WE HAVE REPORTED on an international survey of contact lens prescribing in Contact Lens Spectrum since 2001. The work is conducted by a group of optometry, ophthalmology, and industry colleagues with each taking on responsibility for one or more contact lens markets. Their role is to contact as wide of a group as possible of contact lens-prescribing colleagues in their country (or countries) of interest and to contribute to this annual report. Recipients—who might be optometrists, ophthalmologists, and/or opticians depending on local regulatory rules—are invited to complete a paper or online survey form, which prospectively reports on up to 10 contact lens fits conducted.
The work initially started in 1996 as a United Kingdom-only initiative but soon spread more widely and data have now been collected about contact lens fitting in 71 countries with information collected for more than 450,000 fits. Nineteen countries have provided data each year for the past 10 years, and seven countries have now contributed for 20 consecutive years (Australia, Canada, Japan, Netherlands, Norway, the United Kingdom, and the United States).
The intention of the overall project is to provide data against which individual eyecare professionals can benchmark their own fitting practices and to inform researchers and industry colleagues to help their work.
For each contact lens fit reported, data are collected about the following features: age and gender of the patient; lens material, design, replacement frequency, and wearing modality; the anticipated usage of the lenses (as days per week); 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 2023, information for at least 100 fits was collected for 23 markets and is included in this report (Table 1). We also received entries from five other markets, but the reduced response rates here preclude inclusion in the annual report. There is considerable variation in the number of responses between markets, with Japan and Canada returning the highest number with 2,830 and 1,906 fits, respectively, and an overall total of 13,127 fits were included in the 2023 analysis.
| COUNTRY | TOTAL FITS | MEAN (± SD) AGE | % FEMALE | % NEW FITS | % PART TIME (≤ 3DAYS) |
| Argentina (AR) | 279 | 36.0 ± 16.2 | 60% | 42% | 10% |
| Australia (AU) | 370 | 38.6 ± 18.8 | 60% | 43% | 18% |
| Bulgaria (BG) | 338 | 30.4 ± 12.5 | 58% | 51% | 6% |
| Canada (CA) | 1906 | 36.0 ± 17.5 | 69% | 27% | 21% |
| Colombia (CO) | 186 | 30.0 ± 11.4 | 62% | 48% | 3% |
| Denmark (DK) | 231 | 40.8 ± 15.2 | 60% | 26% | 3% |
| Spain (ES) | 1099 | 32.9 ± 16.2 | 61% | 59% | 15% |
| France (FR) | 220 | 34.6 ± 17.4 | 75% | 47% | 13% |
| Greece (GR) | 698 | 30.9 ± 11.7 | 60% | 20% | 7% |
| Hungary (HU) | 104 | 28.8 ± 14.3 | 57% | 39% | 10% |
| Israel (IL) | 160 | 28.4 ± 8.1 | 70% | 13% | 1% |
| Italy (IT) | 880 | 35.7 ± 17.4 | 58% | 57% | 9% |
| Japan (JP) | 2830 | 31.2 ± 16.5 | 66% | 45% | 14% |
| Lithuania (LT) | 550 | 31.9 ± 11.8 | 69% | 15% | 23% |
| Netherlands (NL) | 203 | 40.9 ± 18.9 | 61% | 50% | 4% |
| Norway (NO) | 140 | 40.5 ± 17.1 | 51% | 22% | 5% |
| Philippines (PH) | 858 | 29.3 ± 10.0 | 70% | 36% | 1% |
| Portugal (PT) | 233 | 34.6 ± 14.9 | 61% | 52% | 9% |
| Sweden (SE) | 136 | 41.7 ± 16.6 | 57% | 25% | 12% |
| Taiwan (TW) | 585 | 32.7 ± 10.9 | 79% | 17% | 2% |
| United Kingdom (UK) | 885 | 38.6 ± 17.7 | 63% | 52% | 29% |
| United States (US) | 126 | 40.1 ± 16.6 | 54% | 23% | 9% |
| Uruguay (UY) | 110 | 34.9 ± 16.6 | 66% | 52% | 9% |
| OVERALL | 13127 | 33.8 ± 16.0 | 65% | 38% | 15% |
The average age of fitting was 33.8 ± 16.0 years (mean ± standard deviation). About two-thirds (65%) of fits were to females and 38% were “new fits” (to people who had no recent contact lens experience). Only 15% of lenses were prescribed to be used on a part-time basis (three days of wear per week or fewer).
Figure 1 shows the gender and age characteristics for markets that have contributed to the annual survey for the five-year period between 2019 and 2023. The chart shows a number of interesting findings. All markets show a majority of fits to females, but this varies from 52% in Spain to more than 70% in a number of Asian markets and reaching more than 80% in Taiwan and Korea.
