<p>A Review of Contact Lens Dropout</p>

Abstract

Purpose: Contact lens (CL) dropout is likely a major factor contributing to the near stagnant growth in the CL market. The purpose of this review is to summarize the current state of knowledge related to the frequency of CL dropout and the factors associated with it. Methods: PubMed.gov was searched on or before March 22, 2020, with the terms "contact lens" with "dropout" or "cessation" or "disruption" or "discomfort". Pertinent articles were collected. The references from these articles were likewise searched to identify additional relevant articles. Only manuscripts written in English were included. No study design or date exclusions were imposed on this review. Results: This literature review found that CL dropout was frequent across developed countries, with a CL dropout frequency that ranged between 12.0% and 27.4% (pooled mean = 21.7%). The top cited reason for CL dropout in established CL wearers was discomfort, while vision was the top reason in neophyte CL wearers. If given the chance, CL dropouts are often able to successfully resume CL wear up to 74% of the time. While the literature is mixed with regard to factors promoting CL dropout, meibomian gland dysfunction appears to promote CL dropout. Conclusion: CL dropout is a frequently encountered condition that may be curtailed by early detection, patient education, alterative CL options, or early treatment of underlying ocular surface diseases such as meibomian gland dysfunction.

Established soft contact lens wearers’ awareness of and initial experiences with orthokeratology

“…These dropout frequencies are on par with a recent review of contact lens dropout, which found a pooled contact lens dropout rate of 21.7% across studies that included both soft and/or rigid lens wearers (n = 8190). 16 The likely difference between the present investigation and the study of Ren et al is that the current study recruited uncomfortable soft contact lens wearers whereas Ren et al recruited myopic adults who had no contraindications for contact lens wear. Although any level of contact lens dropout is unwanted, the results presented here are promising in that they demonstrate that a large percentage of soft contact lens wearers can be fitted with a different lens modality and become successful wearers again.…”

“…17 The current study and past work suggests that some lens wearers do have trouble learning how to apply and maintain gas permeable lenses, and therefore these patients should be closely monitored, especially early on in the fitting process, to ensure that they have everything they need to become successful lens wearers. 16,18 Another issue was that only 21% of subjects learned about orthokeratology from their primary eye care provider, which suggests that practitioners need to be better at educating their patients about all of their refractive error correction options. This need was highlighted by up to 82% of subjects, indicating that they wished that they had learned about orthokeratology sooner.…”

BCLA CLEAR - Effect of contact lens materials and designs on the anatomy and physiology of the eye

“…They contribute most of the tear film lipid layer which protects the aqueous phase from evaporating too quickly and also stabilises the tear film by lowering surface tension. Any abnormalities in Meibomian gland function and/or anatomy lead to reduced meibum secretion and/or altered lipid composition which in turn disrupt the ocular surface integrity and influence contact lens success [54][55][56].…”

Finite Element Analysis of Cornea and Lid Wiper During Blink, With and Without Contact Lens

“…Previous literatures have stated that about 21%-64% of CL wearers discontinue CL use, while others are able to continue wearing their CLs well into their presbyopic years 2,3,4 . Contact Lens-related Discomfort (CLD) 5 is one of the major reasons for dropout rates in about 50% of CL users followed by dry eye (19.9%) 6 , ocular redness (6.8%) 6 , cost of CL (6.8%) 6 and handling issues (6.3%) 6 . Other factors include age, gender, presence of systemic disease, CL solution and care regimen, design, material, the modality of the contact lens 1,7 During a blink, the under surface of the eyelid interacts with the cornea and the conjunctiva 8 .…”