Round-up Report

ROUND-UP REPORT Consumer Insights Series

CooperVision^®

Patient insights provide
evidence for a proactive
communication approach by
eye care professionals

Introduction

When it comes to vision care, particularly contact lenses (CLs), there are some simple yet important patient communication techniques that eye care professionals (ECPs) can adopt to help strengthen their business.

In recent years, CooperVision’s Consumer Insights series surveyed more than 45,000 consumers and over 900 ECP respondents across 11 countries on multiple practice-building topics. This subsequent, retrospective review looks across the combined data to identify several evergreen opportunities to improve communication with current and prospective patients. The results of these surveys have been published in six individual reports, each focused on a different eye care topic, such as digital device use, 1 day lenses, and new contact lens wearer dropout. Survey details are provided in Table 1 below.

Consumer Insights Series Report Title	Survey Data Source	Location
Digital Device Usage and Your Eyes Report	2017 survey PART 1: 9,343 consumers (incl 1,282 CL wearers) PART 2: 18,099 consumers (incl 6,891 CL wearers)	Australia, France, Germany, Japan, Spain, UK, and U.S.¹ Germany, Italy, Japan, Spain, UK, and U.S.²
1 Day Silicone Hydrogel Contact Lens Report: Does professional practice align with consumer expectations?	2018 survey - 1,520 CL wearers 2017 survey - 458 ECPs	Japan, UK, U.S.³ Japan, UK, U.S.^4,5
Reduce New Wearer Dropout: How can eye care professionals help reduce dropout rates among new contact lens wearers?	2018 survey - 1,013 consumers	Germany and U.S.⁶
From Replacement Contact Lenses to 1 Day Lenses: Moving frequent replacement contact lens wearers to 1 day lenses?	2019 survey - 2,000 CL wearers 2018 survey - 450 ECPs	Germany, Italy, Spain, and U.S.⁷ France, Germany, Italy, Spain, and U.S.⁸
Beyond Vision Correction: The real impact of contact lens wear on patients	2019 survey - 5,347 CL wearers	Germany, Japan, Spain, UK, and U.S.⁹
Dual Wearer Report: The importance of giving patients flexibility in their choice of vision correction	2020 survey 8,203 consumers: 4,139 glasses only wearers 4,064 dual wearers (glasses and CLs)	Australia, Canada, Great Britain, Italy, Japan, Sweden, the Netherlands, and U.S.¹⁰

Table 1: Six individual reports from CooperVision’s Consumer Insights series, 2017-2020 [https://coopervision.com/practitioner/practice-building/consumer-insights]

A holistic review of these data has revealed common threads despite the different topics, and these threads point to communication gaps in key areas. This summary report identifies these gaps and explains how ECPs can enhance the overall patient experience and elevate the level of patient trust by making small modifications in their approach to patient care. One simple word —AIR— can serve as a reminder of the three helpful techniques:

A SK patients about the concerns they
have with their eyes

I NFORM patients about all the options
for vision correction

The evidence that supports adopting these three communication techniques is described below, together with some practical tips. Employing these techniques will help the ECP to better meet patients’ expectations and can help build a stronger practice through higher rates of patient satisfaction, retention, and referrals.

TECHNIQUE #1

Ask about
problems or concerns

It makes sense that if patients don’t know a solution exists, then they can’t ask for it. Following are two examples of gaps in communication related to patient concerns that were evident in several of the Consumer Insights reports.

EXAMPLE 1: Data from the digital device use surveys in 2017 revealed that across the globe there was strong interest among contact lens wearers in exploring solutions to reduce device-related eye tiredness and to understand more about the effects of digital device use on their eyes.¹ With the COVID-19 pandemic, digital device use expanded across all age groups as education, work, and social activities became increasingly screen-based. Given that digital device usage has been associated with

dry eye disease (DED) and risk of gradual ocular health deterioration,^11,12 the sharp increase in digital device use during the pandemic, often with extended screen times, was accompanied by more patients experiencing symptoms.¹¹

However, despite patients reporting they had questions and interest in discussing their digital device concerns, it was uncommon for patients or ECPs to raise this topic during eye examinations.¹ Proactive discussions can open opportunities to offer solutions, such as recommending a contact lens specifically designed for digital device use or discussing strategies to manage symptoms associated with digital eye fatigue.

