Article

International Contact Lens Prescribing in 2015

Our 15th annual report in CLS provides information about 23,000 fits in 34 markets.

INTERNATIONAL PRESCRIBING

International Contact Lens Prescribing in 2015

Our 15th annual report in CLS provides information about 23,000 fits in 34 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, AC, DSc, FAAO (DipCCLRT); Lyndon Jones, PhD, FCOptom, DipCLP, DipOrth, FAAO, FIACLE, FBCLA; Ing. Mario Teufl, BSc, MSc; Christina N. Grupcheva, MD, PhD, FEBO, FICO (Hon), FBCLA; Rafael S. Lemos; Deborah Jones, BSc, FCOptom, DipCLP, FAAO; Marion Beeler-Kaupke, Dipl Ing (FH) Augenoptik; Polo Qi; Kah-Ooi Tan, BOptom (Hons), PhD, MBA; Jitka Belikova; Heiko Pult, MSc, PhD, FAAO, FBCLA, FEAO; Ole Ravn, MScOptom; Jacinto Santodomingo-Rubido, OD(EC), MSc, PhD, MCOptom, FBCLA, FAAO; Florence Malet, MD; Athina Plakitsi, PhD; Mihály Végh, MD, PhD; Nir Erdinest, BOptom, PhD; Ali Reza Jafari, BSc, MSc; Giancarlo Montani, Dip Optom, FIACLE, FBCLA; Motozumi Itoi, MD, PhD; Byoung Sun, Chu, MOptom, PhD, FAAO, FIACLE; Jolanta Bendoriene, MD, PhD; Eef van der Worp, BSc, PhD, FAAO, FIACLE, FBCLA; Ricardo Pintor, LOpt, FIACLE; Jose L. Monroy, OD; JhoYan Chia, BOptom, MHSc; Suresh Awasthi, BOptom, MPhil(Optom); Wanda Lam, OD, BSc, PGCert ClinEd; Jeanette Romualdez-Oo, OD, FPCO, FAAO, FIACLE; Carmen Abesamis-Dichoso, OD, MAT, FIACLE, FPCO, FAAO; José Manuel González-Méijome, OD, PhD, FIACLE; Peter Gierow, PhD, FAAO; Mirna Stabuc Silih, MD, PhD; John Hsiao, BA, OD, FAAO, FIACLE; & Jason J. Nichols, OD, MPH, PhD, FAAO

We have been collecting data on worldwide contact lens prescribing habits for almost 20 years. Over this time period, we have amassed prospective information about 315,000 contact lens fits in 59 countries. This article marks our 15th report in Contact Lens Spectrum and features a breakdown of more than 23,000 contact lens fits in 34 markets.

As in previous years, our international network of coordinators distributed survey forms to eyecare practitioners in their market who then recorded generic information about the first 10 patients fit with contact lenses after receipt. Information is gathered about patient age and gender; whether the contact lenses are prescribed as a new fit or a refit; contact lens material, design, and replacement frequency; number of intended days per week of use; wearing modality; and care system. Contact lens fits are weighted to reflect the number of fits undertaken by each eyecare practitioner. The study data were entered and processed at the University of Manchester and at the University of Waterloo.

Lens Wearer Demographics

In 2015, 68% of fittings were to females, with an average age of 31.6 years (Figure 1 and Table 1). There is considerable variation among countries for each of these metrics. The proportion of females is around 80% in a number of Asian markets (Korea, China, Taiwan, and the Philippines in particular) and tends to be lower in Europe. Furthermore, the age at fitting is lower (younger than 30) in developing contact lens markets such as the Philippines and Bulgaria, and it is greater (older than 35) in more established markets such as those in North America and Western Europe. Most patients (69%) were classed as refits, and 91% were fitted for “full-time” wear (four days per week or more).

Figure 1. Age and sex for the 34 surveyed markets.

