An international survey of contact lens prescribing for presbyopia

Abstract

Purpose:The aim was to determine world-wide patterns of fitting contact lenses for the correction of presbyopia. Methods: Up to 1,000 survey forms were sent to contact lens fitters in each of 38 countries between January and March every year over five consecutive years (2005 to 2009). Practitioners were asked to record data relating to the first 10 contact lens fittings or refittings performed after receiving the survey form. Results: Data were received relating to 16,680 presbyopic (age 45 years or older) and 84,202 pre-presbyopic (15 to 44 years) contact lens wearers. Females are over-represented in presbyopic versus pre-presbyopic groups, possibly reflecting a stronger desire for the cosmetic benefits of contact lenses among older women. The extent to which multifocal and monovision lenses are prescribed for presbyopes varies considerably among nations, ranging from 79 per cent of all soft lenses in Portugal to zero in Singapore. There appears to be significant under-prescribing of contact lenses for the correction of presbyopia, although for those who do receive such corrections, three times more multifocal lenses are fitted compared with monovision fittings. Presbyopic corrections are most frequently prescribed for full-time wear and monthly replacement. Conclusions: Despite apparent improvements in multifocal design and an increase in available multifocal options in recent years, practitioners are still under-prescribing with respect to the provision of appropriate contact lenses for the correction of presbyopia. Training of contact lens practitioners in presbyopic contact lens fitting should be accelerated and clinical and laboratory research in this field should be intensified to enhance the prospects of meeting the needs of presbyopic contact lens wearers more fully.

The effect of ageing on the ocular surface parameters

“…For example, in the case of IOL implantation, optimal pre-surgical ocular conditions are required in order to avoid risks such as severe DED, inaccurate IOL power estimation [20] and ocular discomfort after IOL [21]. Despite the fact that most of the research studies conducted until now have demonstrated that MCLs provide good visual quality results [17,[22][23][24][25][26][27], the prescription rate [28,29]) is low. Although many factors could be behind this low adherence, it should be noted that the CLs materials are the same as monofocal CLs.…”

Low toric soft contact lens acceptance study

“…However, this may not prove to be the case when visual performance is examined between spherical and toric correction. Efron et al [4] suggest five possible reasons that eye care professionals do not routinely correct refractive cylinder of 0.75 DC or less: (1) The small visual improvement is not offset sufficiently by the increased chair time or potential for variability in vision due to axis mislocation. (2) The belief that higher modulus soft contact lenses mask astigmatism.…”

Investigating the utility of clinical assessments to predict success with presbyopic contact lens correction

“…However, an international survey reporting data from 2005-9 revealed the majority of presbyopic contact lens patients were fitted with non-presbyopic corrections [2], perhaps suggesting eye care practitioner awareness, fitting skills or confidence in presbyopic contact lens performance may be deficient.…”