Dr. J. Wolffsohn, BSc(Optom) MBA

Fitting the normal eye with soft lenses

A review of soft lens types and fitting strategies that can help reduce the dropout rate among soft lens wearers.
It is obvious that dropout in lens wearers is multifactorial and highly complex. Tear film and ocular surface issues such as lid wiper epitheliopathy and meibomian gland considerations all play a role. However, for several of these issues, the eye care practitioner (ECP) has little influence. But the ECP does, to some degree at least, have control over the lens fit, material choice etc. Small reductions in dropout rates can cause significant changes in the overall lens wearer base. Simple calculations show that if the dropout rate could be reduced by as little as 3.5% per year between 2020 to 2040, then the number of contact lens wearers globally would roughly double. Is it possible that ECPs could reduce the dropout rate by that amount just by optimizing lens fit and taking all of is aspects such as care systems, material, frequency of replacement seriously?

ECPs continue to blame factors such as online internet shopping, including ‘simplecontacts.com’ and companies like Hubble, for polluting the lens market. But, to put things bluntly, what is the profession itself doing differently from/more than many of the online ‘services’? Aren’t they just trying an average lens “off the shelf” and seeing if that works? And, in line with this, on what are the fitting fees that ECPs charge their patients actually based?

This session approaches the dropout rate and aims at reducing it, by looking at it from three different angles.
  1. Defining the normal eye and fitting standard frequent replacement lenses - Eef van der Worp
  2. Fitting the normal eye with soft lenses - James Wolffsohn
  3. Material and solution choices for standard frequent replacement lenses - Lyndon Jones


James Wolffsohn is associate Pro-Vice Chancellor of Aston University. He is also the academic chair of the British Contact Lens Association. He is an owner or shareholder of Eyoto, Ltd, Wolffsohn Research, Ltd, and Aston Vision Sciences, Ltd and has received remuneration, research funding, educational grants, or honoraria from Alcon, Atia Vision, Bausch + Lomb, CooperVision, Johnson & Johnson, Novartis, and Scope Ophthalmic.