Quarter of a century of contact lens prescribing trends in Australia (2000-2024).

Clinical Relevance: Knowledge of contact lens prescribing trends can (a) assist practitioners to benchmark their own prescribing habits, (b) help the contact lens industry understand preferred products, and (c) support academics in scholarly writings.

Background: This work aims to document contact lens prescribing trends in Australia over the past quarter of a century.

Methods: An annual survey of contact lens prescribing trends was conducted in Australia each year from 2000 to 2024, inclusive, by asking optometrists to provide information relating to 10 consecutive contact lens fits undertaken between January and March.

Results: Over the 25-year survey period, a total of 20,281 contact lens fits were reported. Lens wearers were 34.4 ± 14.7 years of age and 65% were female. Over the survey period, rigid lenses increased from 13% to 21% of all lens fits. Of all soft lens fits, silicone hydrogel lenses increased from 22% to 96%; soft torics increased from 24% to 30%; daily disposables increased from 7% to 63%; soft extended wear decreased from 16% to 5%; multifocals increased from 5% to 26%; and myopia control (first fit in 2011) reached 3% by 2024. Rigid lens extended wear (primarily orthokeratology) increased from 0.3% to 17% of rigid lens fits, primarily for myopia control. Multi-purpose lens care solutions are ubiquitous, and peroxide systems are seldom prescribed. Rigid lenses and monthly replacement soft lenses are largely worn full time, whereas daily disposables are worn full time and part time in equal measure. Australian and global prescribing trends are broadly consistent.

Conclusions: Contact lens fitting trends this century can be characterised as: soft lenses - significant increase in silicone hydrogels, daily disposables, torics and multifocals; rigid lenses - dominance of high-Dk materials, and recent resurgence in scleral and orthokeratology fits. There is little extended wear fitting. Multi-purpose care systems are ubiquitous.