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.
This episode, which aired on Dec. 14, 2022, was hosted by Philip Morgan, PhD, MCOptom, professor of optometry, head of optometry, and director of Eurolens Research at the University of Manchester, and continues a series that looks at contact lenses around the world. Here, Dr. Morgan discusses the Latin America contact lens market with Martín Edisson Giraldo Mendivelso, an optometrist from Bogota, Colombia, who specializes in the anterior segment and in contact lenses. He’s currently on the faculty of the optometry program at Universidad de La Salle in Bogotá. He also is regional director for Latin America for the International Association of Contact Lens Educators.
Q: Philip Morgan, PhD, MCOptom: How are contact lenses regulated across the Latin America region? Can they be purchased in any store, or do patients need to have a prescription for that?
A: Martín Edisson Giraldo Mendivelso: We have different scenarios in Latin America for prescribing contact lenses. In countries like Brazil, for example, it is only a skill from ophthalmologists. In countries like Colombia, Peru, Ecuador, and Venezuela, the prescription is needed from optometrist level. And there are other countries like Argentina and Chile, where the prescription is at the technician level. They have two years of training, and they have the ability to prescribe contact lenses. The regulation of the laws is so different—they are so heterogeneous in Latin America.
Q: Dr. Morgan: It sounds like you need a prescription in most countries across Latin America. Is that correct?
A: Professor Giraldo: Yes. In lots of countries, we need a prescription from the optometrist.
Q: Dr. Morgan: What about internet purchasing? Are contact lenses purchased on the internet widely across Latin America?
A: Professor Giraldo: Unfortunately, it’s quite common. There is a kind of free market in contact lenses. For example, in Colombia, anyone can buy contact lenses on the internet. We understand the need of prescribing contact lenses in person and on a professional level, but people can buy them freely.
Q: Dr. Morgan: So, in Colombia, if a patient goes to the internet to purchase contact lenses, do they need to upload a prescription to the website or is it easier than that, can they just buy what they want?
A: Professor Giraldo: There are conditions. If people want to buy [contact lenses] online, the platform or the type requires the prescriptions, but it’s not closely regulated. We have no control of the prescription and the customers from obtaining contact lenses online.
Q: Dr. Morgan: You mentioned that Brazil was a largely ophthalmology market. It’s the biggest country in Latin America‚ the most populous, and an important market to consider. I know there’s been important regulatory changes for optometry in Brazil in recent months, potentially things that could affect contact lens practice.
A: Professor Giraldo: This situation is difficult, yes. As you said, ophthalmologists have control over optometry and contact lens prescribing, even for a refractive error itself. The law is changing, but it’s hard now for the optometrists to prescribe contact lenses freely. It’s not easy now. They are working on the law. They are working on regulations to allow optometrists to receive broader training, but it will take a long time. [Brazil is] the biggest market, but that kind of situation stops the exercise in optometry and contact lens training and fitting.
Dr. Morgan: Each region seems to have its equivalent of Brazil. We have that in Europe, in France, for example, which is largely ophthalmology-dominated. Some parts of Eastern Europe too and, of course, Japan is very much an ophthalmology-based market for contact lenses in Asia. We watch developments there closely, but hopefully, the very high standard in countries like Colombia can sort of spread the message and we can see some developments for our colleagues in optometry in Brazil in the coming years.
Q: Dr. Morgan: What changes might we expect to see in Latin America in the coming years?
A: Professor Giraldo: There are different levels of education, so we would like to unify the training and the skills of the professionals. We want to unify the criteria in terms of fitting contact lenses. We want to improve training programs. We want to improve the hybrid education programs. The COVID pandemic taught us a lot of educational strategies that we have to adopt in the future.
I know that the next years will be a difficult situation with a worldwide economic recession, but we have to support the fitting professional in contact lenses because we need more skills, more commitment, more experience with patients who have keratoconus, special contact lenses, and refractive errors. We have a lot of potential and we will have to work for it.
We want to improve education to the patient about the benefit of fitting contact lenses—people don’t widely appreciate the positives of contact lens wear and we need to work to improve their usage. Some people believe that contact lenses are bad for ocular health. Public health is such an issue in the future.
Q: Dr. Morgan: If we are to see some unification or consistency of contact lens practice and optometry more generally across the region, how might you see this happen?
A: Professor Giraldo: For example, Mexico and Colombia are the leaders in Latin America in contact lens training. We have to improve this training in other countries. We have to invite all the professionals in Latin America for unified training of contact lenses, to share experiences among countries.
Q: Dr. Morgan: Which part of contact lens practice do you feel is important but does not receive enough attention?
A: Professor Giraldo: Professionals need to improve their consciousness that fitting contact lenses requires more follow-up to the patient. Sometimes we fit the contact lenses and the patients leave without full knowledge of lens care. [A contact lens] is a very delicate medical disposable on the eye, and some complications can occur. We need more training really.
Maybe the fitting of contact lenses is so informal sometimes, and we need to know how difficult and how important and how responsible professionals have to be about the fitting of contact lenses.
Dr. Morgan: Lenses are better than they’ve ever been, but fundamentally they’re still a medical device that sits on the front of the eye. They still warrant respect, careful education, and attention. CLS
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