Why one million contact lens wearers dropped out.

The early 1990s saw a large increase in the number of contact lens wearers in the UK. It is estimated that this figure doubled between 1990 and 1996 to reach approximately three million wearers. The increased uptake of contact lenses during this period is thought to have been due to a number of factors, including the availability of frequent replacement soft lenses, the introduction of daily disposable lenses and the effects of television advertisments [1]. However, in the late 1990s there was a subsequent fall in the number of contact lens wearers (Fig. 1). The decline in the use of contact lens may have coincided with the growing appeal of designer fashion spectacles; however, this seems an inadequate explanation for the loss of nearly a million contact lens wearers. A further worrying statistics is that the UK has one of the highest contact lens drop-out rates in Europe [2]. This cannot be explained by the fact that the UK has a higher proportion of people who have tried contact lenses, because in Italy, where a similar proportion have tried contact lenses, the drop-out rate is relatively low. The reasons for discontinuing contact lenses have been evaluated in a number of studies [3–5]. The most commonly cited reason in all of these studies is discomfort, which accounts for between 43 and 72% of the drop-outs. Poor vision, handling difficulties and cost are the other reasons reported by lapsed contact lens wearers. However, the reasons given by patients themselves for their discontinuation of the contact lenses do not provide an adequate explanation of the problem. The patients’ experience of contact lens discomfort may have arisen from a variety of causes, such as contact lens-related dry eye, poor lens fitting or protein deposition. A recent study [6] provided the opportunity to examine some of the underlying causes of contact lens discontinuation and to face up to some of the disappointing realities of contact lens provision in the UK. The study attempted to answer the question: How many lapsed contact lens wearers can be successfully refitted? In a multicentre study involving 15 investigators throughout the