Article

International Contact Lens Prescribing in 2014

Our 14th annual report in CLS provides information about 25,000 fits in 32 markets.

INTERNATIONAL PRESCRIBING

International Contact Lens Prescribing in 2014

Our 14th annual report in CLS provides information about 25,000 fits in 32 markets.

By Philip B. Morgan, PhD, MCOptom, FAAO, FBCLA; Craig A. Woods, PhD, MCOptom, DipCLP, FAAO; Ioannis G. Tranoudis, DO, MSc, PhD, FIACLE, FBCLA; Magne Helland, BSc, MScOptom, FIACLE; Nathan Efron, PhD, DSc, FAAO (DipCCLRT); Lyndon Jones, PhD, FCOptom, DipCLP, DipOrth, FAAO, FIACLE, FBCLA; Edgar Dávila-Garcia, OD, FIACLE, NCLE-AC; Patricia Magnelli, FIACLE; Ing. Mario Teufl, BSc, MSc; Christina N. Grupcheva, MD, PhD, FEBO, FICO (Hon), FBCLA; Deborah Jones, BSc, FCOptom, DipCLP, FAAO; Marion Beeler-Kaupke, Dip Ing; Kah-Ooi Tan, BOptom (Hons), PhD, MBA; Alice Pesinova, BSc; Heiko Pult, MSc, PhD, FAAO, FBCLA, FEAO; Ole Ravn, MScOptom; Jacinto Santodomingo, OD(EC), MSc, PhD, MCOptom, FBCLA, FAAO; Florence Malet, MD; Athina Plakitsi, PhD; Mihály Végh, MD, PhD; Nir Erdinest, BOptom, PhD; Prema K. Chande, MOptom, DBM, FIACLE; Motozumi Itoi, MD, PhD; Jolanta Bendoriene, MD, PhD; Eef van der Worp, BSc, PhD, FAAO, FIACLE, FBCLA; Ricardo Pintor, LOpt, FIACLE; Jose L. Moroy, OD; JhoYan Chia, BOptom, MHSc; Suresh Awasthi, BOptom, MPhil(Optom); Wanda Lam, OD, BSc; Jeanette Romualdez-Oo, OD, FPCO, FAAO, FIACLE; Carmen Abesamis-Dichoso, OD, MAT, FIACLE, FPCO, FAAO; José Manuel González-Méijome, OD, PhD, FIACLE; Vadim Belousov; Peter Gierow, PhD, FAAO; Mirna Stabuc Silih, MD, PhD; John Hsiao, BA, OD, FIACLE; & Jason J. Nichols, OD, MPH, PhD, FAAO

Since the late 1990s, the International Contact Lens Prescribing Survey Consortium has prospectively gathered information about 285,000 contact lens fits from more than 50 countries. This article presents our 14th annual summary of current trends published in Contact Lens Spectrum.

With only minor differences in the distribution of our surveys among markets, we have continued to adopt the same approach throughout the past 18 years. Through national coordinators, we approach contact lens prescribers in each country and ask them to record information about the first 10 patients whom they fit with contact lenses after receipt of our survey form. The information collected is generic, and respondents are weighted to reflect the volume of contact lens fits undertaken by each. For this 2014 report, we present information about 25,179 contact lens fits from 32 countries.

Lens Wearer Demographics

Table 1 shows that 69% of contact lenses were prescribed to females in 2014, a value that has remained remarkably constant since the inception of this project in 1996. In fact, females account for the majority of contact lens fits in all countries assessed except for Spain.