Table 1. Demographic information for the 34 countries surveyed.
Country Total fits Mean (±SD) age % female % new fits % part time (≤3 days)
Austria (AT) 350 37.5 ± 16.1 66% 25% 3%
Australia (AU) 353 36.2 ± 16.5 62% 42% 28%
Bulgaria (BG) 348 26.6 ± 8.3 71% 60% 5%
Brazil (BR) 810 32.7 ± 11.9 67% 26% 4%
Canada (CA) 685 37.1 ± 15.4 68% 28% 17%
Switzerland (CH) 262 36.8 ± 15.9 57% 33% 13%
China (CN) 100 23.8 ± 8.8 79% 40% 11%
Czech Republic (CZ) 480 28.7 ± 12.0 66% 55% 32%
Germany (DE) 174 38.0 ± 15.7 68% 33% 5%
Denmark (DK) 345 38.1 ± 15.1 65% 32% 3%
Spain (ES) 843 33.7 ± 15.9 55% 34% 7%
France (FR) 927 35.1 ± 16.3 69% 43% 5%
Greece (GR) 506 32.1 ± 11.0 58% 28% 5%
Hungary (HU) 169 30.4 ± 13.2 60% 51% 5%
Israel (IL) 754 28.8 ± 11.7 64% 26% 8%
Iran (IR) 593 26.0 ± 5.0 68% 47% 30%
Italy (IT) 590 31.3 ± 12.8 62% 63% 8%
Japan (JP) 4290 30.1 ± 14.6 69% 42% 13%
Korea (KR) 530 25.3 ± 6.6 82% 11% 30%
Lithuania (LT) 428 28.4 ± 11.0 37% 19% 18%
Mexico (MX) 136 30.8 ± 12.9 60% 33% 1%
Malaysia (MY) 474 28.8 ± 9.3 73% 21% 6%
Netherlands (NL) 748 37.2 ± 17.2 64% 36% 3%
Norway (NO) 737 36.8 ± 16.7 59% 28% 6%
Nepal (NP) 127 25.1 ± 10.1 57%
New Zealand (NZ) 645 38.3 ± 17.8 66% 34% 23%
Philippines (PH) 3946 26.4 ± 8.4 78% 29% 3%
Portugal (PT) 164 32.8 ± 13.3 64% 50% 12%
Sweden (SE) 337 39.8 ± 15.6 64% 37% 9%
Slovenia (SI) 120 36.0 ± 17.1 63% 16% 5%
Slovakia (SK) 132 31.6 ± 11.4 70% 56% 25%
Taiwan (TW) 938 36.7 ± 13.7 79% 13% 0%
United Kingdom (UK) 633 37.9 ± 16.4 61% 43% 25%
United States (US) 342 36.6 ± 16.9 63% 29% 6%
Overall 23016 31.6 ± 14.0 68% 31% 9%

GP Lenses

Overall, standard GP lenses accounted for 11% of fits, with an additional 2% of fits for orthokeratology (Table 2). Some European markets (notably Germany, Austria, Switzerland, Slovenia, and the Netherlands) reported much higher volumes of GP fitting. These markets have all reported high levels of rigid lens fitting in the past, probably related to their contact lens educational practices and high-quality local manufacturers offering custom lens designs. Orthokeratology appears to have increased in China, although this is based on a relatively low return rate this year.

