The population of the United States was 336,003,666 as of February 1, 2024. Of that 336 million, an estimated 162 million are older than 40 or presbyopes.1 This group of patients represents a tremendous opportunity for everyone in the eyecare industry. These demographics are driving a tremendous amount of research and product development aimed at providing solutions for this “age old disease.”
Compare the number of presbyopes to what a group recently estimated as 19.5 million children with myopia, and it is easy to see the investment and opportunity not only for companies and products but also for optometrists as providers and clinicians.2 A previous article in this publication provided a more in-depth look at the age demographics of the presbyopia population.3
I have written in previous articles about the opportunities with glasses in this over 40 population, and glasses are a basic, foundational part of most optometric practices. Let’s turn our attention toward another huge opportunity that is widely underutilized for our patients: multifocal contact lenses.
Contact Lenses for Presbyopia
The 2 major options for multifocal contact lenses are the rigid gas permeable contacts and soft contact lenses. While glasses for correcting presbyopia have been around since the 18th century, it was not until 1938 that William Feinbloom received the first patent for a multifocal scleral contact lens for correcting presbyopia. Of course, since that time, the number of options has increased dramatically. In fact, today more than 15 manufacturers produce more than 60 different soft multifocal contact lens options.4 Soft multifocal lenses make up the majority of fits in the United States. Rigid gas-permeable multifocal contacts make up about 1% of all fits, and soft multifocal contact lenses make up 12% of all fits.5
The Demographics and Opportunity for Multifocal Contact Lenses
The opportunity for fitting and promoting contact lenses for presbyopes in our practice is tremendous. Let’s explore the data and numbers to help us understand the opportunity.
According to the US Census Bureau, 336 million people live in the US, and approximately 260 million are older than 18.1 Of these 260 million adults, more than 166 million wear prescription glasses.6 The total number of contact lenses wearers in the United States is estimated to be 45 million.7 Of these contact lens wearers, 35% are older than 40 or presbyopic. So some quick math tells us that about 10% or 15 to 16 million of the 160 million presbyopes are wearing contact lenses. Think about it: less than 1 out of every 10 patients with presbyopia wear contact lenses.8 The story gets even worse because, of the 15 to 16 million presbyopic patients wearing contact lenses, only 6.5 to 7 million are wearing multifocal contact lenses, while 3.5 to 4 million are wearing monovision, and the remaining 5 to 6 million are wearing distance only and using reading glasses.8
In virtually every study, there is a disconnect between what our patients say they want and the numbers above. A 2022 multinational study from surveys of 1,540 patients older than 40 by Shehzad and associates9 reported the following:
Think about it: less than 1 out of every 10 patients with presbyopia wear contact lenses.
1. Thirty-two percent of patients who had previously worn contact lenses but were now wearing only spectacles were interested in trying contact lenses again. The study calculated that 23.8% in this survey had dropped out of contact lens wear, but data from surveys show that as many as 50% of current contact lens wearers may drop out when they reach presbyopia.9,10
2. For the patients wearing contact lenses, 25% were wearing a multifocal lens, 62% were wearing spherical lenses, and 13% were wearing toric lenses. Sixty percent of the patients wearing contacts had been recommended to upgrade by their eye doctor, but in the non-CL-wearing group, contacts had not been recommended or discussed with more than 70% of the patients, and the number 1 reason for patients not wearing contacts was that their eyecare provider had not recommended contacts.9
Turn Multifocal into Multipair…The Power of AND
One of the huge benefits of continuing to fit presbyopic patients in multifocal contact lenses is the power of “AND.” With all the developments and advances in contacts, multifocal lenses still cannot be the sole means of vision correction.
AND Glasses
Patients wearing multifocal contact lenses will also need a pair of glasses for times when they need a break from contacts. This need creates the significant opportunity that we have previously discussed.11
AND Sunglasses
It is estimated that more than 60% of patients wear plano sunglasses. This fact translates to more than $6 billion in sales for the United States, making up 8% of all sales. More than half of patients have 2 or more pairs of sunglasses, and more than 60% say they will buy a new pair in the next 12 months. It should be noted that consumers are price conscious of sunglasses, with more than 70% of patients spending less than $100 on sunglasses.12 All the above numbers are for plano sunglasses. For our patients with presbyopia, consider the opportunity for prescription sunglasses, along with the plano glasses for use with their contacts. Living in Florida, I can tell you that this is a significant opportunity and an option that should be offered to all patients.
AND More Exams AND Intangible Benefits
Another AND that cannot be overlooked is that we see contact lens patients on a more regular basis. Contact lens patients come in for exams more often than our glasses-only patients and will also spend more money than glasses-only patients. This makes the lifetime value of the patient significantly more for this group of patients.13
I have also found that fitting multifocal contacts is a tremendous practice builder. The word-of-mouth referrals, patient loyalty, and overall satisfaction of providing a solution for these patients with generally more disposable income are both personally and professionally rewarding.
References
1. US Census Bureau.
2. Fortin P, Kwan J. The myopia management opportunity in the United States using the 2020 census. Paper presented at: Annual meeting of the Association for Research in Vision and Ophthalmology. May 1-4, 2022; Denver, CO.
3. Spear CH. Why do we have Presbyopia Physician? Presbyopia Physician. 2023;3(3):25-27.
4. Papas E. The history of soft contact lenses. Cont Lens Spectrum. 2021;36(11):20-22,24-26.
5. Nichols JJ, Fisher D. Contact lenses 2022. Cont Lens Spectrum. 2023;38(1):20-22,24-26.
6. Vision Council Data.
7. Healthy contact lens wear and care. Centers for Disease Control and Prevention website. Accessed February 16, 2023. https://www.cdc.gov/contactlenses/fast-facts.html
8. Morgan PB. Contact lens prescribing for presbyopia: an update for 2020; data from 2003-2019 for Australia, Canada, Japan, Netherlands, Norway, UK and USA. Analysis conducted for CooperVision Inc. 2020( April).
10. JJV Data on file 2021, survey conducted with n= 1,750 representative U.S. and U.K. consumers, ages 12-64.
11. Spear CH. The economics of glasses for presbyopia correction. Presbyopia Physician. 2023;3(4):18-19.
12. Vision Council Market Watch Data 2023.
13. Alcon data on file.
Dr. Spear is an industry thought leader with experience in academics, industry, private practice, and consulting. He is a dynamic speaker who looks at the eyecare business logically and offers practical and proven insights on increasing practice profitability.
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