Beyond Vision Correction: The Real Impact of Contact Lens Wear on Patients

Beyond correcting vision, what other benefits do contact lenses wearers say they receive from wearing lenses? Deeper understanding of how contact lenses make people feel can help eye care professionals (ECPs) better articulate the benefits to more patients.

Raising awareness of the option of contact lenses increases the number of people trialing and purchasing lenses, ultimately delighting patients and driving business for ECPs.

A new consumer survey, commissioned by CooperVision, has been conducted to explore these questions.¹ Independently run in five countries, the survey was designed to learn more about some of the deeper, emotional, benefits people gain when wearing contact lenses. This report summarizes the survey, its results and provides advice relevant for use in practice.

When thinking about wearing contact lenses in comparison to wearing spectacles, nearly 80% agreed contact lenses make them feel more like themselves.

Significant opportunity exists to introduce contact lenses to many more patients.

The majority of people who require vision correction are spectacle-only wearers. Best estimates suggest use of dual correction spectacles and contact lenses – occurs in only 27% of people requiring vision correction.²

This illustrates significant opportunity exists to introduce contact lenses to many more patients. Barriers to proactive recommendation should be low when the high fit success rates of modern contact lenses, which are available in a wide range of materials, prescriptions and wearing regimens, are taken into account.

In relation to contact lenses, the gap in communication between the ECP and patient has been highlighted previously.^3,4 Anecdotally, current non-lens wearers report: “if my ECP does not mention contact lenses then I assume they are not a suitable option for me.” Conversely, rather than proactively offering to everyone, an ECP may look to the patient to drive the conversation, assuming they will ask for contact lenses if they are interested in trying them.

Health care professionals are expected by their patients to routinely communicate and proactively initiate prescribing therapies, including medical devices, and recommendations for treatment options. The lack of communication does not follow in other aspects of optometric practice. Spectacle dispensing involves the proactive recommendation of features that will be beneficial to patients such as antireflection coatings or individualized varifocal designs. 

Likewise, in dentistry regular deep cleaning with the dental hygienist is routinely advised. In neither of these examples is the patient expected to initiate the conversation. Ultimately, this level of proactive professional advice should extend to the routine recommendation of contact lenses in the majority of patients.

To overcome this misunderstanding and lost opportunity for contact lens wear, ECPs should routinely discuss the option of contact lenses with suitable patients. 

When this is done the number of new contact lens fits and sales increases.⁵ However, that recommendation may be more compelling if it can be made using language that resonates with patients and reflects the deeper benefits they may hope to gain through contact lens wear. 

The survey was conducted over a two-week period at the end of November, 2019 in Germany, Great Britain, Japan, Spain, and the United States. More than 35,000 people responded to the survey, including a total of 5,347 contact lens wearers, split evenly across the five countries (Table 1).

Of the contact lens wearers, 61% were female, 63% were frequent wearers of between 4-7 days a week, and over half (55%) wore lenses for more than eight hours a day. The distribution of age of the contact lens wearers is shown in Table 1. On average, 37% wore daily disposables, with variation between countries: lowest daily disposable use in Germany, Spain and the United States (28-29%) compared to Japan (42%) and Great Britain (57%). The wearer demographics were broadly representative of the CL wearing population.

Contact lens respondents were asked their level of agreement to a series of statements, with the following options on a 5-point Likert scale: strongly agree, somewhat agree, somewhat disagree, strongly disagree. The proportion of those agreeing to statements includes all responses of “strongly agree and “somewhat agree”. Minimal differences existed between countries for the majority of statements. Results reported are for the average of all five countries unless otherwise stated.

When asked about vision, 86% agreed that they expect their ECP to make a recommendation for the soft contact lenses that provide the best possible vision correction for [their] eyes, regardless of cost. This echoes consumer expectations with regard to the health performance of contact lenses with nearly 7 out of 10 agreeing that they expect their ECP to recommend the lenses that provide 100% of the oxygen that their eyes need, again, regardless of cost.⁴

These results provide more evidence of the opportunity ECPs have to recommend the most appropriate lens for patients, which may include a toric or multifocal option to best correct their vision, without second guessing what that patient is willing to pay.