Table 2. Breakdown on 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
AT 40% 1% 5% 6% 22% 27% 0%
AU 4% 2% 19% 36% 5% 31% 4%
BG 7% 0% 3% 3% 4% 73% 10%
BR 17% 0% 5% 6% 21% 44% 7%
CA 6% 0% 19% 18% 7% 46% 4%
CH 30% 3% 17% 8% 11% 26% 5%
CN 20% 31% 15% 1% 23% 2% 8%
CZ 1% 0% 15% 21% 9% 46% 8%
DE 57% 1% 2% 2% 13% 25% 0%
DK 10% 0% 33% 10% 9% 29% 9%
ES 13% 2% 6% 4% 46% 28% 1%
FR 17% 6% 8% 12% 8% 49% 0%
GR 6% 0% 13% 12% 17% 52% 0%
HU 14% 2% 2% 11% 16% 55% 1%
IL 4% 0% 28% 13% 24% 30% 1%
IR 6% 0% 1% 2% 44% 24% 22%
IT 7% 5% 15% 35% 10% 26% 1%
JP 16% 0% 30% 12% 16% 25% 0%
KR 2% 0% 36% 4% 33% 18% 6%
LT 0% 0% 10% 14% 4% 46% 26%
MX 8% 0% 0% 0% 30% 53% 9%
MY 7% 0% 11% 10% 34% 28% 11%
NL 26% 7% 5% 4% 13% 42% 2%
NO 6% 0% 24% 12% 7% 32% 19%
NP 2% 0% 0% 0% 98% 0% 0%
NZ 7% 2% 13% 28% 8% 39% 3%
PH 2% 0% 2% 4% 35% 35% 22%
PT 5% 0% 19% 9% 14% 52% 2%
SE 17% 5% 17% 8% 7% 38% 8%
SI 82% 0% 2% 3% 2% 11% 0%
SK 0% 0% 7% 10% 17% 64% 3%
TW 1% 2% 54% 0% 37% 5% 0%
UK 7% 1% 27% 22% 3% 37% 3%
US 12% 0% 5% 8% 10% 58% 7%
Overall 11% 2% 15% 9% 21% 34% 8%

Scleral lenses accounted for approximately 8% of all “rigid” lens fits, with a lower number of PMMA lenses also reported. High-Dk materials continue to be the most commonly prescribed GP lens type, with more than half of lenses prescribed on a planned replacement basis (Table 3).

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.
    AT BR CH CN DE DK ES FR IT JP NL NO NZ PH SI UK US Overall
  Rigid lenses for new fits 48% 16% 32% 51% 65% 19% 26% 35% 12% 9% 29% 10% 12% 5% 39% 6% 3% 16%
  Rigid lenses for refits 40% 17% 33% 44% 55% 8% 11% 17% 14% 22% 32% 5% 2% 5% 0% 16% 13% 14%
Materials Low Dk (<40) 10% 0% 22% 0% 20% 0% 63% 1% 1% 13% 16% 3% 0% 3% 0% 1% 4% 10%
Mid Dk (40-90) 75% 10% 30% 0% 77% 17% 7% 6% 14% 27% 30% 20% 9% 63% 40% 46% 86% 31%
High Dk (>90) 15% 90% 48% 100% 3% 83% 30% 93% 85% 61% 54% 78% 91% 34% 60% 53% 10% 59%
Design Sphere 39% 73% 16% 7% 49% 48% 46% 40% 9% 81% 17% 61% 44% 64% 47% 34% 44% 44%
Toric 19% 0% 39% 0% 30% 29% 2% 10% 7% 2% 20% 13% 22% 30% 49% 21% 4% 13%
Multifocal / monovision 26% 0% 22% 0% 5% 10% 2% 7% 4% 12% 29% 16% 12% 4% 0% 20% 48% 11%
Ortho-k 2% 0% 9% 61% 1% 2% 16% 27% 43% 0% 22% 1% 21% 0% 0% 12% 0% 16%
Anti-myopia 11% 0% 5% 29% 0% 7% 17% 3% 0% 0% 1% 0% 1% 1% 0% 8% 3% 5%
Other 3% 26% 10% 3% 14% 4% 16% 13% 36% 5% 11% 9% 0% 2% 4% 5% 2% 11%
  Planned replacement 57% 98% 56% 100% 19% 90% 34% 77% 9% 13% 44% 87% 35% 99% ## 77% 31% 60%
  New fits into EW 8% 2% 11% 66% 0% 6% 2% 10% 39% 1% 5% 10% 7% 40% 0% 26% 35% 18%
  Refits into EW 1% 0% 19% 71% 5% 2% 0% 0% 0% 0% 7% 35% 0% 0% 0% 0% 0% 0%

Figure 2 shows the proportion of GP lenses fitted since 2000 in seven major markets. Evidently, the number of rigid lenses has remained at around 30% for the Netherlands over this time period. Japan has seen a decrease in the proportion of GP lenses from around 35% in 2003 to fewer than 20% today. The other five markets represented are lower prescribers of GP lenses; scrutiny of these countries suggests a decline in GP lens use between 2000 and 2010, with a modest recovery over the past five years, possibly related to increased interest in orthokeratology and scleral lens fitting.