Table 1. Demographic information for the 32 countries surveyed.
Country Total fits Mean (±SD) age % female % new fits % part time (≤3 days)
Argentina (AR) 170 38.6 ± 17.2 59% 49% 5%
Austria (AT) 350 35.3 ± 14.5 64% 25% 1%
Australia (AU) 489 37.4 ± 16.2 65% 42% 22%
Bulgaria (BG) 620 28.4 ± 9.3 74% 56% 4%
Canada (CA) 723 34.7 ± 15.9 67% 36% 14%
Switzerland (CH) 245 37.8 ± 14.4 61% 31% 10%
China (CN) 610 27.4 ± 6.0 80% 19% 8%
Czech Republic (CZ) 323 30.1 ± 14.3 67% 54% 23%
Germany (DE) 296 39.5 ± 16.2 68% 20% 7%
Denmark (DK) 384 38.1 ± 15.8 63% 35% 2%
Spain (ES) 569 33.0 ± 13.8 48% 55% 11%
France (FR) 1140 36.2 ± 15.8 69% 43% 6%
Greece (GR) 345 32.9 ± 11.6 57% 33% 15%
Hungary (HU) 228 29.3 ± 12.7 65% 50% 13%
Israel (IL) 779 29.0 ± 11.1 62% 30% 6%
India (IN) 150 28.8 ± 8.4 68% 63% 13%
Japan (JP) 4071 31.0 ± 14.6 68% 40% 15%
Lithuania (LT) 424 28.6 ± 10.7 69% 18% 16%
Mexico (MX) 684 28.6 ± 10.9 63% 41% 4%
Malaysia (MY) 686 29.8 ± 10.7 77% 28% 8%
Netherlands (NL) 969 36.2 ± 16.3 65% 30% 4%
Norway (NO) 643 37.0 ± 15.8 60% 32% 6%
Nepal (NP) 179 24.7 ± 9.3 58% 99% 0%
New Zealand (NZ) 677 38.6 ± 36.3 64% 36% 13%
Philippines (PH) 5205 27.5 ± 9.1 78% 28% 3%
Portugal (PT) 226 31.3 ± 12.5 69% 56% 8%
Russia (RU) 643 26.9 ± 10.4 54% 37% 4%
Sweden (SE) 506 38.1 ± 15.2 67% 29% 12%
Slovenia (SI) 130 33.7 ± 15.1 60% 44% 3%
Taiwan (TW) 1049 26.9 ± 10.9 82% 8% 0%
United Kingdom (UK) 852 39.1 ± 16.8 66% 45% 21%
United States (US) 814 36.9 ± 16.2 64% 25% 5%
Overall 25179 31.7 ± 14.8 69% 32% 7%

We are seeing more variation in age at fitting. The world average is close to 32 years, but it tends to be younger in some of the Asian markets (for example, 24.7 years in Nepal and 27.4 years in China) and is much older in Europe (39.1 years in the United Kingdom and 39.5 years in Germany).

Most fits are to existing wearers (i.e., “refits”) with new fits accounting for only 32% of lens wearers. Although some markets have modest proportions of part-time lens wearers (i.e., three days per week or less), including the Czech Republic, Australia, and the United Kingdom with 21% to 23% of wearers, overall contact lens fits are dominated by full-time wearers, with 93% of fits to patients scheduled to use contact lenses at least four times per week.

GP Lenses

Standard GP contact lenses account for 20% or more of lens fits in five countries studied: Argentina, Austria, France, the Netherlands, and Slovenia; the overall global average is 7% (Table 2). The data for the Netherlands are further supplemented by a remarkable 10% of all contact lens wearers who are prescribed orthokeratology lenses. No other market reaches more than 3% of all fits for this lens modality. Orthokeratology has a long history of strong use in the Netherlands, where the majority of practices are trained to undertake it. The popularity may result from a high level of education in this area combined with high-quality local manufacturers.

Table 2. Breakdown of all lens fits into seven key categories of lenses. See Table 1 for country abbreviations.
Country Rigid (non OK) OK DD hydrogel DD SH Other DW hydrogel Other DW SH Soft EW
AR 26% 0% 1% 0% 34% 32% 6%
AT 38% 2% 5% 3% 16% 36% 0%
AU 6% 2% 15% 24% 7% 43% 5%
BG 9% 0% 3% 4% 6% 71% 8%
CA 10% 0% 13% 15% 10% 49% 2%
CH 16% 1% 12% 4% 41% 24% 1%
CN 4% 0% 19% 6% 47% 19% 5%
CZ 0% 0% 10% 19% 7% 57% 8%
DE 15% 2% 6% 9% 13% 52% 2%
DK 4% 0% 40% 11% 13% 23% 9%
ES 7% 3% 12% 1% 57% 18% 1%
FR 20% 2% 6% 10% 5% 57% 1%
GR 6% 0% 9% 3% 21% 55% 6%
HU 14% 0% 15% 12% 12% 40% 6%
IL 4% 0% 27% 11% 25% 28% 5%
IN 6% 0% 12% 2% 28% 50% 3%
JP 18% 0% 30% 10% 18% 23% 0%
LT 0% 0% 16% 6% 7% 46% 25%
MX 3% 0% 9% 0% 12% 74% 2%
MY 4% 2% 11% 6% 33% 25% 19%
NL 20% 10% 4% 5% 10% 49% 1%
NO 5% 1% 23% 17% 9% 20% 25%
NP 1% 0% 0% 0% 93% 0% 6%
NZ 19% 1% 14% 15% 9% 38% 3%
PH 1% 0% 2% 1% 54% 31% 12%
PT 3% 0% 12% 10% 15% 59% 1%
RU 2% 1% 11% 9% 18% 51% 9%
SE 2% 1% 22% 11% 5% 43% 15%
SI 44% 0% 3% 4% 5% 43% 0%
TW 2% 3% 50% 1% 42% 3% 0%
UK 5% 0% 17% 23% 6% 45% 4%
US 9% 0% 9% 15% 13% 49% 5%
Overall 7% 1% 12% 6% 31% 35% 7%