Additional results from the survey are summarized below. With high levels of agreement across a range of benefits, ECPs should recognize the power they hold to improve patients’ quality of life and make them feel confident, through the simple act of fitting contact lenses.

Contact lenses enable me to
"...live my life."

Agree that contact lenses:
"have improved my quality of life"
"allow me to live my life on my own terms"

Agree compared to spectacles with similar agreement by age (range 75-82%):
"I see better in contact lenses"

Around 8 in 10 agree they see better in contact lenses than spectacles, and this includes the presbyopic group aged 55 and over. This result may be surprising to some ECPs who, perhaps based on experience with older lens designs, may feel that contact lens visual performance may not always match spectacle acuity. For example on average just 50% of ECPs feel correction with soft toric lenses provides the same visual acuity as a patient’s up to date spectacle prescription.⁶

This perception appears to be at odds with the patient experience as reported in this survey. The visual benefits a patient experiences with contact lenses are likely so much more than simple Snellen acuity: unhindered peripheral vision being just one example. Further, ECPs may be thinking that multifocal contact lenses deliver sub-optimal vision for presbyopes. Wearer feedback in this survey refutes this concern, and should give confidence to ECPs that many more people in this age group may benefit from trying contact lenses.

A simple contact lens experience has the potential to deliver all these benefits to patients. ECPs are ideally placed to expose many more patients to the advantages of contact lenses.

Taking a proactive approach with contact lens recommendation not only helps with building the business, but can actually change how a patient feels, impacting confidence and overall quality of life. Perhaps the best reason of all for ECPs to get more involved: changing people’s lives for the better!

More than 80% agree that with contact lenses:
"I feel attractive when wearing them" (81%)
"Make me feel confident" (82%)
"I think I look natural" (91%)

Agree that compared to spectacles:
"Contact lenses make me feel more like myself"

Consistent Results

It is interesting to note that the high levels of agreement to statements reported by contact lens wearers were fairly consistent across different patient groups. Detailed below, the results show minimal difference in response: men experience the deeper-felt benefits in a similar way to woman, older wearers do not differ significantly from younger ones, and frequent wearers report even higher levels of agreement to statements than the average. Contact lenses really do positively impact a broad range of patients.

Gender

Maximum 3% difference in agreement between men and woman for all statements: men gain similar benefits to women with contact lenses including feeling confident, attractive and improved quality of life.

Use this in practice to explain the benefits of contact lens to men; a group who typically under index in contact lens wear compared to women.

Age

The benefits gained from contact lens wear do not change substantially with age. Across all statements only a range of 9% difference in response by age, for example nearly three-quarters of wearers age 55 or over feel attractive when wearing lenses.

Use this in practice to confidently introduce multifocal contact lenses to presbyopes, knowing they receive both emotional and visual benefits.

Frequency of wear

For those wearing lenses between 4-7 days a week, agreement to statements was 3-10% higher than the average. The impact of contact lens wear is even higher in people who wear their contact lenses more frequently.

Use this is practice to remember that the benefits of contact lenses are recognised across all groups, but perhaps most strongly by those committed to wearing most days in the week.

Discussion

Relevant for younger patients too

These findings are not restricted to adults. Strong similarities to the benefits reported in this new survey have been found in young contact lens wearers too. Children and adolescents also experience improved quality of life,⁸ and improved self-perception in physical appearance, athletic competence and social acceptance.⁹

Make contact lens recommendation part of the daily routine:

• In addition to the practical advantages of contact lenses for sports for example, ECPs should remember that wearers may feel additional emotional benefits to this alternative form of vision correction.
• In practice this means ECPs do not need to reserve recommending contact lenses for specific situations such as sports or a vacation. It is important to routinely recommend contact lenses, in addition to spectacles, to a wide variety of patients.