Figure 2. A historical overview of GP lens prescribing in seven major markets.

Soft Lenses

Soft lenses accounted for 84% of new fits and 87% of refits (Table 4). Silicone hydrogels were the most widely prescribed material at 54% of fits; this figure has remained about the same for the past five years after a very rapid increase in the first decade of this century. These materials are very widely fitted in Eastern Europe and France in particular. Toric lenses accounted for 22% of lens fits. Cosmetically tinted lenses represent 11% of fits overall; these lenses are extremely popular in Taiwan and Korea (61% and 41% of soft lens fits, respectively). Multifocal/monovision lenses accounted for 12% of all soft lens fits and for 56% of soft lenses prescribed to those aged 45 or over. Again, there is considerable regional variation with this modality, with a great majority of presbyopes receiving multifocal or monovision lenses in Bulgaria, Italy, Hungary, Portugal, and France but very few in Taiwan, Israel, Japan, Mexico and Austria (Figure 3).

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.
    AT AU BG BR CA CH CN CZ DE DK ES FR GR HU IL IR IT JP KR LT MX MY NL NO NP NZ PH PT SE SI SK TW UK US Overall
  Soft lenses for new fits 52% 95% 93% 84% 94% 68% 49% 99% 35% 81% 74% 65% 97% 84% 96% 96% 88% 91% 84% 100% 97% 100% 71% 90% 98% 88% 95% 95% 48% 61% 100% 83% 94% 97% 84%
  Soft lenses for refits 60% 94% 94% 83% 95% 67% 56% 99% 45% 92% 89% 83% 92% 75% 96% 92% 86% 78% 99% 100% 88% 91% 68% 95% 98% 77% 98% 95% 86% 10% 100% 99% 91% 84% 87%
Materials Low water content (<40%) 4% 8% 2% 3% 3% 2% 32% 1% 4% 0% 10% 0% 0% 16% 1% 14% 1% 8% 31% 1% 6% 18% 0% 0% 2% 18% 1% 1% 0% 0% 49% 1% 2% 11%
Mid water content (40-60%) 26% 10% 4% 30% 14% 20% 43% 14% 22% 26% 44% 9% 26% 4% 32% 30% 15% 36% 42% 4% 31% 30% 19% 19% 11% 15% 16% 22% 9% 7% 42% 18% 11% 24%
High water content (>60%) 15% 8% 2% 0% 11% 23% 17% 11% 10% 25% 8% 11% 6% 1% 22% 19% 13% 12% 3% 14% 0% 6% 10% 22% 12% 16% 18% 12% 16% 17% 3% 15% 6% 11%
Silicone hydrogel 55% 74% 92% 66% 72% 54% 8% 74% 64% 48% 38% 79% 68% 79% 45% 37% 71% 44% 24% 81% 63% 46% 71% 59% 76% 51% 65% 65% 75% 76% 5% 66% 81% 54%
Design Sphere 50% 52% 76% 54% 49% 32% 49% 54% 32% 31% 49% 33% 62% 47% 54% 56% 47% 78% 41% 59% 74% 52% 34% 45% 86% 42% 67% 34% 37% 59% 45% 32% 40% 50% 54%
