DAILY DISPOSABLE CONTACT lenses have undeniably increased in popularity in recent years due to their significant benefits when compared to reusable contact lenses. This popularity has led to a surge of new daily disposable products on the market.

 

A search of three different contact lens databases (ABB,¹ EyeDock,² and ODSpecs³) shows there are upwards of 45 different daily disposable options. This sheer volume could be overwhelming to the optometry student attempting to select a lens for a patient, but for seasoned clinicians, this is a triumph. 

The industry focus signifies that daily disposable lenses are increasingly being used to manage specific visual needs such as myopia management, refractive error (including increasingly higher astigmatic/hyperopic errors), and presbyopia. Combine those optics with a myriad of well-documented benefits of daily disposable lenses for eye health, and the ability to achieve optimum “fit, vision, and comfort” for nearly all patients becomes a reality.

The current trend of contact lens fitting further supports the increase seen in daily disposable prescribing. In our most recent annual report, data from ABB Optical Group reveals that the fitting modalities in the U.S. this past year firmly support daily disposables as the preferred modality (Figure 1).⁴ It has been found that approximately 55% of the global soft lens market is comprised of daily disposable lenses or close to 30% by dollars. This is a large increase from 2008 to 2009, when it was approximately 35% of the market.

Taking a more global view, worldwide trends of daily disposable lens fittings can help forecast the future of fitting modality preference. Recent international contact lens prescribing data shows the prescribing rates of this lens type for all markets with more than 1,000 fits between 2018 and 2022 (Figure 2).⁵

Denmark holds the highest percentage with 60% of its soft lens wearers fit into daily disposables, followed by the United Kingdom and Australia. With trends heading in that direction and innovation occurring at a rapid pace, it is no surprise to witness such an increasing presence of daily disposables in our current market.

Daily disposables have truly become a viable and versatile solution for the eyecare practitioner (ECP) and show no hint of slowing down. In this feature, we will discuss the top 10 benefits of daily disposable lenses and how they impact patients, practitioners, and the industry.

HEALTH

1. As ECPs, “to do no harm” is always at the front of our minds. A contact lens option that offers the best health benefit for long-term wear to patients will always be a winning choice. The many health-related benefits of daily disposables have been well documented and continue to be a topical focus in the literature.

A 2021 study examined the ocular health of 144 8- to 12-year-olds before and after six years of daily disposable lens wear.⁶ Researchers found no significant change in ocular health based on biomicroscopic evaluations before and after wear in these subjects and no reports of significantly serious adverse events. This study suggests that six years of daily disposable wear in a pediatric population may have minimal impact on ocular physiology.

Furthermore, a decreased risk of developing a severe microbial keratitis may be another health benefit of daily disposable contact lenses; the rate of disease has been documented to be one to two cases per 10,000 wearers per year.⁷ Daily disposable lens type, material properties, and lens design are likely to play a role in the etiology of microbial keratitis in this wear modality. The prevailing thought is that environmental organisms are less likely to be associated with infection in a daily disposable modality, and as an option free of the use of a contact lens storage case, it results in potentially less severe disease.⁸ In other words, not only is the risk to the wearer less, but a potential infection is milder. This is an important consideration for all wearers, but particularly young neophyte wearers who potentially have many contact lens-wearing years ahead of them.

When considering the health of the patient, ECPs should consider what that means, for eye health but also for quality of life. Patient-reported outcome measures (PROMs) have become an important metric in clinical trials and are increasingly utilized in pediatric trials.⁹

A 2015 study with 110 subjects (13 to 19 years old) concluded that not only are daily disposable contact lenses a safe and effective form of vision correction compared to spectacle correction, they also resulted in improved quality of life measures using the Pediatric Refractive Error Profile (PREP) survey and the Quality of Life Impact of Refractive Correction (QIRC) questionnaire.¹⁰

Across visits, significant differences were found between vision correction groups in the PREP responses. This included appearance (p < 0.001), satisfaction (p < 0.001), activities (p < 0.001), peer perception (p = 0.003), and overall score (p < 0.001). The contact lens group gave more favorable responses than the spectacle group (p = 0.02) for the QIRC. Teenagers reported a more positive attitude toward comfort, vision, and safety with contact lenses after six months.

COMFORT

2. Comfort is a critical factor in determining whether a patient will drop out of contact lens wear. Studies show that as many as 25% of patients drop out in the first month, and up to 67% may drop out in the first two months.¹¹ Handling and comfort are often the most cited reasons for new spherical lens wearers to drop out. Practitioners will fit a two-week or one-month lens and then perform a one-week follow-up evaluation. This often misses the life span of the lens and how the patient responds to it over time.

The daily lens eliminates this issue, as the patient will wear a new lens every day until follow-up and will obtain the full effect of the lens modality. This allows more confidence and necessary real-life metrics for the practitioner to reach an informed decision regarding the finalization of a lens.

