Januar 2013 - Danmarks Optikerforening

1. Young G, Sulley A & Hunt C. Prevalence of Astigmatism in Relation to Soft Contact Lens Fitting; Eye & CL, 2011: 37: 20‐25
2. GfK Fit Audit FY 2011
3. 19.4% CL wearers use torics – Internal data, 2012
65% of drop‐outs:
≥ 0.75DC in one eye
Young, Veys, Pritchard & Coleman Ophthal
Phsiol Opt 2002; 22: 516‐52
Sulley A, Young G, Osborn K, et al. A multi‐centre study of astigmatic nonusers of soft toric contact
lenses. BCLA Conference 2011, Poster Presentation.
Sulley A, Young G, Osborn K, et al. A multi‐centre study of astigmatic nonusers of soft toric contact
lenses. BCLA Conference 2011, Poster Presentation.
Sulley A, Young G, Osborn K, et al. A multi‐centre study of astigmatic nonusers of soft toric contact
lenses. BCLA Conference 2011, Poster Presentation.
Sulley A, Young G, Osborn K, et al. A multi‐centre study of astigmatic nonusers of soft toric contact
lenses. BCLA Conference 2011, Poster Presentation.
01 02
10/11/2012
01
Astigmatism ‐ prevalence,
Johan Lønsmann insights & Poulsen opportunities
Astigmatism and its prevalence
02
03
Caroline Christie
Randi starrfelt
November 2012
Anna Sulley BSc (Hons) MCOptom FBCLA FAAO
Medical Affairs Associate Director EMA
03
Young G, Sulley A and Hunt C. Prevalence of
Astigmatism in Relation to Soft Contact Lens Fitting.
Eye & Contact Lens 2011; 37 (1): 20‐25
24%
23%
53%
Spherical or
/=0.75DC in one
eye only
>/= 0.75DC in
both eyes
(N=11,624)
04
10/11/2012
04
05
Henrik Holton
20%
Anna Sully 15%
Prevalence eyes with various levels astigmatism
Prevalence
30%
Hyperopes
25%
Myopes
All
31.7% myopes >0.75DC
10%
15.7% hyperopes >0.75DC
Prevalence astigmatism increases with Studies age to gain key insights into astigmatic patient
behaviour, awareness and needs
Prevalence
30%
0.50DC or less
>/= 0.75DC at least one eye
25%
1 – Non‐toric User 2 – Qualitative 3 ‐ Astigmatism 4 – Usage & Attitude
20%
Clinical Study
Interviews Awareness Survey Survey
Background questionnaire Interviews and On‐line survey ‐
On‐line survey –
15%
to evaluate ease of fitting focus groups Independent
Independent
non‐toric CL users &
MR agency
MR agency
10%
clinical performance 2
ASD torics
1. Non‐toric Use Clinical Study
No. of subjects
Spherical Wearers
Spherical wearers: 67
CL Drop‐outs: 72
Neophytes: 61
Drop-outs
Neophytes
5%
0%
0.00 0.25 0.50 0.75 1.00 1.25 1.50 1.75 2.00 2.25 2.50 >2.50
Cylinder (D)
Young G, Sulley A and Hunt C. Prevalence of
Astigmatism in Relation to Soft Contact Lens Fitting.
Eye & Contact Lens 2011; 37 (1): 20‐25
5%
0%
8‐19 20‐29 30‐39 40‐49
Age range (Years)
Young G, Sulley A and Hunt C. Prevalence of
Astigmatism in Relation to Soft Contact Lens Fitting.