We noted 196 scleral lenses prescribed across the survey in 2014. This represents an increase of 15% since 2013, although scleral lenses still account for less than 0.1% of all contact lens fits reported.

High-Dk materials are the most commonly prescribed for standard GP contact lenses (Table 3). Spherical lenses are the most widely fitted GP lens design, with torics, multifocals/monovision, and orthokeratology lenses each representing about 13 percent of GP fits. About half of all GP lenses are prescribed on a planned replacement schedule.

Table 3. Detailed information for all prescribed GP lenses only. See Table 1 for country abbreviations. Data presented for countries reporting > 35 GP lens fits. EW = extended wear.
  AR AT AU BG CH CN DE ES FR IL JP MY NL NO NZ PH SI UK US Overall
Materials Rigid lenses for new fits 13% 37% 3% 6% 14% 4% 29% 8% 29% 6% 9% 8% 28% 11% 16% 1% 38% 3% 13% 9%
Rigid lenses for refits 39% 41% 10% 14% 19% 4% 15% 15% 20% 4% 24% 6% 31% 6% 23% 1% 49% 8% 8% 9%
Low Dk (<40) 22% 30% 0% 0% 3% 10% 3% 33% 2% 3% 9% 16% 6% 0% 0% 21% 1% 8% 12% 10%
Mid Dk (40-90) 78% 55% 27% 48% 38% 7% 67% 8% 9% 17% 29% 24% 36% 34% 14% 63% 20% 53% 66% 33%
High Dk (>90) 0% 14% 73% 52% 58% 83% 30% 59% 89% 80% 61% 60% 58% 66% 85% 16% 79% 39% 22% 58%
Design Sphere 64% 45% 47% 88% 19% 2% 38% 35% 36% 56% 84% 29% 23% 39% 41% 48% 34% 46% 50% 48%
Toric 14% 19% 6% 9% 44% 6% 26% 12% 14% 23% 2% 16% 22% 21% 13% 9% 59% 11% 4% 14%
Multifocal / monovision 22% 16% 0% 2% 11% 2% 14% 8% 26% 6% 10% 3% 14% 2% 7% 3% 7% 32% 15% 13%
Ortho-k 0% 4% 29% 0% 5% 2% 10% 30% 10% 6% 1% 37% 34% 20% 7% 26% 0% 3% 1% 13%
Anti-myopia 0% 8% 0% 0% 3% 1% 7% 1% 14% 6% 0% 7% 2% 0% 4% 1% 0% 0% 1% 4%
Other 0% 9% 18% 0% 18% 88% 5% 14% 0% 3% 4% 9% 5% 17% 27% 13% 0% 8% 28% 9%
Planned replacement 52% 23% 29% 99% 64% 100% 67% 49% 76% 58% 11% 72% 54% 78% 36% 83% 100% 31% 24% 48%
New fits into EW 0% 0% 30% 0% 22% 2% 15% 29% 11% 21% 0% 44% 26% 7% 3% 3% 0% 16% 1% 13%
Refits into EW 0% 0% 4% 0% 5% 1% 0% 5% 0% 0% 0% 4% 0% 9% 0% 33% 9% 8% 10% 0%

Soft Lenses

Soft lenses account for 91% of contact lens fits (Table 4). Silicone hydrogels are the most widely used material of the four soft lens categories studied (49%), although a review of recent years suggests that the rapid increase of silicone hydrogel lens use observed since the start of the century has now reached a plateau. The use of silicone hydrogels varies considerably around the world, from more than 80% of soft lens materials in Bulgaria and France to less than 10% in Taiwan and Nepal (Figure 1).

