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Today’s contact lens dropout rate similar to 1990s
Lens discomfort continues to be the leading cause.
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While contact lens technology is continually developing, lens wear discontinuation rates have not markedly decreased in 20 years, a recent study found, and discomfort continues to be the primary reason.
“Despite the improvements in lens materials, wearing modalities and care regimens, discontinuation from contact lens wear remains a serious concern for eye care providers,” Kathryn Dumbleton, PhD, MCOptom, FAAO, said in an interview with Primary Care Optometry News. Dumbleton is head of clinical research for the Centre for Contact Lens Research at the University of Waterloo School of Optometry and Vision Science and one of the study authors.
“By offering patients who may be struggling with comfortable lens wear opportunities to try new products as they become available, clinicians may be able to help reduce dropout rates and keep patients in contact lenses for longer,” she said.
Kathryn Dumbleton
Previous studies investigating discontinuation from contact lens wear have been conducted, but none since the introduction of silicone hydrogel lens materials and none since the number of daily disposable lens wearers has significantly increased, Dumbleton said. It was not known whether these factors have had a significant effect on discontinuation rates with contact lens wearers.
Therefore, an online survey was conducted in Canada in 2010 in which both current and lapsed contact lens wearers answered a series of questions regarding their contact lens wearing experiences during the period of 2008 to 2010. In the case of lapsed wearers, their reasons for discontinuing lens wear were evaluated.
The survey was distributed through Facebook and produced 4,207 eligible responses, according to the study. Forty percent of respondents said they had ceased lens wear for at least 4 months during the measured time period; however, 62% of these lapsed wearers had resumed wear prior to responding to the survey, and about one-third of those had again discontinued, the study said.
The study also found that lapsed wearers were older, began lens wear at an older age and had not worn lenses for as long as non-lapsed wearers (P < .001) and that more non-lapsed wearers wore silicone hydrogels than lapsed wearers (49% vs. 38%, P < .001).
The primary reason respondents gave for discontinuation was discomfort (24%), followed by dryness (20%), red eyes (7%) and expense (7%), the study said. The authors noted that the study included contact lens wearers who had obtained their lenses from a variety of sources, not just their eye care professional.
“The resultant final rate for lapsed wear was 23%, which is similar to previous reports from studies conducted in Canada in the 1990s,” Dumbleton said. “Discontinuation rates were found to be lower in silicone hydrogel lens wearers, but slightly higher in daily disposable wearers.
“In my opinion,” she said, “there has not been a marked decrease in contact lens discontinuation since 1990 because of the perpetual problem of contact lens discomfort. Researchers, the industry and clinicians need to work together to provide lenses that can be comfortably worn for longer periods of time.”
The study, according to the authors, did not fully investigate compliance with all aspects of lens care, however, so it cannot accurately report on whether wearers were more likely to lapse from lens wear due to poor lens care. It is possible that many of the patients who responded to this survey may have discontinued wearing their lenses for reasons not evaluated in the survey.
While the study did not consider this, it has been hypothesized that Baby Boomers are perpetuating the contact lens dropout rate due to presbyopia, dryness and coexisting ocular pathology, Dumbleton told PCON. Significant progress in improving dropout rates may not occur until the Baby Boomers have cycled out, she said.
This study was funded by Alcon. – by Daniel R. Morgan
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Disclosures: Dumbleton has no direct financial interests, but she has received travel honoraria from Alcon to make presentations at educational meetings.