Use of this database indicates the user is an Eye Care/Health Care Professional and has read, understands and accepted all the terms of use as outlined in the Disclaimer.

Our kids haven’t been to school – apart from the virtual one – for months now. While they seem to be doing fine, there is a huge question mark regarding ‘dropout rates’ of a significant part of the teenage population. It is not the bulk, but it is ‘an important portion’. On the outer edges of the spectrum, kids seem to drop off the radar as they do not participate (enough) in online classes, and simply don’t get the education they need. What does this do to their lives, their future and our society going forward?


Dropping the Dropout Rate

It may not be the best bridge ever but let me hop from school dropouts to contact lens dropouts. In 1993, Weed and Fonn were among the first to report that after five years of lens wear, approximately one-third of lens wearers had dropped out. What is stunning, is that despite all new developments in lens materials, designs, care solutions etc, the dropout numbers from 25 years ago remain largely unchanged today.

Small reductions in dropout rates can cause significant changes in overall lens wearer base. Simple calculations show that if we could reduce the dropout rate by as little as 3.5% between 2020 to 2040, we could double the number of contact lens wearers in our practices. A specially dedicated session at the GSLS with myself, James Wolffsohn and Lyndon Jones looked at that topic of soft lens dropout, with a particular emphasis on lens fit and lens fit options.

In essence, it comes down to this: first and foremost, we need to define whether we are dealing with standard eye shapes before considering lens options. That is where “Finding NEMOs” comes in, in which NEMOs is an acronym for: “Normal Eye Measured Ocular Surfaces.” In all honesty: in terms of lens fit, there is not all that much that we can do for normal eyes. If we have normal eyes, then it makes much more sense to consider other variables such as material properties (friction, on-eye wettability, water content), replacement frequency, and even lens care systems rather than (just) the lens design or fit.

Thinking Inside ánd Outside the Box

This is when we have to think ‘inside the box’: quite literally. We have better lenses than we ever had; in terms of material (and solution) options, and certainly in terms of replacement frequency (up to daily). It also proves that these standard lenses are good for normal eyes, but they cannot “fit” all eyes. That is where the ‘outside of the box’ thinking comes in: fitting non-NEMOs with extended-parameter lenses and
potentially with pure custom-made lenses. Some companies are now offering affordable custom-made lenses (e.g., in the price range of daily disposables) in a monthly replacement modality that is 100% customized to the topography of a given eye.

If we adhere to this philosophy and take soft lens ‘fitting’ serious again, then based on this alone the dropout rate could be reduced by the aimed 3.5% with the given benefits as described. Isn’t this a good time, while it is hard to fit new patients with lenses, to at least do everything we can to keep our existing patients in lenses? We can be ‘superheroes’ for our existing lens wearers. Looking for a good documentary during the lockdown on school dropouts in America? From the makers of ‘an inconvenient truth’, check out ‘Waiting for Superman’. In these times, every parent is a teacher. And a bit of a superman/women.



This Eef@online series is kindly supported by an educational grant from Contamac

See for more “DROPPING THE DROPOUT RATE’ article in Contact Lens Spectrum

"We can be ‘superheroes’ for our existing lens wearers"

In the series Eef@online
#contact lens #eye #dropouts
@ Lyndon Jones
@ James Wolffsohn
@ Contact Lens Spectrum