There is also a considerable variation in the age at fitting. It is apparent that all the northern European, North American, and Australasian markets sit in a tight group with an average age of fitting between 36 and 39 years, with only Argentina from another global region. Decreasing fitting ages are then observed for markets in southern Europe, eastern Europe, and Asia.
Table 2 shows the distribution of lens fits for each market across seven key lens categories. In total, 10% of fits were with rigid lenses (including 1% orthokeratology fits)—with high prescribing rates noted for the Netherlands in particular—and with daily disposable lenses (45%) now fitted more than daily wear reusable lenses (40%). Only 4% of lenses were with soft extended wear products.
| AR | AU | BG | CA | CO | DK | ES | FR | GR | HU | IL | IT | JP | LT | NL | NO | PH | PT | SE | TW | UK | US | UY | OVERALL | ||
| LENS TYPE | Rigid (non OK) | 14% | 21% | 5% | 14% | 12% | 18% | 9% | 32% | 0% | 21% | 2% | 13% | 10% | 0% | 45% | 21% | 1% | 19% | 23% | 2% | 3% | 10% | 23% | 9% |
| OK | 1% | 2% | 0% | 1% | 0% | 0% | 4% | 4% | 0% | 22% | 0% | 20% | 0% | 0% | 2% | 0% | 0% | 0% | 5% | 0% | 0% | 0% | 0% | 1% | |
| DD hydrogel | 7% | 5% | 8% | 6% | 0% | 14% | 8% | 3% | 3% | 17% | 29% | 28% | 24% | 2% | 11% | 11% | 14% | 6% | 5% | 46% | 11% | 8% | 2% | 12% | |
| DD Si-H | 9% | 43% | 8% | 44% | 10% | 35% | 17% | 24% | 12% | 12% | 27% | 28% | 33% | 36% | 10% | 30% | 16% | 21% | 21% | 11% | 59% | 18% | 1% | 33% | |
| Reusable hydrogel | 14% | 2% | 22% | 3% | 3% | 9% | 15% | 6% | 18% | 2% | 16% | 28% | 10% | 0% | 3% | 2% | 4% | 6% | 4% | 34% | 1% | 17% | 6% | 7% | |
| Reusable Si-H | 52% | 21% | 41% | 29% | 75% | 21% | 45% | 31% | 61% | 23% | 23% | 17% | 23% | 41% | 27% | 28% | 56% | 48% | 33% | 8% | 25% | 46% | 66% | 33% | |
| Soft EW | 3% | 5% | 17% | 3% | 0% | 2% | 2% | 0% | 6% | 3% | 3% | 15% | 0% | 20% | 2% | 7% | 8% | 0% | 9% | 0% | 0% | 1% | 2% | 4% | |
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See Table 1 for country abbreviations. |
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Italy was the market in 2023 that most closely matched the global position across these seven categories (Figure 2). Conversely, the market that was least typical was Taiwan based on its reported 585 fits (Figure 3). Here, 46% of lenses prescribed were daily disposable hydrogels (around four times the global proportion) with 34% of lenses reusable hydrogels. With 80% of fits with hydrogel lenses, Taiwan comfortably has the highest prescribing rate of any market versus the global average of 19% (the balance being silicone hydrogel lenses).
RIGID CORNEAL AND SCLERAL LENSES
Details for rigid lenses are shown for the nine markets reporting at least 35 rigid lens fits in Table 3. Scleral lenses continue to represent a significant fraction of rigid lenses prescribed (22%) although high-Dk corneal lenses account for the largest of the five rigid lens categories reported, with 52% of fits. Spherical lenses account for 34% of rigid lens fits with 11% of rigid fits prescribed as standard (non-myopia control) orthokeratology.
