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Carla Mack

Addressing Compliance, Cost, and Care Challenges in the Future of Contact Lens Wear
How can we inspire and enable greater contact lens compliance among patients while simultaneously addressing cost concerns? Carla Mack, Global and US Head, Professional Education and Development, discusses potential drivers—and solutions—to gaps in current contact lens offerings for patients and eye care professionals (ECPs).

By Carla Mack, OD, MBA

Throughout my career as an optometrist, I have seen otherwise responsible patients neglect their eye care, whether they knew it or not, for a variety of reasons. Despite being two of our most important organs, our eyes can sometimes become an afterthought to other everyday tasks and health priorities.

Brushing our teeth is a no-brainer. Nightly skincare routines are a mainstay. But timing, tracking, and complying with contact lens replacement schedules is an area where some patients really struggle. In fact, for contact lens wearers, the average rate of non-compliance can be upwards of 90%.1

The operative word here is can. Compliance does not have to be an issue, especially when ECPs educate and empower patients to adopt a lens option that fits naturally into their lifestyle— heightening compliance, addressing cost concerns, and inspiring comprehensive eye health and wellness in the process.

The Key to Compliance: Sync with Established Patient Routines

Contact lens compliance is integral to maintaining eye health over a lifetime. Failing to replace one’s contact lens at the appropriate time means the lens will not perform as well in terms of comfort and vision.2 It’s like changing an air filter in a car’s engine – when it’s working properly, you likely won’t notice it. But if you fail to change it out routinely, you’ll start to see a dip in performance over time.

When patients are non-compliant with their lens replacement schedules, the challenges can stack up – lens functionality decreases, as does patient satisfaction.2-3 As a result, patients can get frustrated by the perceived lack of value from their choice of lens. Meanwhile, higher rates of compliance are associated with better patient outcomes and improved patient retention.3-4

But why are patients non-compliant? Most often, it boils down to their scheduled routines – and the fact that their contact lens replacement schedule can be harder to remember. By understanding patients’ common activities and lifestyles, lens selection and replacement schedules can be aligned to improve compliance.

Weighing the Costs

Nine out of ten ECPs believe daily disposable SiHy lenses are better for their patients overall** and can help to mitigate compliance issues and improve overall outcomes.5 Eight out of ten optometrists agree that when it comes to contact lens replacement schedules, shorter is a better choice for patients.6-7*

A daily lens change schedule is easy to remember and integrate into life, and compliance is shown to be highest for dailies, among all disposable contact lenses.2,8

However, more than half of new patients are still being fit in reusable lenses, and eight in ten of these reusable wearers are choosing them for a very specific reason — lower cost.5,9

Exploring the Link Between Intuitive Habits, Open Dialogue, and Enhanced Care

While ECPs typically fit two-week lenses as a compromise between more frequent lens change and cost concerns, many patients find two-week lens replacement schedules difficult to remember.2,8 This can create a catch-22 of compliance or cost. However, if we can address both concerns simultaneously, we have an opportunity to improve eye care for contact lens patients.

In life, there aren’t many things that happen every two weeks. It’s not intuitive or natural to remember that 14 days have passed, and patients don’t often think in two-week terms. Two-week lenses are shown to have the lowest compliance rates among all disposables.2,8

Like brushing our teeth or making our bed, lens replacement schedules are best tied to regular routines. Most habits occur on a daily, one-week, or one-month interval.

As a physician with my own established habits that occur each week — from brunching every Sunday with friends and attending my Wednesday yoga class, to picking up my dry cleaning on Fridays and going to the farmer’s market on Saturdays — I have often considered that a viable solution to some patients’ struggle with contact lens compliance, cost, and care may be as intuitive as a one-week replacement lens. This replacement schedule could provide patients and ECPs with an option closest to a daily disposable, at the more affordable price point of a reusable lens.

As we innovate for the future, we must consider the patient behaviors and decision-making factors driving contact lens satisfaction and outcomes. This approach will enable us to uncover and address gaps in care and further explore new, more affordable technologies that will improve patient outcomes and overall eye health for millions of people around the world.


  1. Donshik PC, Ehlers WH, Anderson LD, Suchecki JK. Strategies to better engage, educate, and empower patient compliance and safe lens wear: compliance: what we know, what we do not know, and what we need to know. Eye Contact Lens. 2007 Nov;33(6 Pt 2):430-3; discussion 434. doi: 10.1097/ICL.0b013e318157f62a. PMID: 17975441.
  2. Dumbleton et al, Patient and Practitioner Compliance With Silicone Hydrogel and Daily Disposable Lens Replacement in the United States Eye & Contact Lens, 2009.
  3. Dumbleton et al. The relationship between compliance with lens replacement and contact lens related problems in silicone hydrogel wearers. Contact Lens & Anterior Eye. 34(5):2011; 216-222.
  4. Dumbleton, K., Richter, D., Bergenske, P., & Jones, L. W. (2013). Compliance with lens replacement and the interval between eye examinations. Optometry and Vision Science, 90(4), 351–358. https://doi.org/10.1097/opx.0b013e318288afcb
  5. Alcon data on file, 2022.
  6. 2023 Global Strategic Insights - Ipsos Market Research.
  7. In a survey of 500 ECPs; Alcon data on file, 2023.
  8. Dumbleton et al, Compliance with Contact Lens Replacement in Canada and the United States, Optometry and Vision Science, 2010
  9. Global CLI annualized Q3 YTD 2022 including Cosmetic. GfK FY 2022 shares for available countries. GfK $ shares used to approximate CLI sell in DD SiHy DD Non SiHy splits; Alcon data on file, 2022.

* Based on a survey of 500 US optometrists who fit contact lenses.

** Based on agreement with the statement “I believe daily disposable lenses are better for my patients overall.”