An international survey of contact lens prescribing for presbyopia

Purpose:  The aim was to determine world-wide patterns of fitting contact lenses for the correction of presbyopia.

Methods:  Up to 1,000 survey forms were sent to contact lens fitters in each of 38 countries between January and March every year over five consecutive years (2005 to 2009). Practitioners were asked to record data relating to the first 10 contact lens fittings or refittings performed after receiving the survey form.

Results:  Data were received relating to 16,680 presbyopic (age 45 years or older) and 84,202 pre-presbyopic (15 to 44 years) contact lens wearers. Females are over-represented in presbyopic versus pre-presbyopic groups, possibly reflecting a stronger desire for the cosmetic benefits of contact lenses among older women. The extent to which multifocal and monovision lenses are prescribed for presbyopes varies considerably among nations, ranging from 79 per cent of all soft lenses in Portugal to zero in Singapore. There appears to be significant under-prescribing of contact lenses for the correction of presbyopia, although for those who do receive such corrections, three times more multifocal lenses are fitted compared with monovision fittings. Presbyopic corrections are most frequently prescribed for full-time wear and monthly replacement.

Conclusions:  Despite apparent improvements in multifocal design and an increase in available multifocal options in recent years, practitioners are still under-prescribing with respect to the provision of appropriate contact lenses for the correction of presbyopia. Training of contact lens practitioners in presbyopic contact lens fitting should be accelerated and clinical and laboratory research in this field should be intensified to enhance the prospects of meeting the needs of presbyopic contact lens wearers more fully.

Use of silicone hydrogel contact lenses by Australian optometrists

Background: Prior to the launch of silcone hydrogel (Si-H) materials in Australia in 1999, only 1.6 per cent of lenses were prescribed on a continuous wear basis.

Methods: One thousand surveys were distributed randomly to practitioners in Australia during January 2000, 2001 and 2002 (total surveys 3,000). Each anonymous survey requested data about the next 10 patients fitted with contact lenses, including date, age, gender, new fitting or refitting, lens material type, lens design, frequency of replacement, modality of wear, uses per week and care regimen.

Results: Twenty per cent (599) were returned, reporting data on 5,976 fittings. A total of 710 fittings used Si-H contact lenses (11.9 per cent), which represented 18.6 per cent of all soft lens fittings. During the three years, the proportion of practitioners prescribing Si-H lenses increased from 42.2 to 52.5 per cent. In 2000, 43.8 per cent were daily wear, which decreased to 32.2 per cent by 2002. The solution system of choice for daily wear lenses was multipurpose solutions (98.4 per cent); the only alternative was hydrogen peroxide systems. Continuous wear represented 11.7 per cent of all fittings, ofwhich 85.7 per cent were Si-H, 3.0 per cent RGP lenses and 11.3 per cent conventional hydrogels. For continuous wear, 79.0 per cent of fittings were to existing wearers, whereas for daily wear, 59.4 per cent were existing wearers. More males were prescribed Si-H continuous wear contact lenses, while females were more likely to be prescribed Si-H on a daily wear basis.

Discussion: Si-H contact lenses were introduced to the Australian market as a continuous wear contact lens, yet many practitioners use this product for daily wear with multipurpose solutions. By 2002, more practitioners were prescribing Si-H contact lenses for continuous wear than in 2000, suggesting a growing confidence in that product for that mode of wear. A comparison with an earlier survey shows there is an increase in continuous wear from 1.6 per cent to 11.7 per cent over a five-year period.

Survey of contact lens prescribing to infants, children, and teenagers

Purpose. To determine the types of contact lenses prescribed for infants (aged 0 to 5 years), children (6 to 12 years), and teenagers (13 to 17 years) around the world.

Methods. Up to 1000 survey forms were sent to contact lens fitters in each of 38 countries between January and March every year for 5 consecutive years (2005 to 2009). Practitioners were asked to record data relating to the first 10 contact lens fits or refits performed after receiving the survey form.