Table 4. Detailed information for all prescribed soft lenses for markets reporting >100 soft lens fits. See Table 1 for country abbreviations. The final row indicates the proportion of multifocal and monovision lenses prescribed when patients were over 45 years of age.
  AR AT AU BG CA CH CN CZ DE DK ES FR GR HU IL IN JP LT MX MY NL NO NP NZ PH PT RU SE TW UK US Overall
Materials Soft lenses for new fits 87% 63% 97% 94% 91% 86% 96% 100% 71% 96% 92% 71% 94% 88% 94% 96% 91% 100% 98% 92% 72% 89% 98% 84% 99% 98% 97% 94% 56% 97% 87% 91%
Soft lenses for refits 61% 59% 90% 86% 90% 81% 96% 100% 85% 95% 85% 80% 91% 85% 96% 90% 76% 100% 96% 94% 69% 94% 92% 77% 99% 96% 97% 97% 99% 92% 92% 91%
Low water content (<40%) 12% 1% 1% 0% 6% 0% 27% 2% 1% 1% 13% 3% 2% 2% 4% 0% 9% 5% 1% 10% 3% 1% 0% 3% 3% 1% 8% 2% 45% 2% 5% 7%
Mid water content (40-60%) 40% 24% 13% 8% 10% 48% 43% 6% 12% 29% 54% 6% 25% 28% 40% 40% 38% 6% 16% 43% 8% 26% 100% 17% 36% 14% 18% 20% 47% 15% 12% 29%
High water content (>60%) 0% 10% 9% 3% 10% 17% 7% 9% 12% 31% 11% 5% 6% 5% 14% 5% 12% 19% 4% 6% 10% 18% 0% 10% 25% 13% 6% 11% 3% 8% 9% 15%
Silicone hydrogel 48% 65% 76% 89% 73% 34% 23% 83% 75% 39% 22% 86% 67% 65% 43% 55% 41% 70% 78% 42% 79% 55% 0% 69% 36% 72% 68% 67% 4% 75% 74% 49%
Design Sphere 33% 21% 53% 72% 43% 31% 65% 50% 46% 39% 51% 38% 57% 64% 53% 50% 79% 76% 39% 45% 42% 51% 85% 46% 73% 44% 76% 37% 34% 38% 48% 61%
Toric 44% 27% 34% 18% 30% 33% 6% 34% 35% 30% 36% 27% 26% 20% 33% 31% 13% 9% 53% 25% 36% 27% 3% 34% 13% 40% 18% 36% 3% 34% 29% 20%
Cosmetic tint 3% 0% 0% 2% 1% 0% 15% 2% 0% 0% 0% 1% 4% 5% 7% 9% 4% 9% 4% 15% 0% 0% 11% 0% 10% 2% 2% 0% 62% 0% 1% 8%
Multifocal / monovision 19% 47% 14% 6% 25% 31% 5% 14% 20% 31% 13% 34% 11% 11% 6% 9% 4% 6% 3% 13% 22% 21% 0% 19% 4% 14% 4% 26% 0% 28% 22% 11%
Anti-myopia 1% 5% 0% 2% 0% 5% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 2% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%
Other 1% 0% 0% 0% 0% 0% 10% 0% 0% 0% 0% 0% 1% 0% 0% 0% 0% 0% 0% 0% 0% 0% 1% 0% 0% 0% 1% 0% 0% 0% 0% 1%
Replacement Daily 2% 13% 44% 8% 32% 20% 27% 31% 19% 59% 15% 20% 14% 35% 43% 15% 49% 29% 10% 24% 13% 59% 0% 39% 3% 23% 22% 41% 53% 44% 28% 22%
1-2 weekly 9% 5% 14% 4% 12% 6% 4% 14% 16% 6% 1% 21% 20% 8% 19% 18% 47% 3% 9% 4% 12% 4% 0% 10% 1% 2% 28% 7% 10% 6% 24% 11%
Monthly 34% 59% 40% 83% 54% 31% 45% 52% 53% 32% 76% 58% 61% 56% 35% 57% 2% 67% 78% 61% 65% 36% 0% 46% 52% 75% 41% 52% 35% 49% 47% 47%
3-6 monthly 11% 10% 0% 4% 0% 40% 13% 0% 3% 3% 5% 1% 3% 0% 2% 0% 0% 1% 0% 8% 10% 1% 0% 3% 12% 0% 7% 0% 0% 0% 1% 7%
Annually 43% 4% 0% 1% 0% 2% 12% 3% 5% 0% 3% 1% 0% 2% 1% 10% 0% 0% 3% 2% 1% 0% 100% 2% 32% 0% 1% 0% 2% 0% 0% 13%
Unplanned 1% 7% 2% 0% 1% 0% 0% 0% 5% 0% 0% 0% 1% 0% 0% 0% 2% 0% 0% 0% 0% 0% 0% 1% 0% 0% 0% 0% 0% 0% 0% 1%
New fits into EW 5% 0% 2% 7% 1% 3% 2% 9% 0% 10% 1% 1% 8% 2% 1% 2% 0% 20% 1% 18% 0% 28% 7% 5% 15% 3% 10% 1% 0% 2% 2% 8%
Refits into EW 13% 5% 8% 12% 4% 1% 5% 5% 3% 9% 0% 1% 6% 11% 5% 6% 0% 27% 3% 15% 2% 27% 0% 3% 10% 0% 9% 15% 0% 5% 7% 8%
EW with silicone hydrogels 72% 100% 98% 99% 100% 100% 43% 100% 100% 91% 54% 98% 91% 100% 51% 50% 0% 90% 100% 86% 100% 95% 0% 100% 52% 100% 98% 96% 100% 96% 100% 68%
MPS solutions 81% 54% 95% 94% 68% 35% 96% 86% 65% 89% 93% 87% 96% 99% 93% 100% 83% 81% 100% 89% 96% 94% 100% 85% 91% 91% 98% 96% 70% 97% 81% 89%
Presbyopes multi / mono 25%/30% 81%/2% 25%/11% 64%/0% 53%/15% 62%/18% 0%/0% 46%/7% 42%/3% 51%/17% 49%/7% 76%/2% 68%/3% 52%/4% 45%/3% 61%/19% 24%/1% 61%/0% 54%/3% 62%/8% 47%/1% 49%23% 0%/0% 28%/18% 31%5% 72%/0% 33%/0% 37%/11% 3%/0% 45%/21% 34%/16% 45%/9%

