This article was originally published in a sponsored newsletter.

A recent study evaluated the impact of national affluence on the prescribing patterns of various types of soft contact lenses.¹ Derived from an extensive bank of contact lens prescribing data, the study used survey forms collected from contact lens practitioners who fit more than 100 contact lenses between 2017 and 2021.

The study sought to determine the relationship between the percentage of daily disposable, toric, silicone hydrogel, and multifocal contact lens prescriptions versus the gross domestic product at purchasing parity per capita (GDP [PPP]). The GDP (PPP) is basically a measure of the average wealth, or affluence, of citizens of a specific nation.² Essentially, this method evaluates the correlation between prescribing a specific type of contact lens versus wealth.³

Data from 39 countries and 94,181 contact lens fits were studied. The relationship between the percentage of contact lens prescribing versus GDP (PPP) was highly statistically significant for daily disposable lenses and marginally significant for toric lenses. Toric lenses were more expensive than spherical lenses, and silicone hydrogel lenses were more expensive than hydrogel lenses.¹ Of interest, there was no association between silicone hydrogel or multifocal contact lenses.¹ The prescribing patterns of daily disposable contact lenses, and to a smaller extent toric contact lenses, are indeed affected by the affluence of lens wearers in different nations.

Variations in training, attitudes, and collective confidence of practitioner groups can also influence rates of contact lens prescribing.¹ For instance, lower rates of prescribing toric lenses are found in countries where ophthalmology is the predominant contact lens-prescribing profession.¹ Examples of such countries are Argentina, Bulgaria, Japan, Lithuania, Mexico, Moldova, and Russia. In these countries, contact lenses are often based on spectacle prescriptions from ophthalmologists and are dispensed by technicians or optical assistants who may have limited knowledge of optics and may select a simpler approach of providing spherical lenses to astigmatic patients.

A limitation of this study is that it does not consider variances in affluence within nations, where there might be a large intranational disparity of disposable incomes and, thus, a disparity in fiscal ability to purchase lenses.¹

The authors of this publication recommend that the contact lens industry, practitioners, and governments/regulatory bodies should be aware of these associations and reduce cost barriers to the purchase of contact lens products so they can be prescribed based on important clinical and lifestyle considerations.

REFERENCES

1. Efron N, Morgan PB. Affluence and Contact Lens Prescribing. Eye Contact Lens. 2022 Nov;48:455-459.

2. IMF. World Economic Outlook Database. 2019. Available at: https://www.imf.org/en/Publications/WEO/weo-database/2019/April. Accessed June 20, 2023.

3. Efron N, Morgan PB, Woods CA, International Contact Lens Prescribing Survey Consortium. An international survey of daily disposable contact lens prescribing. Clin Exp Optom. 2013 Jan;96:58–64. Erratum: Clin Exp Optom. 2013 Mar;96:250.

Melissa Barnett, OD, FAAO, FSLS, is the director of optometry at the University of California, Davis in Davis, specializing in anterior segment disease and specialty contact lenses. She is the past president of the Scleral Lens Education Society. She is an advisor to and/or has received honoraria or travel expenses from AccuLens, Alcon, Allergan, Bausch + Lomb, Bruder, Contamac, CooperVision, Johnson & Johnson Vision, Ocusoft, ScienceBased Health, Shire, Tarsus, and Visus Therapeutics.