Results. Data were received relating to 105,734 fits [137 infants, 1,672 children, 12,117 teenagers, and 91,808 adults (age ≥18 years)]. The proportion of minors (<18 year old) fitted varied considerably between nations, ranging from 25% in Iceland to 1% in China. Compared with other age groups, infants tend to be prescribed a higher proportion of rigid, soft toric, and extended wear lenses, predominantly as refits for full-time wear, and fewer daily disposable lenses. Children are fitted with the highest proportion of daily disposable lenses and have the highest rate of fits for part-time wear. Teenagers have a similar lens fitting profile to adults, with the main distinguishing characteristic being a higher proportion of new fits. Orthokeratology fits represented 28% of all contact lenses prescribed to minors.

Conclusions. Patterns of contact lens prescribing to infants and children are distinctly different to those of teenagers and adults in a number of respects. Clinicians can use the data presented here to compare their own patterns of contact lens prescribing to minors.

International contact lens prescribing in 2011

This is the 11th annual report of contact lens prescribing trends that we have prepared for Contact Lens Spectrum. Each year, we capture current modes of contact lens practice by asking practitioners in each market (optometrists, opticians or ophthalmologists, as appropriate) to provide information about the first 10 lens fits undertaken after receiving our paper or electronic survey form. In 2011, we captured information about 22,362 fits in 29 countries.

International contact lens prescribing in 2010

For the past nine years, we have described the current state of contact lens fitting worldwide in Contact Lens Spectrum. This year, we report on 24,642 lens fits in 27 markets. As in all previous years, coordinators in each market distributed up to 1,000 paper or electronic survey forms to contact lens practitioners who, in turn, collected information about their next 10 fits. Data were processed and checked in the survey administrative offices in Manchester, United Kingdom and in Waterloo, Canada.

International contact lens prescribing in 2007

Our annual review of international prescribing trends reports on close to 20,000 prospectively conducted fits in 27 countries.

International contact lens prescribing in 2006

Our annual update on contact lens prescribing trends reports on more than 22,000 prospectively conducted fits in 19 countries.

Longitudinal trends, individual quality, and foraging of a temperate seabird

Tanya investigated individual quality of Australasian gannets specifically breeding success, foraging behaviour, and diet. Tanya’s thesis presented previously unreported findings of how quality manifests itself among seabirds, and, demonstrated the importance of accounting for individual variation when examining parameters of reproductive success, particularly in relation to long-term ecological processes.

Estimativas de herdabilidade e tendências genéticas para características de crescimento e reprodutivas em bovinos da raça Nelore: Estimates of heritability and genetic trends for growth and reproduction traits in Nelore cattle

Foram estimados os coeficientes de herdabilidade e a mudança genética para peso à desmama (PD), peso ao sobreano (PS), ganho de peso do nascimento à desmama (GND), ganho de peso da desmama ao sobreano (GDS), perímetro escrotal (PE) e idade ao primeiro parto (IPP) em animais da raça Nelore. Foram utilizados dados de 128.148 animais nascidos entre 1984 e 2006. Os componentes de variância foram estimados pelo método da máxima verossimilhança restrita, e os valores genéticos foram preditos por modelos mistos aplicando-se modelo animal bicaracterística, incluindo peso à desmama em todas as análises. As tendências genéticas foram estimadas pela regressão dos valores genéticos sobre o ano de nascimento dos animais. Os coeficientes de herdabilidade do efeito direto estimados foram de 0,23 (0,07) (PD); 0,24 (0,02) (PS); 0,21 (0,01) (GND); 0,23 (0,01) (GDS); 0,46 (0,02) (PE) e 0,15 (0,01) (IPP). As tendências genéticas diretas estimadas foram de 0,171 (0,01); 0,219 (0,02); 0,186 (0,03) e 0,224 (0,02) kg/ano para PD, PS, GND e GDS, respectivamente, o que representa incrementos de 0,10; 0,08; 0,13 e 0,22% nas médias das mesmas características ao ano, respectivamente. Para o PE e a IPP no período de 1984 a 1995, as tendências genéticas foram nulas, com valores de 0,011 (0,03) cm/ano e -0,003 (0,06) dias/ano, respectivamente. No segundo período considerado (1996 a 2006), as tendências genéticas para PE e IPP foram de 0,069 (0,01) cm/ano e -3,024 (0,04) dias/ano, respectivamente, indicando melhorias consideráveis em tais características. Esses valores sugerem que características produtivas e reprodutivas, quando utilizadas como critério de seleção, proporcionam progresso genético no rebanho, sendo indicadas para seleção de animais da raça Nelore.