of contact lens wearers had
concerns and questions about digital device use

of contact lens wearers actively
look for information on how to keep their eyes
healthy with digital device use

of contact lens wearers were interested in discussing with their ECP ways to reduce their eye tiredness

BUT only

of surveyed contact
lens wearers reported discussing their concerns
about their screen time and digital device use
with their ECP

EXAMPLE 2: In 2018, more than 1,000 patients new to contact lenses (wearing contact lenses for 2-12 months) were surveyed about their problem areas to understand reasons for new contact lens wearer dropouts. Difficulties with lens handling during application/removal and discomfort while wearing were cited as major obstacles.⁶ While ECPs may be more diligent in asking their new contact lens wearers about problems during the patient’s first few post-fit follow-ups, the survey results encourage ECPs to tailor their inquiries to the patient’s lifestyle and

needs, and to proactively address issues, to help reduce contact lens dropouts within the first year. This problem-solving approach is soundly based on the results of a multi-site UK study published in 2016 that showed almost half of those who drop out from contact lens use in the first year do so within 60 days of wear.¹³ Fortunately, lens-handling problems and other issues can be identified early with targeted questioning, and corrective actions can be taken, such as retraining.⁶

experienced difficulty
handling the contact lens

were uncomfortable putting
the contact lenses on and/or taking them off

experienced discomfort
while wearing the contact lenses

Key Points

ASK about problems or concerns

ECPs can better meet their patients’ needs by routinely asking about their concerns or problems, especially when the patient’s vision correction modality doesn’t meet their needs.

Look for opportunities to ask about digital device fatigue, any limitations experienced when wearing glasses, and contact lens handling and comfort.

Asking further questions about lifestyle and activities can uncover opportunities to make better recommendations.

Advising patients with an ‘I’m here to help’ approach will reinforce the role of ECPs as a trusted source of information.

TECHNIQUE #2

Inform about
contact lens options

If a patient doesn’t ask about contact lenses, should the ECP introduce the topic? How best would the conversation proceed? A survey of over 4,000 respondents who only wear glasses provided a strong reminder that there are still patients who believe that contact lenses are not suitable for them — essentially because their ECP had not recommended them as an option.¹⁰

Some patients also were not aware that their prescription could be applied to contact lenses.¹⁰ This gap in communication could be holding back many potential new contact lens wearers, even though among glasses only wearers surveyed across eight countries, many reported they did not enjoy wearing glasses.¹⁰

Nearly

reported they ‘did not enjoy
anything about glasses’

were unaware that
contact lenses were available for
their prescription

said they don’t wear
contact lenses because their ECP had
never recommended them

While the ECP can offer an overview of contact lens advantages, additionally sharing with the patient how contact lens wearers have personally described the benefits, including some of the deeper, emotional gains, can influence patient perceptions. Responses from over 9,000 contact lens wearers across two surveys, spanning four continents, showcased both the practical and emotional benefits that contact lens wearers appreciated.^9,10 ECPs can use these insights to better describe these benefits to spectacle wearers when they discuss contact lens opportunities.

Citing the phrases used by existing contact lens wearers^9,10 can help the ECP better convey to non-contact lens wearers those benefits that may be hard to imagine, particularly intangible benefits like boosting self-confidence. Relating contact lens benefits to an individual patient’s lifestyle will help the ECP to personalize their recommendation as it applies to, for example, sports, sunglasses, or the patient’s social activities. Better still, a lens on eye experience as a ‘trial,’ even briefly as a practical aid when selecting spectacle frames, will allow patients to directly appreciate a snapshot of contact lens benefits.¹⁴

agreed that with contact lenses,
‘I think I look
natural’

More than

of contact lens wearers agreed contact lenses made them feel more confident

Around 8 in 10 adults among all respondents, regardless of age, agreed they could see better in contact lenses than with spectacles

started
contact lens wear because spectacles were inconvenient (e.g., for exercise, dancing, vacation)

Nearly 90%
agreed that contact lenses have improved their
quality of life

appreciated that contact
lenses don’t get dirty or
foggy like glasses

reported contact
lenses as more
convenient than glasses

It is estimated that around 1 in 4 people (27%) in the U.S. who require vision correction are ‘dual wearers’ — those who use both glasses and contact lenses.¹⁵ New contact lens wearers said that with contact lenses, they can see clearly during activities where they wouldn’t be able to wear glasses.⁶ Given that a majority of contact

lens wearers reported an improvement in confidence and freedom compared to when they wear glasses,^6,10 ECPs should consider recommending contact lenses even to those patients who clearly love their glasses, potentially enabling these patients to enjoy the benefits that both vision correction modalities offer.

