Over the period 2012-2014, Zed Marketing conducted multiple qualitative research projects with Eye Care Professionals (ECPs: i.e. opticians, ophthalmologists and optometrists) and consumers (glasses wearers) in France, Spain, Germany, Switzerland, China, the U.S. and Canada. From these, Zed Marketing was able to gain an understanding of consumer awareness and ECP management of preventive eye care to feed into impactful and relevant communication recommendations.
We live in a visual society, but the eye is not number one
“Good vision is a part of good health, being safe and avoiding danger.” (U.S., 27, female) 
The eye is a highly complex organ that allows us to see and understand the world around us. Vision has always been important and is becoming increasingly so in today’s society, where even our mobile telephones have become more visual than audio.  Consequently, the loss of sight is the number one health fear in the U.S., higher even than HIV/AIDS or cancer.  Despite this importance placed on being able to see, the eye is often overlooked as a part of the body that cannot be protected or get ill in the same way as other organs.
To prevent an issue from happening is the best way to look at health; I do whatever I can to implement preventive measures.
“Honestly, the health of the eye is something I just don’t think about, it’s not as important as my heart or my circulation.” (France, 51, male) 
When things go wrong with our sight under the age of 40 it is thought to be due to ‘bad genes’. Everyone is then aware that from the age of 45 or so, our eyesight starts to worsen. Presbyopia is accepted as inevitable and there is often little thought or question as to what could potentially be done to prevent, slow down the onset or the rate of deterioration.
Challenging perceptions of how the environment affects our sight
In more developed countries, consumers are only just beginning to consider additional exogenous factors and the impact it can have on the health of their eyes.
Ultra violet (UV) is the main offender, and is widely known already due to its noxious effect on skin.  However, the dangers associated with UV and its exact impact on eyes are often not clear and are under-
estimated. As a consequence, prevention against UV is currently often limited to wearing sunglasses on sunny days. The idea that UV can also affect the eyes on a day-to-day basis is often ignored.
Asia leads the way against Europe in terms of awareness and understanding about UV issues and related eye damage (a subject matter which has been widely reported about in Asian media).
“UV protection is very simple, therefore no excessive description is needed. This is because everybody knows the damage that UV does to eyes.” (Optometrist, Taiwan)
Globally, a dependence on technology and an increase in the number of hours spent looking at screens have raised concerns about ‘visual fatigue’ and the short term symptoms. Glasses-wearers are also beginning to notice that use of certain electronic devices for extended periods may be negatively affecting their visual performance in the long term.
“Before we used to read only books, now we are using all sorts of vision that never existed before.” (Canada, 30, female) 
Consumers in Asia are generally more anxious about ‘waves’ (radiations) in general, living in countries that rely heavily on technology and that have seen a drastic increase in the number of myopic children. 
Coupled with bad pollution in cities, this health-threatening environment has encouraged people to find strategies to try and avoid blue light (BL) damage with many anti-BL products available on the market. 
“It’s all those screens: too much TV, computer and playing on iPad.” (China, parent of a myopic child) 
Increased awareness about UV, BL, and the rise in the use of technology have started making people question the fragility of the eye and its health, before its unavoidable ageing.
Nonetheless, other than regular visits to an eye doctor, there would appear to be a general lack of awareness as to what should or can be done to keep the eye ‘healthy’.
“I see my doctor and use eye drops for dry eyes. What else is there left to do?” (France, 46, female) 
ECPs: currently control and correct
The earlier preventive measures are taken, the more beneficial and impactful the effect can be.
Even if it may contribute to ‘healthier’ eyes, the act of going to see an ECP is often more reactionary than proactive. People currently do not think of going to see an eye doctor unless they require corrective glasses/contact lenses or have a problem with their eyes. For this reason, all eye care professionals are perceived by people as helping to correct vision and solve eye issues, rather than offering any preventive benefits.
This belief is further underpinned by the ECPs themselves (especially opticians and optometrists), as even though in Europe and USA they are fully versed in UV damage, some are not always able to pinpoint the exact damage that can occur.  As a result, talking about the more abstract long-term benefits of protecting against UVs to their customers can prove to be challenging. At the time of our studies (2012, early 2013), only ECPs in Asia felt comfortable talking about BL to consumers to warn them of the dangers. 
