Contact Lens Aftercare Refinement Initiative for Frequency Intervals

Overview / Background / unmet need:

Soft contact lens technology and contact lens related clinical practice have evolved significantly over the last three decades[1] . Improvements have been made in every direction: significant improvement in material biocompatibility and transmissibility, enhanced lens designs and optics, wider power ranges, better care regimes, and almost all possible and flexible modalities of lens wear and replacement frequencies. Similarly, eye care professionals (ECPs) are also directed by UK clinical practice guidelines detailed by professional bodies which are aimed at maintaining high levels of ocular health and providing satisfactory vision and comfort [2].

However, current approach for soft contact lens fitting and subsequent follow up appointments, which is defined in the UK by the number of patient visits required to satisfy a new contact lens fit[3], proceeded by follow-up visits to continue safe and healthy lens wear have remained largely conservative[3] . The general course of action has not evolved over recent decades where patients are recalled several times during their journey of contact lens fit in the first few months of wear, likely due to potential complications and challenges faced by the earlier lens materials, designs and limited replacement frequencies [4] and habits formed by ECPs over the years. Although current contact lens materials are superior for benefits such as oxygen performance, wettability and deposition, a variety of wearing modalities and replacement frequencies are available, along with a wide range of powers such that virtually all potential wearers can be fitted with contact lenses. With the advent of a range of virtual assessment tools, contact lens aftercare and frequency of routine clinic visits remained empirical and outdated whether for new or refitting existing contact lens wearers[3] .

Currently, a new soft contact lens wearer may need to visit an ECP several times to finalise a fitting whether for a new or existing wearer, and whether this is a spherical, or toric lens, which can consume significant ECP chair time and may cause patient inconvenience. Given the clinical performance and success rates with contemporary soft contact lenses, and possibility of fitting support with online tools and a range of virtual consultation options, the number of in person visits could be reduced.

The global market in terms of lens replacement in 2023, about half of all lenses prescribed were daily disposables (DD) and one third were monthly replaced contact lenses. In the United Kingdom, more than 60% of contact lens fits were DD which has been steadily increasing over the last few decades [5]. The increase in popularity of DD lenses is also supported by minimised risk of significant and non-significant adverse events related to these lenses, however the absolute rates and risks of microbial keratitis (MK) has remained consistent at 2-4 per 10,000 contact lens wearers per year [6].