81% of dual wearers felt that having the option of both forms of vision correction gives them the ‘best of both worlds’¹⁶

Over half (51%) of dual wearers wore their contact lenses more than 8 hours/day

About 4 in 10 new contact lens wearers appreciated that with contact lenses, they can see clearly for activities in which they can’t wear glasses (e.g., getting a haircut, putting on makeup), as well as the ability to participate in sports or physical activities without worrying about their glasses

Among dual wearers,

wore reusable contact lenses, and nearly

wore daily disposables

When dual wearers go out in public,

preferred glasses

had no preference

preferred
contact lenses

Key Points

INFORM about contact lens options

Nearly 4 in 10 spectacle wearers ‘do not enjoy anything about spectacles.’

ECPs can enhance their patients’ choices and enjoyment of their vision correction by proactively explaining the practical and emotional benefits that contact lenses offer.

Providing a ‘lens on eye’ experience will demonstrate intangible contact lens benefits.¹⁴

Individualize your contact lens explanations (e.g., contact lenses offer the freedom that physically active patients appreciate; activity-based occasional contact lens wear is feasible).

Many patients enjoy maximum benefits from being ‘dual wearers,’ even when they love their glasses!

TECHNIQUE #3

Recommend the most suitable
option for the patient, regardless of cost

When considering their choices, do patients welcome a recommendation? Survey responses from thousands of contact lens wearers uncovered a strong desire to receive a recommendation from their ECP regarding the most suitable contact lens option for them, regardless of the cost.^2,3

Nearly

contact lens wearers were willing to pay a premium for a contact lens that reduces symptoms of digital eye fatigue

of contact lens wearers expected their ECP to recommend contact lenses that provide 100% of the oxygen their eyes need, regardless of cost

of contact lens wearers were likely to follow the advice of their ECP, regardless of cost

These attitudes confirm that patients expect and value guidance from their ECP. They expect to have healthy options explained to them and most would be likely to follow their ECP’s advice, regardless of cost.³

ECP beliefs about healthy contact lens wear options were identified in three different surveys.^4,5,8 Responses from this combined total

of 908 ECPs regarding healthy contact lens wear options indicated an overwhelming preference for silicone hydrogel materials, with a clear majority reporting it as their first choice for the daily disposable modality.^5,17 In addition, ECPs reported an increase in the number of patients they were moving from frequent replacement (FRP) contact lenses to 1 day lenses.⁸

However, these ECP attitudes did not align with ECP prescribing practices:

of 1 day
lenses are being prescribed in silicone
hydrogel materials¹⁹

of new
contact lens fits are with 1 day lenses¹⁹

patients who
moved from FRP silicone hydrogel
materials were fitted with 1 day
hydrogel materials²⁰

Key Points

Always RECOMMEND the most suitable contact lens option

ECPs can meet their patients’ expectations by remaining informed and up to date about healthy contact lens options.

Avoid pre-judging what patients are prepared to pay for their contact lens choice.

Proactively recommend the most suitable, healthy contact lens option for each patient, regardless of cost, such as silicone hydrogel, 1 day lenses, and digital device lens designs.

Adopting new techniques to
change the conversation…

The combined data set discussed in these six Consumer Insights series reports, based on substantial cohorts of more than 45,000 patients and more than 900 ECPs surveyed across a range of eye care topics, highlighted communication gaps in eye care examination rooms around the world. To close these gaps, responsibility for initiating individualized conversations rests largely with the ECP, reinforcing their role as an expert guide and eye health advocate.

Patients are not necessarily informed about the latest advances in eye care that present new opportunities for them, such as new contact lens materials, lenses for digital device use, expanded prescription ranges, multifocal lenses, 1 day lenses, and occasional wear options.

