Contact lenses or eye surgery: the true 10-year cost

“Refractive surgery is expensive.” That is the most stubborn misconception of all. Yet once you line up the real budget for contact lenses and glasses, year after year, the comparison deserves to be laid out plainly. In short: a laser procedure is a one-off expense that, over about ten years, often becomes comparable to, or even lower than, the cumulative cost of contact lenses. Here are the figures, the break-even calculation, and the limits to keep in mind.

Straight answer: what does it really cost?

Key point. In France, and for both eyes, daily disposable lenses come to €500 to €800 a year, and monthly lenses to €300 to €500 including care solutions. At the practice, a laser refractive surgery package for both eyes ranges from €2,500 (PRK) to €3,500 (PresbyLASIK), paid once. Many complementary health insurance policies provide a dedicated allowance that covers part of it; the national health insurance, for its part, does not cover this procedure. Compared with daily disposable lenses, glasses included, the break-even point most often falls between 3 and 6 years; compared with monthly lenses, between 4 and 9 years. Beyond that, surgery becomes the less costly option, but cost is only one criterion among several, and it never decides an indication.

The cost of contact lenses, year after year

The contact lens budget depends above all on how often the lenses are replaced. Daily disposable lenses, the simplest to use, generally come to between €500 and €800 a year for both eyes: a box of thirty units, that is one month for one eye, so two boxes a month for both eyes, costs from around twenty to a little over thirty euros, and there is no care solution to buy. Monthly lenses, like those replaced every fortnight, are cheaper to buy (€220 to €380 a year), but they require a care budget, solutions and cases, of €80 to €120 a year, giving a total often between €300 and €500.

To this must be added a detail many people forget: reimbursement from the national health insurance is marginal, and it is not automatic. It takes the form of an annual allowance of €39.48 per fitted eye, reimbursed at 60%, that is €23.69 per eye per year, and only in six specific medical situations: irregular astigmatism, myopia of at least 8 dioptres, accommodative strabismus, aphakia, anisometropia of 3 dioptres not correctable with glasses, and keratoconus (ameli.fr). Outside these indications, which is to say for the vast majority of wearers, there is no cover at all, and care solutions are never reimbursed.

The national health accounts confirm this at country level. On the single item of corrective contact lenses, €861 million consumed in France in 2024, the national health insurance funds only €5 million, less than 1%. The remainder is split between complementary health insurers, which carry €685 million, and households, which pay €171 million straight out of their own pockets. Contact lenses do not belong to the “100% santé” basket, which in optics covers only spectacle lenses and frames (DREES, Les dépenses de santé en 2024). In practice, most of the expense stays with you or with your insurance policy, and it comes back every year, with no end in sight.

And what about glasses?

A contact lens wearer must also have glasses — for the evening, when an eye is irritated, and because no contact lens should be worn continuously. In France, a complete pair (frame and lenses) receives almost no funding from the national health insurance. Across the country, on the whole of medical optical spending, glasses and contact lenses taken together, it covers only 4%, against 68% for complementary health insurers and 28% paid directly by households (DREES). Since the “100% santé” reform, an offer with nothing left to pay does exist, but it is limited to a defined basket: outside that basket, a pair with single-vision lenses commonly costs a few hundred euros, more for progressive lenses. The frame is replaced every few years, and the lenses change as soon as the correction evolves. Spread over a year, a complete pair replaced every two to three years comes to something in the order of one hundred to two hundred and fifty euros. This “glasses” budget therefore adds to the lens budget: it inflates the cumulative bill on the optical correction side.

The cost of refractive surgery

Refractive surgery is a one-off expense, and its price is stated up front. At the practice, the packages for both eyes are €2,500 for PRK, €3,000 for LASIK, €3,300 for SMILE and €3,500 for PresbyLASIK. The ICL phakic implant, reserved for corrections too strong for the laser, starts at €4,700 for both eyes. That floor price already includes the implant, at the price of the least expensive model. Two items are added to it and are priced on quotation: the supplement for a more expensive implant model, and the anaesthetist’s fees, which are those of a colleague.

What the laser package pays for, and what it does not, deserves to be read closely: it covers the procedure, the operating theatre, the follow-up appointments of the first post-operative month, and a possible touch-up during the first six months if it is medically justified. Billed separately are the pre-operative assessment and the post-operative eye drops, the prescription for which is handed to you on the day of the procedure. The item-by-item breakdown appears on the refractive surgery prices page.

