Contact lens industry data reveal good news and bad news for the contact lens portion of your practice. The good news? There is a large upswing in male and middle-aged wearers, and contact lens wear continues to increase overall. The bad news? More than half of contact lens dropouts said they would definitely not return to contact lens wear, and patients are less likely to purchase their lenses from you.

Concrete data that tell you who is wearing contact lenses, why they are wearing them, and more, arms you with the information you need to address current and potential patient and practitioner problems and focus on presenting contact lenses to patient populations you may have either neglected in the past or never considered, says optometrist Glenda Secor, who has a contact lens specialty practice in Huntington Beach, Calif.

We asked Dr. Secor and some of your other colleagues to comment on the possible reasons for the following facts and figures presented in this article.

Whos Wearing Contacts?
As of June 2005, 40 million people in the United States reported wearing contact lenses. This represents an increase of 3.4 million, or 9%, from a year earlier and 4.5 million, or 13%, from June 2003. (VisionWatch data are extrapolated to the entire population.)

Soft lenses are the most popular lens choice, worn by 92% of all contact lens wearers. Rigid took second place with 4.9%, dont know came in third with 2.3% and sometimes rigid, sometimes soft came in last with 0.8%. When broken down by age and sex, VisionWatch data showed:

A large upswing in contact lens usage by men. While more women than men said they currently wear contact lenses (22.2% vs. 13.7%), data on length of contact lens usage revealed that more men than women have been wearing their lenses for six months or less (7.5% vs. 5.3%), seven months to a year (5.5% vs. 3.3%) and one to two years (7.0% vs. 5.4%). This suggests that men make up a larger share of new contact lens wearers.

Soft contact lenses take the lion"s share.

Another reason: In the past, many of my male patients told me that they werent interested in contacts because they didnt want the hassle of removal, Dr. Secor says. But the 30-day continuous wear lenses have reduced this hassle, allowing not only men, but contact lens wearers in general, to wear their lenses longer.

A large upswing in contact lens wear among middle-aged patients. Historically, patients tended to discontinue contact lens wear once they became presbyopic. However, those age 55 and older were the largest group to report being contact lens wearers for more than two yearsthe largest amount of time offered by this study.

One possible explanation: Many of these patients may have worn contact lenses since their teens. People in this age group are more willing to contend with the occasional problems that accompany lens wear, Dr. Secor says. Their attitude is: This is just another stage in my life and just another stage of having to deal with how my contact lenses work. They are more loyal to the modality because of their history with it.

Although 18- to 34-year-olds are the largest age group to report wearing contact lenses, data on length of wear revealed that 45- to 54-year-olds now equal the 18- to 34-year old group for six months or less length of wear.

The data on the 45- to 54-year-olds reflects the increasing array of bifocal and multifocal options for these patients, Dr. Shovlin says.

Wearing Schedules
Since December 2001, contact lens wear all of the time, including while sleeping has steadily increased. Consider: In December 2001, 1.5% of adults reported this wear schedule. This number grew to 2.4% as of December 2004 and 2.6% as of June 2005.

We know that people have been wearing their lenses longer than they should all along, but they just didnt admit it because it was something they werent supposed to do, Dr. Secor says.

Today, however, practitioners probably are telling patients that they may wear lenses made of newer, more breathable materials for longer periods, Dr. Shovlin adds.

When patients were told by their practitioner to replace their lenses once a year or less often, 95.8% of patients said they complied with this schedule. This was the largest amount of compliance achieved. The lowest amount of compliance was seen with patients told to replace their lenses every three weeks (39.8%) and every two weeks (51.0%).

Three-week replacement in particular is awkward from a calendar standpoint, which may explain why these patients are not complying, Dr. Shovlin says. I think that every two weeks is a reasonable reminder, though I also think its very easy for the two-week replacement patients to fall into the trap of my lenses feel fine; I think Ill wear them for another two weeks or more, he says. Dr. Secor agrees. Its all about educating the patient in the exam room, she says. Patients need to be told exactly why it is in their best interest to follow the replacement schedules we give  them.

Contact Lens Dropouts
Some 82% of those surveyed do not currently wear contact lenses, but 17.6% of these patients are former contact lens wearers. Inconvenience/hassle was the biggest reason for discontinuing lens wear, as cited by 36.5% of the contact lens dropouts.