Recent literature alludes to the fact that, even if wearers are not successful in a modality, there is a good probability they can be refit successfully.¹² A study by Michaud and Forcier showed that switching the modality of a wearer to a daily disposable can improve comfort of the lens wearer with moderate-to-severe symptoms of contact lens discomfort; however, newer daily disposable silicone hydrogel materials could show gains even in a patient who has marginal contact lens discomfort.¹³

Patients who suffer with contact lens-related dry eye have also been noted to benefit from daily disposable lenses. The daily disposable modality has been found to help decrease tear osmolarity compared to reusable contact lens wear.¹⁴

Additionally, daily disposable lenses are less likely to accumulate deposits on the contact lens surface compared to reusable lenses.¹⁵ Deposits can lead to exacerbation of discomfort and dryness, and potentially to reduced acuity.¹⁶

A similar success has been noted with allergy sufferers.¹⁷ A study investigating contact lens wear in allergy sufferers found that 67% of the subjects reported improved comfort with daily disposable lenses, and some subjects reported a reduction or cessation of anti-allergy medications.¹⁸

CONVENIENCE

3. Daily disposable lenses offer patients a higher level of convenience. Patients who travel can simply toss a sleeve of lenses into their travel bags. Athletes can keep a sleeve in their gym bags.

Part-time lens wearers can easily transition between glasses and contact lenses. Typically contact lens solution is not required, allowing patients a portability that is more difficult to achieve with a monthly or two-week lens. A majority of first-time daily disposable contact lens wearers reported finding the lenses more comfortable than expected (91%), found the lens modality convenient (98%), and wanted to continue to purchase and wear the lenses (92%).¹⁹

Compared to reusable lenses, daily disposable contact lenses offer the convenience of no cleaning or disinfection steps, and the wearer is more likely to have extra lenses if they lose or tear one.²⁰ When presenting options to a potential new wearer or an established refit, do not underestimate the power of convenience as an important feature of daily disposables. This may be something the patient would not consider without proper awareness and input from the provider.

COMPLIANCE

4. It could be argued that if patients explicitly followed compliance and cleaning protocols, daily lenses would share similar wearing benefits with bimonthly or monthly lenses. However, the additional steps required for reusable modalities make for poorer compliance despite education regarding the risk.²¹

Daily disposables require fewer steps, fewer additional products, and less thought about wear cycles. In a 2009 survey, 1,654 patients weighed in on compliance. Daily disposable wearers showed the highest compliance (88%), then one-month lenses (72%), followed by two-week lenses (48%).²² Losing track of which day to replace lenses was the most common reason for overwear of contact lenses (51%).

To make matters more complicated, not only is wear schedule an issue, but the issues surrounding reusable contact lens cleaners is well documented. Multipurpose solutions can create several problems: disruption of ocular homeostasis, cytotoxicity from preservatives, impact on corneal tight junctions from a chelating agent, and even type IV cell-mediated allergic response to preservatives.²³ The use of hydrogen peroxide preservative-free cleaners can offset this; however, reusable lenses still require strict compliance for efficacy versus a daily disposable.²⁴

Proper care of cases, hygiene, and lens storage become nonissues with daily disposables, making them an easy solution for everyone in the household. In 2011, Morgan and colleagues examined compliance with 4,021 contact lens wearers in 14 countries. Perfect compliance with any type of lens wearing modality is unlikely; however, those wearing daily disposable lenses showed significantly better compliance. Unsurprisingly, use of care products with reusable modalities had the lowest levels of compliance.²⁵

FLEXIBILITY

5. Simply put, not all patients desire a contact lens for every day. Having the ability to wear contact lenses part time is a great option for patients. Patients can wear their lenses for physical activities, for a break from spectacles, or for special occasions, and daily disposable lenses offer them an easy option.

One of the best features of daily disposables is the flexibility to wear them on and off throughout the day. Not only that, but you can have flexibility with a dynamic range of vision goals for one patient. Some patients prefer distance-only vision for certain sports or events, a multifocal for working in the office, a fixed distance for specific tasks, such as a musical instrument, and perhaps a color-enhancing lens for a night out. Patients can enjoy all these aspects with daily disposable lenses to accommodate their specific goals with freedom and flexibility.

Another benefit of this flexibility emerges when it comes to activities on, or with exposure to, water. From water sports, pool activities, showers, or simply patients’ poor handling and storing habits, the threat of potentially visually devastating Acanthamoeba keratitis is very real.

Proper education and compliance for patients is critical and the messaging is clear: patients should avoid exposing their contact lenses to water.²⁶ However, many of us know sometimes a water incident is unavoidable, can occur by mistake, or the patient was simply unprepared. The ability to remove and replace a compromised daily disposable lens versus a monthly or biweekly lens should not be discounted and should be considered as a potential benefit if a patient is higher risk for such an event.

VALUE

6. Many may argue that the up-front cost of daily disposables can be prohibitive, but it is important to see the whole picture. Rebates on full-year purchases are often very generous, and an emphasis should be put on value over cost. Also, as discussed, not all patients wear lenses every day, so depending on a specific patient’s usage, it may in fact be more cost effective to prescribe a daily disposable lens.²⁷ In addition, the cost of solutions adds up over time, and when a patient loses or tears a lens, it is less financially impactful to replace a daily disposable than to pay for other modalities.