Figure 1. Soft lens fitting by material (H = hydrogel, SH = silicone hydrogel) and modality of wear (DW = daily wear, EW = extended wear). See Table 1 for country abbreviations.

Toric lenses account for 20% of all soft lens fits, with this number increasing to about 25% if monovision, multifocal, and cosmetic tinted lenses are excluded from this analysis (Figure 2) (i.e., we assess the proportion of toric lens fits to the overall number of torics and spheres). This value falls short of the expected 35% of fits if all patients who have 1.00DC of astigmatism or greater are prescribed toric contact lenses, or around 45% if those who have 0.75DC are included. Again, we see great variation in this metric around the world, with torics reaching 50% or greater of combined sphere/toric lenses in Austria, Argentina, Switzerland, and Mexico and fewer than 10% of fits in Lithuania, Taiwan, and Nepal.

Figure 2. Toric contact lens fitting as a proportion of spherical and toric contact lenses prescribed. See Table 1 for country abbreviations.

Figure 3 outlines the increase in soft toric lens prescribing in seven major markets since 2000. For most markets, there has been an approximate doubling in the proportion of toric lenses prescribed, presumably reflecting better soft toric performance and increasing practitioner confidence; the exception here is Japan, where toric prescribing has remained historically low.

Figure 3. Proportion of toric lenses prescribed (of spheres and torics) in seven major markets.

Daily disposable lenses accounted for 22% of soft lens fits in 2014, although this proportion tended to be much higher in northern Europe, Japan, Taiwan, and Australia. Despite the relatively recent introduction of daily disposables manufactured from silicone hydrogel materials, there has been quick uptake of such lenses. We noted 11 countries in which most of the daily disposables prescribed were silicone hydrogels; in five markets (Austria, Czech Republic, France, Slovenia, and the United States), more than 60% of daily disposables were in this material category.

Overall, monthly replaced lenses were the most widely prescribed replacement schedule at 47%, with only 1% of soft lenses fitted on an “unplanned” replacement basis. Contact lenses for extended wear remain rarely prescribed (8% of both new fits and refits), usually with silicone hydrogel materials. As in previous years, Norway (28% of new fits into extended wear) and Lithuania (20%) are significant outliers from the normal practice for this modality. CLS

Funding and/or assistance was provided for the following markets: Argentina, Bulgaria, Czech Republic, Greece, Israel, Hungary, Mexico, Slovenia, and Switzerland—Johnson & Johnson Vision Care; Australia—Optometrists Association Australia; Norway—the Norwegian Association of Optometry; Netherlands—Bausch + Lomb; Spain—Spanish General Council of the Colleges of Opticians-Optometrists; Sweden—the Swedish Optometry Association and the Swedish Contact Lens Association; Switzerland—the Swiss Optometry Association.