An important point: many complementary health insurers offer an allowance dedicated to refractive surgery, often €200 to €1,000, which reduces what is left to pay by the same amount. The national health insurance, for its part, does not reimburse this procedure: it is not among the procedures it covers, whatever the refractive error being corrected. It is worth checking your policy before deciding: a “refractive surgery” allowance you are unaware of is several hundred euros you give up without knowing it.

The 10-year comparison: the break-even point

The calculation comes down to a single division. Call C the net cost of the procedure, the package price minus whatever your complementary insurer reimburses, and D the annual spending you will no longer have to make. The break-even point T*, expressed in years, is then:

T* = C / D

Take a LASIK on both eyes at €3,000 and a daily disposable lens wearer whose optical budget, glasses included, comes to €600 a year:

• After 5 years: optical correction ≈ €3,000, surgery €3,000. The two cumulative amounts meet: that is the undiscounted break-even point.
• After 7 years: optical correction ≈ €4,200, surgery still €3,000. The gap reaches €1,200.
• After 10 years: optical correction ≈ €6,000, surgery still €3,000. The gap reaches €3,000.
• After 20 years: optical correction ≈ €12,000, four times the price of the procedure. The gap keeps on widening.

Two corrections make this calculation more honest. The first: a euro spent ten years from now does not weigh as much as a euro spent today. Discounting future spending at 3% a year, a rate used here as a convention, for want of an official reference applicable to a household budget, pushes the break-even point back a little, from 5.0 to about 5.5 years in the example above. The second works the other way: if your complementary insurer pays an allowance, it comes straight off C. An allowance of €400 brings the net cost down to €2,600 and the break-even point, still discounted, to about 4.7 years. It is the term that weighs most in the equation, and the one most often forgotten; we devote a whole article to reimbursement by complementary health insurance.

With monthly lenses (around €450 a year, care solutions and glasses included), the break-even point comes later, at about seven and a half years. The logic itself does not change: a contact lens is a cost that repeats indefinitely, surgery a one-off expense. The longer the horizon, the more the equation tips towards the procedure, and the younger you are, the longer that horizon is.

Your profile, not an average

There is not one break-even point, but as many break-even points as there are ways of correcting your sight. A daily disposable wearer and a wearer of glasses only do not avoid the same annual spending, so their calculations are nothing alike. The first two profiles count contact lenses and glasses: a lens wearer has to own a pair, for the evening, in case of a red eye, and because no contact lens should be worn continuously. Counting the contact lenses alone would understate the spending actually avoided. The table below applies the formula T* = C / D while discounting future spending at 3% a year, for a laser package of €3,000 for both eyes and with no complementary health insurance allowance.

The table reads plainly: for someone wearing glasses only who replaces the spectacle lenses just every five years, the financial argument does not hold. Their payback horizon is counted in decades, and budget is not the reason for which such a person should consider a procedure. Conversely, a thirty-year-old daily disposable wearer recovers the outlay before reaching forty.

These ranges remain averages. To run the calculation on your spending — the real one, from your boxes of lenses, your care solutions and your last pair of glasses — and to subtract your insurer’s allowance from the cost of the procedure, the break-even calculator plots the curve for your profile and also tells you when the answer is no.

Beyond money: the “health” cost of contact lenses

Budget is not the only parameter. Wearing contact lenses over the long run is not a trivial matter for the surface of the eye. The main risk is microbial keratitis, a corneal infection which, although rare, can be severe. Its incidence has been quantified, and the gap between daytime wear and overnight wear is considerable. An Australian study of 285 cases and 1,798 controls gives, per 10,000 wearers per year: 2.0 cases among wearers of daily disposable lenses, 1.9 among wearers of reusable soft lenses removed every evening, but 19.5 with overnight wear of soft lenses and 25.4 with overnight wear of silicone hydrogel. In other words, setting these figures against one another, keeping your lenses in overnight multiplies the risk by ten to thirteen depending on the type of lens. Loss of vision itself occurs in 0.6 cases per 10,000 wearers per year, all wear patterns taken together (Stapleton, Ophthalmology, 2008). Another study, on continuous thirty-day wear, and therefore on that same overnight wear, finds an order of magnitude close to those overnight values, at 18 cases per 10,000 (Schein, 2005). Those 18 cases and the 19.5 to 25.4 of overnight wear are not strictly comparable: the populations, the lens types and the years of observation differ.