ECPs should promote value when presenting the options to their patients and not skip over products due to perceived cost. Often, patients come to their ECPs for a recommendation, and basing it on cost alone is limiting to the patients. In fact, in 2018, 1,520 adult contact lens wearers were polled online between March 26 and April 3, 2018, and the majority (68%) expected that, regardless of cost, their ECP would recommend a highly oxygenated contact lens for them, and 75% would consider a purchase based on their ECP’s suggestions, despite cost.

OPTICS

7. New insights into contact lens dropout have been building in the literature over recent years. Neophyte spherical lens wearers tend to cite lens comfort and handling as critical factors. However, once you shift to established wearers—particularly those who have more specific visual demands—the quality of vision increasingly appears to play a role in lens wear success.

In 2019, Zeri and colleagues investigated the primary factors that impact a presbyopic contact lens wearer’s potential success.²⁸ Despite not being specific to daily disposable lenses, the takeaways from the multicenter survey can be applied. That study categorized subjects as successful or unsuccessful wearers and found that convenience was a major factor contributing to successful wear, whereas, interestingly, poor vision was the primary reason for discontinuation of presbyopic contact lens wear.²⁸ A similar finding was reported for astigmatic patients who discontinued contact lens wear.¹¹

As innovation and technology improve the optical quality of these lenses, it will be beneficial to determine whether retention rates shift over time. The advent of dynamic multifocal designs, precision stability of toric optics, and blue light filtering technology²⁹ have moved the use of daily disposables forward, addressing the demands and needs of the patients we are seeing today and already anticipating the needs of tomorrow. Optical innovation is occurring in a very intentional way in the daily disposable space, and this benefit translates directly to our patients.

PARAMETER EXPANSION

8. A limiting factor for many daily disposables over the last 25 years has been availability of parameters. Thankfully, in the last few years, there has been an intentional expansion of parameters. Multifocal, astigmat (power and axis), and hyperopic ranges have multiplied across most popular lens brands, allowing ECPs to offer all these options to a broader community that has not had prior access. ECPs should target patients at their next annual exam, as they are now likely candidates for daily disposable correction.

MATERIALS

9. Daily disposables have been on the market for approximately 25 years, and the silicone daily lens has been available since 2008.^20,30 According to Morgan and colleagues, disposable hydrogel lenses have remained relatively stable at between 12% and 20% of fits over the study period (2006 to 2022), whereas daily disposable silicone hydrogels have increased to 28% of fits worldwide since their introduction in 2008.⁵ As previously mentioned, silicone hydrogel in daily disposable lenses is a potentially strategic lens material choice to help transition those labelled with contact lens discomfort into a more successful fit.¹³

Enhanced materials, higher oxygen delivery, and the disposable nature of daily disposable lenses allow for minimal lens buildup and fewer inflammatory markers on the front of the eye that might contribute to lens wear issues or discomfort. New materials also offer creative new solutions for daily disposables, such as medication-eluting lenses that may provide benefits to patients who have ocular conditions ranging from allergic conjunctivitis to primary open-angle glaucoma. Technology of materials will only continue to improve and offer innovation to a growing population of daily disposable lens wearers.

PRACTICE MANAGEMENT

10. Daily disposables are an excellent investment for patients, practitioners, and industry. It has been estimated that 50% of patients purchase contact lenses from their ECP’s practice, and daily disposables are leading the way for sales as reported by Contact Lens Spectrum, ABB (independent optical industry platform), and GfK Retail and Technology (a market research service).

ECPs can increase their capture rate by actively attempting to refit previously unsatisfied contact lens wearers with new daily disposables and offering convenient purchasing options, competitive incentives, and excellent personal customer service. Offering these services and modalities to patients not only satisfies their visual needs but shows them that the ECP is staying current, being innovative, and offering them the best option for their eyes.

Daily disposables are an excellent solution for an entire family. They offer optimized vision and extended parameters, allowing the practitioner to solve visual demands and accommodate dynamic needs. As myopia management shifts into the frame of “standard of care,” many practitioners are adopting this into their practices. With the current U.S. Food and Drug Administration-approved myopia management daily disposable soft lenses,³¹ more and more families are being exposed to the daily disposable modality.

Daily disposables are a great option for kids, supported by all the benefits listed above, and having a child in your chair is a perfect opportunity to explain why daily disposable contact lenses are a great option for everyone else in the family as well. This can be an effective method to recapture patients who did not think they were daily disposable candidates or assumed contact lens discomfort was unavoidable. Consider this an opportunity to build not only your myopia management practice but also your sales of daily disposables.

With all the benefits of daily disposable contact lenses, it is difficult to find a reason not to immediately select this modality for our patients. It will be exciting to see what industry has on the horizon. As more ECPs reach for daily disposables, they can continue to help fill the gaps of what comes next. CLS

References

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