We analyzed the prescription rate, based on the type of eyeglasses, and the ratio of the type of accommodative function and divided the data into five 3-year periods from 2008 to 2021. With regard to accommodative function, accommodative spasms occurred only in young men and women in the early periods, but this phenomenon has recently spread through all age groups. In addition, accommodative dysfunctions that we could not classify by a past accommodative diagnosis increased in accordance with the spread of smartphone. The prescription rate of progressive addition lens glasses 30 years or older surpassed 80%, based on recent prescription judgments, and the prescription ratio of prism glasses was nearly 70% in teenagers and adult. Consideration of accommodation and convergence is becoming increasingly important when prescribing eyeglasses for digital device users.

In recent years, soft contact lenses (SCLs) have evolved remarkably in terms of materials and optical design. Use of silicone hydrogel SCLs and daily disposable SCLs has increased worldwide, and the same trend is apparent in Japan, the second largest market in the world. However, most prescriptions in Japan are still single vision SCLs, and there are fewer prescriptions of toric and multifocal SCLs than the global average. This suggests a need to understand the characteristics of SCLs, which are becoming increasingly diverse, to ensure appropriate prescription of these contact lenses.

Orthokeratology (OK) is a treatment for refractive error that involves changing the corneal shape with specially designed contact lenses. In Japan, OK is generally used for myopia correction and control. In some other countries, OK has also been used for correction of astigmatism, hyperopia and presbyopia. A practitioner can adjust and estimate lens fittings more accurately using tear-layer simulation software based on corneal topography data and the values of lens parameters. The developments and new technique in OK are of interest and require attention.

Corneal keratoplasty is often the treatment of choice for cases of contact lens intolerance. However, there are many special contact lenses available around the world, and recent advances in materials and technology have led to many reports on their usefulness. We will discuss the characteristics and prescription methods of hybrid contact lens (HCL) and scleral lens (ScCL) among special contact lenses, as well as the additional ophthalmologic functions expected of special contact lenses in the future. The anticipated additional ocular functions of specialty contact lenses will also be explained.

Technology of contact lenses (CLs) has continued to evolve, and smart CLs have been developed that add value to conventional CLs that correct refraction and presbyopia. Smart CLs with functions such as biomonitoring, drug delivery, and augmented reality are typical examples. Progress with these CLs has been accelerated by developments in electronics, microfabrication, materials, and sensing technologies. I will touch on the current status and potential of this area and consider the future of smart CLs.