Eye & Contact Lens 2011; 37 (1): 20‐25
1‐month, open label, Practitioners and Consumers aged CL wearers
randomised, DW study astigmats (lapsed, 18 to 54 (n=819) Aged 16‐54 years
current spherical,
Representative CL
neophytes)
population by age,
50‐59 60‐70
gender, modality
200 astigmats 60 each group Spectacles/CL
n=3525
wearers (n=538) (n = 1018 astigmats)
UK, 16 sites UK & Italy UK 9 countries in Europe
Male Female
Prevalence Astigmatism vs. Fits Data
Astigmatic Drop Outs
Neophytes –
key reasons for not wearing CLs (n=61)
Drop‐outs –
key reasons for discontinuation (n=72)
Percentage (%)
Although toric soft CL prescribing
increasing ‐ not to levels expected if all
astigmats fully corrected
50
45
40
35
30
25
47
20
15
20 19
10
5
0
Prevalence Toric fits UK ‐ Industry Norway 3
astigmatism (≥0.75D data 2
at least 1 eye) 1
A high percentage of CL dropouts
are astigmats
Spectacles more convenient
Concerned about comfort
Haven't got round to it
Cost
Don't like thought of putting CLs in eye
Never thought about it
Get lost in eye
Irritation/infections
CLs too much trouble to care for
• Astigmats over represented among CL drop‐outs
Handling
• Poor vision due to uncorrected cylinder contributing factor
in CL discontinuation
39%
33%
33%
31%
30%
23%
18%
15%
Reasons wider
15%
beliefs of nonlens
15%
wearers
Discomfort
Spectacles more
convenient
Poor vision
Dryness
Cost
Ran out of CLs and didn't
get round to getting more
CLs too much trouble to
care for
15%
15%
39%
35%
31%
24%
21%
Key factor was CLs
did not meet specific
vision needs
Figur 1 Kun ca. 40% af astigmatikere
korrigeres med toriske linser.
Figur 2 65% af drop outs udgøres af astigmatikere
Figur 3 39% angiver manglende komfort som medvirkende
årsag til at droppe brugen af kontaktlinser
med en cylinder på 0,75 D eller derover på det øje.
Background questionnaire 1 ‐ Spherical wearers – key
reasons for not wearing toric CLs (n=67)
2. Qualitative interviews
Unaware there were
lenses for astigmatism
28%
Lapsed Wearers
Current Lens Wearers
Unaware I had
astigmatism
22%
05
Practitioner never
12%
offered me toric CLs
interview ANNA SULLEY
Cost
Astigmatism didn't
warrant toric CL
18%
Main reason for
not wearing ‐ ‘lack
of awareness’
12%
1 in 10 said TSCLs
not offered
Astigmatism qualitative interview s, UK & Italy, 60 practitioners, 60 patients, 2011
Optikerens udsendte overværede flere foredrag om netop kontaktlinser, og jeg havde en kort interview
Anna Sully, efter at have hørt hendes foredrag ”Seneste nyt om kontaktlinser og astigmatisme”.
Budskabet var det samme som i flere af foredragen om kontaktlinser. Anna Sully havde velunderbygget
statistik om tilpasning af toriske, hvor det fremgår, at optikerne undlader at finde til de toriske løsninger
frem. Anna Sully havde også sørget for nogle mere eller mindre tilfældige danskere var blevet spurgt, om
de viste, at de kan anvende kontaktlinser, hvis de har bygningsfejl. – Og det vidste de ikke. Samtidig leverer
Anna Sully velunderbygget dokumentation, der viser, at de største drop out af linsebærere netop er astigmatikere
med dårlig visus.
Jeg spurgte Anna Sully: ”Når der nu er så mange toriske løsningsmuligheder med kontaktlinser, hvorfor
siger du ikke bare til optikerne: Så brug dem dog! Lad være med at inddrage patienter i, om de har bygningsfejl
eller ej. Lav nogen kontaktlinser patienterne kan se med.”
Anna Sully virkede lidt overrasket og svarede: ”Jamen det koster jo flere penge for patienten, så det er
nødvendigt. Jeg kan godt se, at det måske er fornuftigt først at vise patienten, hvordan de kan komme til
at se, og så fortælle, hvad det koster.”
Anna Sully fortalte om, hvordan det historisk er en tradition, at optometrister taler meget om bygningsfejl
i forbindelse med kontaktlinsebæring, fordi der var mange år, hvor det ikke var muligt for astigmatikere,
at få et optimalt syn med kontaktlinser. Anna Sully var meget åben for at rutinerne måske skal ændres,
hvis der skal opnås bedre tilpasninger og dermed færre drop outs.
Statistikken taler for sig selv. Dårlig visus og manglende komfort er årsag til at mange kontaktlinsebrugere
dropper ud og finder andre løsninger på synsproblemerne.
Non wearers
2
25