Focus on prevention
Prevention has become a focus of health strategies in many countries, especially those with growing ageing populations. Changes are also happening in the attitudes and perceptions of individuals, all encouraging signs that eye health may soon be taken more seriously. Two consumers groups in particular emerge as being more engaged in the health of their eyes: women and those over the age of 50.
Over 50: prepared to help prevent
With age, many people start to suffer from their first health issues, with certain diseases known to become more common. 50 is often used as a milestone for someone to take stock of their health and, where necessary, consider some healthy changes.
This can include a change in diet, increasing exercise and other preventive measures such as taking vitamins or getting regular health checks. Those over 50 are often proactively looking as to how they can stay healthy and avoid serious illnesses, and this too would seem to extend out to their eye health.
“To prevent an issue from happening is the best way to look at health; I do whatever I can to implement preventive measures.” (France, 62, female) 4
Over 50: more aware of what can go wrong
AMD is like Alzheimer’s of the eye, you lose your vision little by little, and it must be awful!
The over-50s have a better general awareness of eye-related diseases (especially Age-Related Macular Degeneration (AMD), glaucoma and cataracts).
“AMD is like Alzheimer’s of the eye, you lose your vision little by little, and it must be awful!” (France, 55, male) 
This is thanks firstly to national disease awareness campaigns (which are sometimes directed specifically at this age group) inviting them to take self-diagnosis tests or to visit a doctor; and secondly, people over 50 have more experience of peers who have already been directly affected.
AMD is also becoming a much talked about topic, its incidence rate increasing with ageing populations. 
Over 50: more aware of what is going wrong
For many, the onset of presbyopia is the first time in their lives that will require them to wear corrective glasses. As they become aware of something happening to their eyesight, they are, by association, more concerned about the overall health of their eyes.
Women: avoid ageing at all costs
Women are more readily open to the idea of prevention as they have already integrated it for another organ: their skin. They are aware of and are often taking specific measures to slow down and prevent premature signs of ageing on their skin. The negative impact of UV on skin in this respect is well known, so the need to also protect eyes against UV light damage is more intrinsic for women. Inclusion of an AR or anti-UV coating can be an important criterion of lens choice for women. 
Women: the importance of being seen (by an ECP)
Women visit health care professionals more often than men  and are more likely to seek out preventive care.  This may be due to women being more likely to report poorer health  or because, as women are often responsible for their family’s health, it is in their best interest to stay healthy. This means that preventive health care measures are generally more top of mind.
“My grandma has AMD, I want to be sure that I have my eyes checked as often as possible.” (Canada, 44, female) 
Men, on the other hand, seem to have lower awareness about health problems and are more reluctant to go to the doctor. 
ECPs: moving towards prevent and protect
Good vision is a part of good health, being safe and avoiding danger.
ECPs, too, are thinking more preventively, as they now have better options that they can propose to consumers. Whilst prevention has always been considered more within the remit of ophthalmologists, opticians are also keen to get involved. 
“The optician proposed the [anti-reflective] treatment because I work on the computer a lot and spend considerable time outside as well.” (U.S., 46, male) 
However, going further than offering a preventive solution – and explaining how the use of optical products can help the prevention of premature eye ageing and eye disease – can be a difficult and abstract idea for consumers to accept. 
“Mentioning that the lenses help to prevent eye diseases is not convincing enough. The customers cannot feel the benefit directly.” (Taiwan, optometrist) 
“Glasses only correct vision, I’m not aware of how they could work as prevention.” (France, 58, female) 
Looking to the future
As positive as it may be that certain groups of society and ECPs are increasingly concerned about preventive eye health, some key questions remain.
Firstly, how to engage men, non-corrective eye-glasses wearers and most importantly younger generations on eye health matters that are not necessarily top of mind?
The earlier preventive measures are taken, the more beneficial and impactful the effect can be. This is going to be significant in Asia, with their ever-growing number of children with myopia.
Secondly, how to further educate on risks associated with cumulative exposure to harmful light, a non-tangible subject for many consumers, as it is not something that can necessarily be seen? Europe and the U.S. should perhaps look to Asia for guidance and examples on how best to communicate and raise awareness about UV and BL. These questions may become even more important in the global context of today’s screen-society – young people currently spend on average six hours 50 minutes per day looking at a screen  – and this looks set only to increase.
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