| AU | CA | DK | ES | FR | IT | JP | NL | UK | OVERALL | ||
| Rigid lenses for new fits | 24% | 15% | 32% | 13% | 46% | 15% | 5% | 34% | 2% | 12% | |
| Rigid lenses for refits | 24% | 16% | 14% | 15% | 26% | 16% | 14% | 61% | 5% | 12% | |
| TYPES/MATERIALS | Scleral | 22% | 27% | 58% | 19% | 11% | 13% | 0% | 56% | 18% | 22% |
| PMMA | 4% | 0% | 0% | 11% | 0% | 1% | 3% | 0% | 0% | 2% | |
| Low Dk (< 40) | 0% | 10% | 6% | 3% | 0% | 14% | 13% | 2% | 3% | 8% | |
| Mid Dk (40-90) | 4% | 4% | 0% | 28% | 4% | 34% | 20% | 29% | 26% | 15% | |
| High Dk (> 90) | 70% | 59% | 36% | 39% | 85% | 39% | 64% | 13% | 54% | 52% | |
| DESIGN | Sphere | 28% | 23% | 34% | 12% | 17% | 34% | 70% | 19% | 35% | 34% |
| Toric | 22% | 9% | 29% | 25% | 15% | 14% | 1% | 62% | 9% | 17% | |
| Multifocal | 5% | 7% | 5% | 4% | 6% | 7% | 15% | 11% | 26% | 9% | |
| Monovision | 1% | 2% | 0% | 4% | 0% | 0% | 1% | 0% | 0% | 2% | |
| Orthokeratology | 10% | 9% | 2% | 30% | 12% | 22% | 3% | 4% | 3% | 11% | |
| Myopia control | 12% | 41% | 8% | 19% | 2% | 8% | 2% | 0% | 10% | 13% | |
| Other | 22% | 8% | 21% | 6% | 47% | 14% | 7% | 4% | 17% | 14% | |
| Planned replacement | 21% | 43% | 80% | 97% | 100% | 78% | 21% | 32% | 61% | 62% | |
| Extended wear | 16% | 22% | 0% | 43% | 0% | 6% | 0% | 0% | 15% | 10% | |
| See Table 1 for country abbreviations. Data presented for countries reporting > 35 rigid lens fits. PMMA = polymethyl methacrylate. | |||||||||||
SOFT LENSES
Soft lenses accounted for 90% of lens fits in 2023 (Table 4). Silicone hydrogels represented more than three-quarters of lens fits; their use varied from only 19% of soft lens fits in Taiwan (as detailed above) to 96% in Colombia. The uptake of silicone hydrogel materials since the turn of the century for 17 markets is shown in Figure 4.
| AR | AU | BG | CA | CO | DK | ES | FR | GR | IL | IT | JP | LT | NL | NO | PH | PT | SE | TW | UK | OVERALL | ||
| Soft lenses for new fits | 90% | 76% | 97% | 85% | 91% | 68% | 87% | 54% | 100% | 100% | 85% | 95% | 100% | 66% | 66% | 96% | 79% | 41% | 100% | 98% | 89% | |
| Soft lenses for refits | 81% | 76% | 93% | 84% | 87% | 86% | 85% | 74% | 100% | 98% | 84% | 86% | 100% | 39% | 80% | 100% | 83% | 82% | 98% | 95% | 90% | |
| MATERIALS | Low water content (< 40%) | 6% | 0% | 0% | 3% | 0% | 0% | 4% | 0% | 0% | 4% | 2% | 6% | 1% | 0% | 0% | 11% | 1% | 0% | 59% | 2% | 5% |
| Mid water content (40-60%) | 14% | 6% | 5% | 4% | 1% | 19% | 16% | 2% | 21% | 33% | 15% | 26% | 0% | 7% | 4% | 2% | 3% | 7% | 20% | 6% | 12% | |
| High water content (> 60%) | 6% | 3% | 39% | 4% | 3% | 10% | 7% | 13% | 1% | 10% | 9% | 6% | 2% | 20% | 15% | 8% | 11% | 7% | 1% | 5% | 6% | |
| Silicone hydrogel | 74% | 90% | 56% | 89% | 96% | 71% | 73% | 86% | 78% | 53% | 73% | 62% | 97% | 73% | 81% | 79% | 85% | 86% | 19% | 87% | 77% | |
| DESIGN | Sphere | 38% | 36% | 58% | 33% | 38% | 27% | 28% | 29% | 59% | 45% | 21% | 69% | 73% | 30% | 28% | 61% | 22% | 16% | 85% | 33% | 48% |
| Toric | 45% | 28% | 16% | 29% | 33% | 40% | 36% | 36% | 29% | 39% | 39% | 20% | 12% | 44% | 33% | 24% | 56% | 42% | 13% | 34% | 28% | |
| Cosmetic tint | 4% | 0% | 1% | 1% | 0% | 0% | 1% | 0% | 2% | 0% | 1% | 2% | 3% | 0% | 0% | 2% | 4% | 0% | 0% | 0% | 1% | |
| Multifocal | 9% | 18% | 14% | 28% | 12% | 26% | 27% | 25% | 10% | 14% | 32% | 6% | 10% | 18% | 32% | 12% | 13% | 33% | 2% | 24% | 17% | |
| Monovision | 2% | 10% | 6% | 6% | 7% | 2% | 1% | 3% | 1% | 0% | 1% | 1% | 0% | 4% | 5% | 0% | 0% | 6% | 0% | 4% | 3% | |
| Myopia control | 2% | 8% | 4% | 3% | 9% | 2% | 6% | 2% | 0% | 2% | 5% | 1% | 1% | 5% | 2% | 0% | 5% | 2% | 0% | 4% | 3% | |
| Other | 0% | 1% | 0% | 0% | 1% | 3% | 1% | 4% | 0% | 0% | 2% | 0% | 0% | 0% | 0% | 0% | 1% | 0% | 0% | 0% | 1% | |
| REPLACEMENT | Daily | 19% | 67% | 21% | 60% | 12% | 62% | 29% | 42% | 15% | 59% | 52% | 63% | 49% | 40% | 58% | 34% | 34% | 42% | 58% | 73% | 52% |