I believe that these findings reflect the fact that, again, many practitioners are not educating their patients about how the new options, such as extended- and continuous-wear lenses, preclude much of the inconvenience and hassle that has been associated with contact lenses in the past, Dr. Shovlin says. If we take the time to edu-cate, I truly believe that these numbers will change.

Other reasons for discontinuing lens wear were:

Need for bifocal lenses (17.5% of dropouts). Although those age 55 and older were the largest group to report their length of lens usage at over two years, this same age group was the largest group to report discontinuing lens wear due to the need for bifocal lenses.

These findings tell me that many practitioners arent educating their older patients about the availability of bifocal lenses, Dr. Secor says.

Unfortunately, some older practitioners are reluctant to offer these lenses because these practitioners have been burned with past bifocal/multifocal options, Dr. Shovlin adds. But with the way technology has influenced lens design and comfort, these practitioners should get back on the bandwagon.

Didnt make vision good enough (10.9% of dropouts). I think that this number will decrease if we, as practitioners, work really hard to correct astigmatism, Dr. Shovlin says. We need to show patients the available options of astigmatic lenses.

Cost (9% of dropouts). This number indicates that many of us are meeting the eye health needs of our patients without hitting them in the wallet, and they really appreciate that, Dr. Secor says. I also think that the per lens cost is pretty insignificant nowadays compared with the cost of gasoline, for instance.

Had refractive surgery (6.7% of dropouts). In the 12 months ending June 2005, 968,000 adults in the United States reported having an initial LASIK procedure, according to VisionWatch data. This means that 2.5% of all those ages 18 to 64 in the United States underwent LASIK. Regardless, the number of contact lens wearers continues to grow.

LASIK does not mean that patients no longer need eye exams, spectacles or contact lenses. For instance, presbyopes who undergo LASIK oftentimes have to wear spectacles for nearwork, and some of us have educated these patients about bifocal contact lenses, Dr. Secor says. So, that may be an example of why contact lens use continues to rise despite LASIK surgery.

Some 62.6% of dropouts said they would definitely not return to contact lens wear, and 21.7% said they would probably not return to contact lens wear. Another 11.1% said they were not sure. Meanwhile, 2.8% said they were fairly likely to return to contact lens wear, and 1.8% said they were very likely to do so.

Although there are now more comfortable and convenient modalities, patients may not be aware of this. I think that a lot of patients who found their old lenses inconvenient were not told that there are newer options available, Dr. Shovlin says. Its really the same old story. Its our job to educate our patients. If we told borderline dropouts about 30-day continuous-wear lenses, for example, these patients would likely be inclined to try them, and these numbers would change quickly.

The Competition
Patients are less likely to purchase their lenses from independent optometrists. Whats more, independent O.D.s are the least profitable in contact lens sales. Consider the following facts:

Some 43% of respondents said they bought their contact lenses from an independent optical practitioner (this includes all independent locations).

The remaining 57% bought their lenses from chains, such as Lens-Crafters, online venues such as 1-800-CONTACTS, and other outlets.

Chains, online venues and other outlets received 58.4% of the $2.1 billion spent on contact lenses in 12 months ending June 2005. This represents an increase of 4.4% over the previous year. Independent O.D.s received 41.6%, a decrease of 1.9% from last June.

You dont have to match prices with these outlets, but you do need to be comparable, says optometrist Gary Gerber, of Franklin Lakes, N.J. You also need to keep a small inventory of lenses in your office and be able to refer your patients to your own online ordering system. Do these things, and your patients will stick with you.

Some 58.2% of the 598.1 million lenses sold in 12 months ending June 2005 were sold by chains, online venues and other outlets. Independent practitioners sold only 41.8%.

One possible reason: Independent practitioners are less likely to encourage patients to buy an annual supply of contact lenses, Dr. Gerber says. Chains are very good at that, he says.

While the overall increase in contact lens wear and the upswing in men and middle-aged wearers is exciting news, you cannot ignore the less-than-stellar contact lens dropout and competition data. To begin with:

More than half the contact lens dropouts said they would definitely not return to contact lens wear.

Inconvenience and hassle was cited as the number one reason for dropping out.

The need for bifocals was the second reason for dropping outdespite the increase in middle-aged wearers.

All of these facts indicate that patients may need further education about new materials and designs.

The fact that the chain stores, online venues and other outlets are more profitable and popular than you indicates that you may lack the convenience and comparable pricing that patients desire.

While the above facts may seem daunting, do not be discouraged. By learning from these facts, you can make the necessary changes to your practice to retain your current contact lens patients and inspire others to try this constantly evolving modality.