Compared to the control, the results of these studies showed positive outcomes for both spectacles AND contact lenses:

• Patients spent up to 32% more on their spectacles,^10,11 and reported higher levels of satisfaction with their dispensing experience.^10,11
• Between 63% and 88% agreed to try contact lenses,^8,9 were greater than 2.5 times more likely to have had, or have scheduled, a full contact lens fit,¹¹ leading to 2.5 times more patients purchasing contact lenses.¹⁰
• These findings demonstrate that BOTH spectacles and contact lenses can be successfully offered together. They complement each other, enhancing overall patient satisfaction with the ECP and practice.

Provide a contact lens experience

• Those new to contact lenses may have concerns about how the lens will feel when worn. It is helpful to be able to offer a short lens experience on the same day to enable those fears to be overcome. This also provides an opportunity for the patient to experience how contact lens wear makes them feel.
• Two separate studies have explored offering contact lenses to help with spectacle frame selection.^10,11 The benefits being that lenses can be tried immediately, and the focus is taken away from having to decide if the patient wants to become a contact lens wearer or not. They are simply used to enhance the spectacle dispensing process.
• It is important to optimize the contact lens wearing experience in new wearers. To help avoid the natural drop out seen over the first 2-12 months of wear, ECPs should ensure that patients are confident handling their lenses, and find contact lens delivers comfortable, clear vision. Being aware of these reasons for early drop out ensures practices can support patients through the early weeks of wear by putting in place educational materials, follow up phone calls and appointments.^{12, 13}

Final take-away message

Neither the ECP or patient can predict how contact lenses will make them feel – so the best advice is to routinely discuss contact lenses with all suitable patients, and to offer an easy route to enable them to experience lens wear.

Use proactive contact lens recommendation with the knowledge that wearers gain deep emotional benefits in addition to simple vision correction.

1.    CVI data on file 2020. YouGov Plc online consumer survey Nov/Dec 2019 in Germany, UK, Spain, Japan, USA. N=5,347 Contact Lens wearers (“consumers”), screened from total N=35,397 adults. Data weighted and representative of adults in each market (aged 18+).
2.    CVI data on file 2019. Industry and Market data, US consumer CL market in 2018.
3.    CVI data on file 2017. Barriers to 1-day silicone hydrogel online research. July 2017. Cello Health Insight. Data on file. Survey carried out online in US (n=61), UK (n=47) and Japan (n=50).
4.    CVI data on file 2018. YouGov online survey on silicone hydrogel lenses. N=1520 adult CL wearers (US 519, UK 501, Japan 500).
5.    Jones L, Jones D, Langley C, et al. Reactive or proactive contact lens fitting - does it make a difference? J Brit Contact Lens Assoc 1996;19:41-3.
6.    CVI data on file 2020. Kubic online survey; n=404 US ODs who prescribe toric soft CLs.
7.    Draper M, Patel K, Russell N. Mixed-methods study of behaviours and attitudes to vision correction of spectacle and contact lens wearers. CLAE. 2019;42:e23.
8.    Walline JJ, Gaume A, Jones LA, et al. Benefits of contact lens wear for children and teens. Eye & CL 2007;33:317-21.
9.    Walline JJ, Jones LA, Sinnott L, et al. Randomized trial of the effect of contact lens wear on self-perception in children. OVS.2009;86:222-32.
10.    Atkins NP, Morgan SL, Morgan PB. Enhancing the approach to selecting eyewear (EASE): a multi-centre, practice-based study into the effect of applying contact lenses prior to spectacle dispensing. CLAE. 2009;32:103-7.
11.    Mayers M, Jansen Bishop M, Walerius D, et al. Improving your spectacle patients’ in-practice experience with contact lenses during frame selection. CLAE. 2019;42:406-10.
12.    Sulley A, Young G, Hunt C. Factors in the success of new contact lens wearers. CLAE. 2017;40:15-24.
13.    Sulley A, Young G, Hunt C, et al. Retention Rates in New Contact Lens Wearers. Eye & CL 2018;44 Suppl 1:S273-S82.