Toric 36% 22% 13% 30% 27% 31% 12% 36% 43% 29% 28% 28% 21% 22% 37% 23% 25% 14% 16% 12% 23% 27% 38% 31% 3% 37% 11% 38% 33% 31% 39% 5% 33% 34% 22%
Cosmetic tint 0% 2% 1% 5% 1% 0% 27% 2% 0% 0% 1% 2% 2% 7% 4% 21% 0% 3% 41% 16% 0% 14% 0% 0% 1% 0% 16% 0% 0% 6% 1% 61% 0% 4% 11%
Multifocal / monovision 14% 23% 7% 10% 23% 34% 4% 8% 25% 37% 20% 36% 14% 24% 4% 0% 28% 4% 2% 11% 3% 7% 27% 23% 0% 21% 5% 29% 30% 4% 15% 2% 25% 13% 12%
Anti-myopia 0% 0% 2% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 1% 0% 0% 0% 0% 0% 1% 0% 0%
Other 0% 1% 0% 0% 0% 2% 8% 0% 0% 4% 2% 0% 2% 0% 0% 0% 0% 0% 0% 2% 0% 0% 0% 0% 9% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%
Replacement Daily 18% 60% 7% 14% 42% 41% 38% 39% 9% 53% 13% 25% 26% 15% 43% 4% 58% 51% 44% 32% 0% 25% 14% 48% 0% 46% 8% 30% 37% 28% 17% 56% 55% 17% 30%
1-2 weekly 17% 6% 2% 31% 8% 4% 4% 13% 6% 3% 4% 15% 25% 10% 19% 3% 4% 46% 11% 2% 0% 8% 6% 8% 0% 6% 1% 3% 12% 23% 15% 8% 7% 31% 14%
Monthly 45% 31% 85% 40% 50% 49% 32% 46% 63% 38% 69% 58% 43% 74% 36% 33% 36% 2% 21% 62% 88% 59% 73% 33% 0% 39% 55% 67% 51% 40% 67% 35% 37% 52% 42%
3-6 monthly 14% 2% 6% 0% 1% 2% 15% 0% 11% 6% 4% 2% 3% 0% 1% 54% 2% 0% 24% 4% 0% 7% 6% 9% 0% 2% 16% 0% 0% 1% 0% 0% 0% 0% 8%
Annually 4% 1% 0% 14% 0% 5% 10% 3% 11% 0% 8% 0% 2% 1% 2% 2% 0% 0% 0% 0% 12% 0% 1% 2% 100% 3% 21% 0% 0% 8% 1% 1% 0% 0% 6%
Unplanned 3% 0% 0% 0% 0% 0% 0% 0% 0% 0% 2% 0% 1% 0% 0% 4% 0% 1% 0% 0% 0% 0% 0% 0% 0% 5% 0% 0% 0% 0% 0% 0% 0% 0% 1%
  New fits into EW 0% 3% 7% 8% 2% 4% 7% 9% 0% 9% 1% 0% 1% 0% 1% 19% 1% 0% 10% 22% 8% 11% 2% 18% 6% 2% 26% 7% 14% 0% 5% 0% 1% 6% 8%
  Refits into EW 0% 6% 18% 9% 6% 8% 19% 7% 1% 11% 1% 1% 0% 2% 2% 27% 1% 0% 6% 27% 11% 13% 5% 22% 6% 3% 20% 0% 6% 0% 0% 0% 5% 9% 10%
  EW with silicone hydrogels 100% 100% 96% 87% 100% 100% 0% 98% 100% 86% 98% 100% 74% 100% 69% 98% 50% 55% 33% 97% 100% 65% 100% 95% 100% 95% 53% 100% 89% 100% 100% 100% 99% 55% 66%
  MPS solutions 75% 91% 100% 100% 82% 47% 100% 83% 39% 82% 81% 84% 91% 72% 97% 99% 90% 83% 94% 80% 98% 97% 93% 84% 100% 89% 97% 92% 96% 73% 96% 91% 96% 80% 90%
  Presbyopes multi / mono 22%/12% 45%/19% 100%/0% 24%/24% 52%/17% 45%/22% 0%/0% 49%/4% 42%/20% 61%/10% 51%/4% 79%/3% 65%/5% 88%/0% 21%/6% 0%/0% 93%/1% 28%/1% 42%/19% 59%/0% 33%/0% 50%/2% 48%/9% 38%/11% 67%/0% 42%/12% 35%/14% 84%/0% 40%/9% 14%/0% 68%/7% 7%/0% 44%/12% 47%/5% 48%/8%

Figure 3. Lens fits to presbyopes in 2015.

