Figure 2).
It is also of note that there is a clear disparity between many markets here; soft torics represent at least 30% of all soft lens fits in most markets, but there is a smaller group of countries, including Bulgaria, Lithuania, and Japan, where this value is less than 20%. This latter group generally features markets where ophthalmologists prescribe contact lenses, whereas the former set of countries is generally optometry-led.
Multifocal and monovision lens designs account for 18% and 3% of soft lens fits, respectively. When only presumed presbyopes are considered (patients aged 45 years and older) these proportions rise to 53% and 7%, respectively. In other words, 60% of presbyopes fitted with soft lenses receive a form of presbyopic correction, with the remaining patients presumably mainly fitted with distance single-vision lenses. This rate of “correct” prescribing for presbyopes has more than doubled in the past 20 years (Figure 3), probably due to the same factors that have caused soft toric usage to increase—better products resulting in greater practitioner confidence and patient satisfaction.
For soft lens replacement frequency, daily disposable lenses account for half of all soft lens fits (48%), with monthly and weekly/biweekly lenses the next most prescribed (34% and 15% of lens fits, respectively). The use of daily disposables varies worldwide. Figure 4 shows the prescribing rates of this lens type for all markets for which we have collected information for more than 1,000 fits between 2018 and 2022. Over this period, more than 60% of soft lens wearers in Denmark, the United Kingdom, and Australia were prescribed daily disposables (a value that increases to around 70% if only spherical lenses are considered). On the other hand, daily disposables represented fewer than 10% of fits in the Latin American markets of Argentina, Mexico, and Colombia during 2018 to 2022.
Extended wear was reported in 7% of soft lens fits in 2022, with silicone hydrogel materials prescribed in more than 90% of extended wear cases. Multipurpose solutions were prescribed to 88% of patients where a care regimen was required. Such solutions dominated in most markets (Figure 5), although multipurpose solution usage was somewhat lower than average in Italy, Lithuania, Canada, and Denmark. CLS
Funding and/or assistance was provided for the following markets: Australia—Optometry Australia; Bulgaria—Vision Protect Ltd; Greece and Israel—Johnson & Johnson Vision; Netherlands—Dutch Association of Contact Lens Suppliers; Spain—Spanish General Council of the Colleges of Opticians-Optometrists.
The authors acknowledge the administrative support of Eurolens Research, University of Manchester, and the Centre for Ocular Research & Education (CORE) at the University of Waterloo.
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