The authors acknowledge the administrative support of Eurolens Research and the Centre for Contact Lens Research at the University of Waterloo, Canada.

Southeast and East Asia

Data for the Philippines was recorded for the first time in 2014, with a large return of 5,205 contact lens fits; information was also gathered for Malaysia after an absence of some years. Figure 4 shows summary results for these markets alongside other markets in the southeast and east Asia region, with some clear differences apparent. Very few GP or daily disposable lenses are prescribed in the Philippines compared with other regional markets, such as Japan (high GP prescribing) and Taiwan (high daily disposable prescribing). Malaysia shares some similar prescribing trends with the Philippines, including a relatively high rate of extended wear prescribing.

Figure 4. Prescribing in southeast and east Asia. OK = orthokeratology; DD = daily disposable; SH = silicone hydrogel; DW = daily wear; EW = extended wear.

Dr. Morgan is director, Eurolens Research, The University of Manchester, UK.

Dr. Woods is an associate professor, School of Medicine (Optometry), Deakin University, Australia.

Dr. Tranoudis is director, Professional Affairs, Emerging Markets, Europe, Middle East, Africa, & Latin America, Johnson & Johnson Vision Care.

Dr. Helland is a docent/associate professor at the Department of Optometry and Visual Science, Buskerud and Vesthold University College, Kongsberg, Norway.

Dr. Efron is a research professor, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia.

Dr. Lyndon Jones is director, Centre for Contact Lens Research, University of Waterloo, Canada

Dr. Dávila-Garcia is an optometrist in private practice in San Juan, Puerto Rico.

Patricia Magnelli is associated with Morón University, Argentina

Mario Teufl is an optometrist in Kärnten, Austria.

Dr. Grupcheva is a professor, head of the Department of Ophthalmology and Visual Science, and vice rector for Innovations and Translational Research, Medical University-Varna, Bulgaria.

Dr. Deborah Jones is a clinical professor, School of Optometry and Vision Science, University of Waterloo, Canada.

Marion Beeler-Kaupke, Swiss Society of Optometry and Optics.

Dr. Tan is associate program director for the Optometry degree program at Singapore Polytechnic.

Alice Pesinova is associated with the Czech Association of Contactology, Prague.

Dr. Pult is an optometrist in Weinheim, Germany.

Ole Ravn is an optometrist at the Danish College of Optometry and Visual Science, Randers, Denmark.

Dr. Santodomingo is Clinical Affairs Manager and Senior Research Scientist, Menicon Co., Ltd.

Dr. Malet works at PointVision, Bordeaux, France.

Dr. Plakitsi is a lecturer in the Department of Optics and Optometry at the Technological Educational Institute of Athens, Greece.

Dr. Végh is associate professor, Department of Ophthalmology, University of Szeged, Szeged, and professor, School of Optometry, Semmelweis University, Budapest, Hungary.

Dr. Erdinest works at Hadassah Hebrew University Medical Center, Jerusalem.

Dr. Chande works at Lotus College of Optometry, Mumbai, India.

Dr. Itoi is an associate professor, Department of Ophthalmology, Juntendo University, Tokyo.

Dr. Bendoriene works at Siauliai University, Siauliai, Lithuania.

Dr. van der Worp works at Eye Research Institute, Maastricht, the Netherlands.

Ricardo Pintor works for Johnson & Johnson Vision Care, Mexico and Caribbean.

Dr. Moroy is an optometrist in Mexico City.

Dr. Chia works at SEGi University, Malaysia.

Dr. Awasthi works at Geta Eye Hospital, Dhangadhi, Nepal.

Dr. Lam is the course controller for Contact Lenses, Department of Optometry, Auckland University, Auckland, New Zealand.

Drs. Romualdez-Oo and Abesamis-Dichoso practice in Manila, Philippines.

Dr. González-Méijome works at the Clinical and Experimental Optometry Research Laboratory, University of Minho, Portugal.

Vadim Belousov is editor, Journal of Optometry, Moscow.

Dr. Gierow is professor, Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden.

Dr. Silih is an assistant professor, Eye Hospital, University Medical Centre, Ljubljana, Slovenia.

Dr. Hsiao is an associate professor, Department of Optometry, Chung Shan Medical University, Taichung, Taiwan.

Dr. Nichols is an assistant vice president for industry research development and professor at the University of Alabama-Birmingham, as well as the editor-in-chief of Contact Lens Spectrum.