Overall, the prescribing of a “correct” lens type for presbyopes (i.e., a multifocal or monovision solution) showed an increase from around 30% of fits in 2003 to 50% in 2010, with a plateau thereafter (Figure 4).

Figure 4. Change with time of lens fitting to presbyopes.

Most soft lenses are prescribed on a monthly (42%), daily (30%), or one- to two-week (14%) basis, with fewer than 10% of soft lenses prescribed for extended wear. Ninety percent of patients needing a care system were prescribed a multipurpose product, a value very similar to that of recent years. CLS

Funding and/or assistance was provided for the following markets: Brazil, Czech Republic, Greece, Hungary, Israel, Slovakia—Johnson & Johnson Vision Care; Australia—Optometry Australia; Bulgaria—Vision Protect Ltd.; China—China Optometric and Optical Association; Korea—CooperVision; 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.

Contributors

Dr. Morgan is director, Eurolens Research, The University of Manchester, UK. Dr. Woods is an associate professor, School of Medicine (Optometry), University of Deakin, Australia. Dr. Tranoudis is senior director, Professional Affairs, Europe, Middle East, Africa, & Latin America, Johnson & Johnson Vision Care. Magne Helland is an associate professor at the Department of Optometry and Visual Science, Buskerud and Vestfold 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. 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. Mr. Lemos is an ophthalmic technologist for Johnson & Johnson Vision Care in Sao Paolo. Dr. Deborah Jones is a clinical professor, School of Optometry and Vision Science, University of Waterloo, Canada. Marion Beeler-Kaupke, Augenoptik, Schweizerischer Berufsverband für Augenoptik und Optometrie SBAO, Switzerland. Polo Qi is chairman of the Education Committee, China Optometric and Optical Association. Dr. Tan is associated with Brien Holden Vision Institute, Sydney. Jitka Belikova is associated with the Czech Association of Contactology, Prague. Dr. Pult is the owner of Optometry and Vision Research in Weinheim, Germany. Ole Ravn is an optometrist at the Danish College of Optometry and Visual Science, Randers, Denmark. Dr. Santodomingo-Rubido 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 of the Hungarian Contactologic Society, Szeged, Hungary. Dr. Erdinest works at Hadassah Hebrew University Medical Center, Jerusalem. Ali Reza Jafari is a contact lens researcher at the Basir Eye Health Research Center in Tehran, Iran. Giancarlo Montani is affiliated with the University of Salento, Lecce, Italy. Dr. Itoi is an associate professor, Department of Ophthalmology, Juntendo University, Tokyo. Byoung Sun, Chu. works in the Department of Optometry & Vision Science, Catholic University of Daegu, Korea. Dr. Bendoriene works at Siauliai University, Siauliai, Lithuania. Dr. van der Worp works at Eye Research Institute, Maastricht, the Netherlands. Ricardo Pintor is Professional Affairs Manager, CooperVision Latin America. Dr. Monroy is president/founder of the Latin America Contact Lenses and Cornea Association. Ms. Chia is a lecturer in the Faculty of Optometry and Vision Sciences at SEGi University, Malaysia. Dr. Awasthi works at Geta Eye Hospital, Dhangadhi, Nepal. Dr. Lam works for the School of Optometry and Vision Science, University of 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. 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 and Contact Lenses Today.

New Markets Reported in 2015

We received fitting information for three new countries in 2015: Brazil, Iran, and Slovakia. With a population of more than 200 million people, Brazil is potentially a very important contact lens market. Our analysis suggests that its rate of rigid lens prescribing is more than average, with few daily disposables prescribed. This latter lens type is also rarely fitted in Iran, where silicone hydrogel prescribing is also lower compared to the global average, and extended wear lenses appear to be more popular. In Slovakia, monthly silicone hydrogel lenses are the most commonly used, with very few GP or extended wear lenses.

Figure 5. Prescribing in Brazil, Iran, and Slovakia.
Abbreviations: OK = orthokeratology; DD = daily disposable; SH = silicone hydrogel; DW = daily wear; EW = extended wear.