They trust that their ECP will remain up to date on the latest information and will recommend the most appropriate options for their lifestyle and ocular health, regardless of cost. Overall, these surveys provided insights showing these proactive, individualized conversations were often absent.

Understanding patient expectations is a critical factor in building a successful business, and this summary report emphasizes that patient expectations are clear and straightforward: they want more AIR in discussions with their ECP:

A SK me about the concerns I have
with my eyes

I NFORM me about all the options for vision correction

By applying the AIR communication techniques described, ECPs can be better able to help meet the needs and expectations of their patients, as they continue building a more successful practice.

References

CooperVision data on file. YouGov Plc online consumer survey conducted August 2017 in Australia, France, Germany, Japan, Spain, UK, and US. Total sample size was 9,343 adults, of which 1,282 wear contact lenses. The figures have been weighted and are representative of all adults (aged 18+) from each country.
CooperVision data on file. YouGov Plc online consumer survey conducted October 2017 in Germany, Italy, Japan, Spain, UK, and US. Total sample size was 18,099 adults (6,891 contact lens wearers). The figures have been weighted and are representative of all adults (aged 18+) from each country.
CooperVision data on file. YouGov Plc online consumer survey: Silicone hydrogel lenses. Survey conducted in March/April 2018 in US, UK, and Japan. Total sample size was 1,520 adults who wear contact lenses.
CooperVision data on file. Cello Health Insight online survey for ECPs: Barriers to 1 day silicone hydrogel research. Survey conducted in July 2017 in US, UK, and Japan. Total sample size n=158 (US n=61, UK n=47, Japan n=50).
CooperVision data on file. Cello Health Insight online survey conducted in November 2017 in US, UK, and Japan. Total sample size n=300 (100 ECPs in each country).
CooperVision data on file. YouGov Plc online consumer survey. Survey conducted in October/November 2018 in Germany and US. Total sample size was 1,013 adults (502 in Germany, 511 in US) who had been wearing contact lenses for between 2 and 12 months.
CooperVision data on file. Basis consumer survey, 2019. 500 consumers in each of Germany, Italy, Spain, and the US (n=2,000) who had switched from FRP to DD in the last 6 months, or who were open to using DD in future.
CooperVision data on file. Basis online consumer survey: Migration from FRP to DD. Surveys conducted in Q1 2019 in France, Germany, Italy, Spain, and the US. 75 eye care professionals (ECPs) in each European country, with French sample weighted to 75; 150 ECPs in the US.
CooperVision data on file. YouGov Plc online consumer survey conducted in November/December 2019 in Germany, UK, Spain, Japan, USA. Total sample was 5,347 contact lens wearers (“consumers”), screened from total of 35,397 adults. Data weighted and representative of adults in each market (aged 18+).
CooperVision data on file. YouGov online survey conducted in October 2020 in Australia, Canada, Great Britain, Italy, Japan, Sweden, the Netherlands, and US. Total sample size was 8,203 adults aged 18+ who either wear glasses only (n=4,139) or wear both glasses and contact lenses (n=4,064).
Bahkir FA, Grandee SS. Impact of the COVID-19 lockdown on digital device-related ocular health. Indian J Ophthalmol. 2020;68:2378-2383.
Wolffsohn J. Dry eye, blinking and digital device use. Contact Lens Update. Issue 62 online: November 12, 2021.
Sulley A, Young G, Hunt C. Factors in the success of new contact lens wearers. Cont Lens Anterior Eye. 2017;40:15-24.
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. Cont Lens Anterior Eye. 2009;32:103-107.
CooperVision data on file. Industry and market data, US consumer contact lens market in 2018.
Draper M, Patel K, Russell N. Mixed-methods study of behaviours and attitudes to vision correction of spectacle and contact lens wearers. Cont Lens Anterior Eye. 2019;42:e23.
Orsborn G, Dumbleton K. Eye care professionals’ perceptions of the benefits of daily disposable silicone hydrogel contact lenses. Cont Lens Anterior Eye. 2019;42:373-379.
CooperVision data on file. Kubic LLC survey conducted in August 2018 in US. Sample of 183 US optometrists who wore 1 day contact lenses.
Morgan PB, Woods C, Tranoudis IG, et al. International contact lens prescribing in 2022. Cont Lens Spectrum. 2023;38:28-35.
CooperVision data on file and industry reports. 2018.