Please cite this article in press as: Dumbleton KA, et al. A multi-country assessment of compliance with daily disposable contact lens wear. Contact Lens Anterior Eye (2013), http://dx.doi.org/10.1016/j.clae.2013.05.004 ARTICLE IN PRESS G Model CLAE-628; No. of Pages 9 Contact Lens & Anterior Eye xxx (2013) xxx–xxx Contents lists available at SciVerse ScienceDirect Contact Lens & Anterior Eye jou rn al hom ep age : w w w.elsevier.com/locate/clae A multi-country assessment of compliance with daily disposable contact lens wear Kathryn A. Dumbleton a,∗ , Doris Richter a , Craig A. Woods b , Bente M. Aakre c , Andrew Plowright d , Philip B. Morgan d , Lyndon W. Jones a a Centre for Contact Lens Research, University of Waterloo, Waterloo, Ontario, Canada b School of Medicine (Optometry), Deakin University, Warun Ponds, Victoria, Australia c Department of Optometry and Visual Science, Buskerud University College, Konsberg, Norway d Department of Optometry, University of Manchester, Manchester, United Kingdom a r t i c l e i n f o Article history: Received 8 February 2013 Received in revised form 10 April 2013 Accepted 31 May 2013 Keywords: Daily disposable Contact lens Compliance Replacement Overnight wear Re-use a b s t r a c t Purpose: To investigate compliance with daily disposable contact lens (DDCL) wear and investigate re-use of lenses according to country and DDCL material worn. Methods: Optometrists invited eligible DDCL patients from their practices to participate in a survey on DDCL wear in Australia, Norway, the United Kingdom (UK) and the United States (US). Eligible participants completed an online or paper version of the survey. Results: 805 participants completed the survey (96% online): Australia 13%, Norway 32%, UK 17%, US 38%. The median age was 38 years; 66% were female. Silicone hydrogel (SiHy) DDCLs were worn by 14%. Overall, 9% were non-compliant with DDCL replacement; Australia 18%, US 12%, UK 7% and Norway 4%. There were no differences with respect to sex, years of contact lens wear experience or DDCL material (SiHy versus hydrogels). The primary reason for re-use was “to save money” (60%). Re-use of DDCLs resulted in inferior comfort at insertion and prior to lens removal (p = 0.001). 75% reported occasional napping and 28% reported sleeping overnight for at least one night in the preceding month, while wearing their DDCLs. Conclusion: Non-compliance with replacement of DDCLs occurred in all countries investigated; the rate was highest in Australia and lowest in Norway. Re-use of DDCLs was associated with reduced comfort. DDCL wearers often reported wearing lenses overnight. It is important for optometrists to counsel their patients on the importance of appropriate lens wear and replacement for DDCLs. © 2013 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved. 1. Introduction Daily disposable contact lenses (DDCLs) are becoming increas- ingly popular among patients and eye care practitioners (ECPs) worldwide [1,2]. In addition to the benefits and convenience of a fresh new lens each day and no requirement for a contact lens care system, this modality of lens wear has been shown to offer many health benefits when compared with reusable contact lenses [3]. Superior comfort, vision and relief from allergies have also been reported with the use of DDCLs [4–7]. While very few complica- tions have been reported to occur with DDCL wear when compared with spectacle wear, [8] serious complications have been reported to occur with this modality [9,10]. Unfortunately, not all patients wearing DDCLs are compliant with their replacement. In previous studies conducted in Canada ∗ Corresponding author at: CCLR, School of Optometry, University of Waterloo, Waterloo, Ontario, Canada N2L 3G1. Tel.: +1 519 888 4567; fax: +1 519 888 4303. E-mail address: kdumble@uwaterloo.ca (K.A. Dumbleton). and the United States, non-compliance with DDCL replacement has been reported to occur at rates between 12 and 13% [11–13]; how- ever, the numbers of DDCL wearers in these studies were relatively low and the figures reported may not be representative of com- pliance with wear and replacement of DDCLs in other countries. At the time that these studies were conducted, silicone hydrogel DDCLs [14,15] were not available commercially, and compliance rates for replacement of these lenses has not been investigated to date. The purpose of this survey was to further evaluate compliance with replacement of DDCLs since the introduction of these new materials, and to investigate any differences in compliance with the replacement of DDCL among several countries around the world. The survey was also designed to investigate the reasons for non- compliance; the frequency of overnight lens wear with DDCLs; the regular source of purchase of the participants’ lenses; the lens storage procedures and care system commonly used during non- replacement; an estimation of the participants understanding of the risk of non-replacement; and the reported subjective comfort of DDCLs when they are re-used. 1367-0484/$ – see front matter © 2013 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.clae.2013.05.004