| 1-2 weekly | 9% | 5% | 4% | 6% | 1% | 3% | 3% | 13% | 33% | 23% | 5% | 36% | 2% | 10% | 2% | 0% | 1% | 1% | 1% | 2% | 11% | |
| Monthly | 59% | 26% | 69% | 33% | 60% | 32% | 63% | 40% | 51% | 18% | 36% | 1% | 49% | 49% | 37% | 65% | 63% | 57% | 40% | 25% | 35% | |
| 3-6 monthly | 2% | 0% | 6% | 0% | 25% | 2% | 3% | 4% | 0% | 0% | 5% | 0% | 0% | 1% | 3% | 1% | 0% | 0% | 0% | 0% | 1% | |
| Annually | 9% | 1% | 0% | 0% | 3% | 0% | 2% | 0% | 0% | 0% | 2% | 0% | 0% | 0% | 0% | 0% | 3% | 0% | 1% | 0% | 1% | |
| Unplanned | 2% | 1% | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 0% | |
| Extended wear (EW) | 4% | 6% | 19% | 3% | 0% | 2% | 3% | 1% | 6% | 3% | 0% | 0% | 20% | 4% | 9% | 8% | 0% | 13% | 0% | 0% | 5% | |
| EW with silicone hydrogels | 100% | 100% | 74% | 95% | • | 100% | 86% | 100% | 99% | 40% | 100% | 100% | 100% | 33% | 64% | 80% | 100% | 95% | • | 80% | 93% | |
| MPS solutions | 96% | 97% | 91% | 93% | 97% | 81% | 94% | 86% | 97% | 85% | 79% | 84% | 89% | 95% | 90% | 96% | 87% | 100% | 96% | 96% | 91% | |
| Presbyopes multi/mono | 25%/5% | 42%/23% | 74%/3% | 62%/14% | 56%/38% | 55%/4% | 77%/3% | 74%/10% | 67%/1% | 78%/0% | 75%/1% | 29%/1% | 49%/0% | 43%/6% | 50%/9% | 63%/0% | 44%/2% | 51%/9% | 17%/0% | 55%/11% | 53%/8% | |
| See Table 1 for country abbreviations. The final row indicates the proportion of multifocal and monovision lenses prescribed for patients over 45 years of age. | ||||||||||||||||||||||
With the sole exception of Taiwan, all markets show a similar pattern of use, growing from an average of around 10% of fits in 2004 to about 80% in 2015 and plateauing at this level since. Uptake in the use of this material category shows the potential dynamism of the contact lens market when breakthrough products are launched. In the case of silicone hydrogels, it was the introduction of newer, daily wear-oriented materials in 2004 that appears to have fueled the great rise in their popularity.
Spherical lens designs accounted for around half of all soft lens fits, with 28% of fits including at least one toric lens and 17% being multifocals. Lenses for myopia control accounted for 3% of soft lens fits; this headline value represents the use of this lens type across all ages of patients, bearing in mind that they are aimed at young patients.
To account for this, Figure 5 shows the use of soft lenses for myopia control in patients between six and 17 years of age across the 21 markets for which we have information of at least 1,000 contact lens fits between 2019 and 2023. Significant levels of fitting of myopia control lenses (25% of soft lens fits or greater) are seen for five markets in particular: Spain, Netherlands, Portugal, Italy, and Australia.
In terms of lens replacement, about half of all lenses prescribed were daily disposables and one-third were monthly-replaced lenses. Figure 6 shows the use of daily disposables since 2000. Unlike the case of silicone hydrogels (Figure 5), the rate of increase has been relatively conservative with average prescribing changing from about 20% of soft lens fits at the turn of the century to about 40% today.
Nevertheless, the doubling of the use of these lenses over this period is also a significant change in the market. More variation between countries is seen when compared with the silicone hydrogel results. Some markets (notably Australia and the United Kingdom) see more than 60% of fits as daily disposables whereas this value is much lower in the Netherlands, Spain, and Bulgaria.
Only 5% of soft lenses were prescribed for extended wear, with silicone hydrogel materials used in 93% of such cases. Multipurpose products were prescribed for 91% of contact lenses when a solution was needed. 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.