Over time, this cumulative risk is not negligible. A meta-analysis comparing lens wearers and patients operated on by LASIK reports, at five years, a higher cumulative incidence of corneal infections among lens wearers than among operated patients (Masters, J Cataract Refract Surg, 2017); this is a comparison between case series, not a randomised trial, and it establishes a difference, not a cause. In other words, the two options do not carry the same risk profile: that of surgery is bounded, concentrated on the weeks that follow the procedure; that of contact lenses is lower at each wear, but it comes back every day for as long as they are worn. Add to this a documented fact: a significant share of wearers eventually give up lenses, most often because of discomfort and dryness (Dumbleton, Eye Contact Lens, 2013), a factor that also weighs, in its own way, in the balance.

The limits of this reasoning

An amortisation calculation gives a clean-cut figure, and that is precisely what makes it misleading. Four caveats deserve to be set out before it is used to decide anything.

• Eligibility comes before the calculation. A cornea that is too thin, early keratoconus, an unstable correction or severe dry eye rule the procedure out, whatever the financial equation may say. It is the pre-operative assessment that decides, not the spreadsheet.
• Correcting myopia, hyperopia or astigmatism does not do away with all correction for life. The ageing of the crystalline lens, for its part, runs its course. Presbyopia sets in around the age of forty and may then call for reading glasses: this is the indication for PresbyLASIK, the laser technique intended for doing without them. A calculation run over several decades has to include that residual expense.
• Future spending is a set of assumptions. The price of lenses, the content of your complementary insurance policy, your tolerance of lens wear: all of it moves over ten years. A wearer who would have given up lenses in three years anyway is not saving decades of lenses.
• Surgery carries risks, and so does a contact lens. Both options have a risk profile, simply not of the same shape: bounded and concentrated over a few weeks on one side, low but renewed every day on the other. Neither of the two is neutral, and this comparison belongs in consultation, not in a table.

FAQ

Frequently asked questions

Sources

1. Assurance maladie. Correction de la myopie et suivi de l’enfant myope — « La chirurgie réfractive n’est pas prise en charge par l’Assurance Maladie. » (Refractive surgery is not covered by the French national health insurance.) ameli.fr.
2. Assurance maladie. Lunettes et lentilles: remboursement — annual allowance of €39.48 per fitted eye, reimbursed at 60%, subject to eligible indications. ameli.fr.
3. DREES. L’optique médicale, in Les dépenses de santé en 2024, 2025 edition, sheet 16. drees.solidarites-sante.gouv.fr.
4. Stapleton F, Keay L, Edwards K, et al. The incidence of contact lens-related microbial keratitis in Australia. Ophthalmology. 2008;115(10):1655-1662. PMID: 18538404.
5. Schein OD, McNally JJ, Katz J, et al. The incidence of microbial keratitis among wearers of a 30-day silicone hydrogel extended-wear contact lens. Ophthalmology. 2005;112(12):2172-2179. PMID: 16325711.
6. Masters J, Kocak M, Waite A. Risk for microbial keratitis: Comparative metaanalysis of contact lens wearers and post-LASIK patients. J Cataract Refract Surg. 2017;43(1):67-73. PMID: 28317680.
7. Dumbleton K, Woods CA, Jones LW, Fonn D. The impact of contemporary contact lenses on contact lens discontinuation. Eye Contact Lens. 2013;39(1):93-99. PMID: 23266586.

Further reading

• Refractive surgery prices: the breakdown by technique
• LASIK: procedure and recovery
• SMILE: small-incision surgery
• The pre-operative assessment
• Refractive surgery: what will complementary health insurance reimburse?

Refractive assessment at the Cachan practice · Tel. +33 1 45 47 08 11

In summary

Over the long term, the cost of optical correction weighs heavily: €500 to €800 a year to fit both eyes with daily disposable lenses, to which is added the pair of glasses that every contact lens wearer must have, and the national health insurance funds only a marginal share of it. A laser refractive surgery package, at €2,500 to €3,500 for both eyes depending on the technique, is a one-off expense, likewise not reimbursed, but often partly covered by a complementary health insurance allowance. Compared with daily disposable lenses, glasses included, the break-even point most often falls between 3 and 6 years; beyond that, surgery becomes the less costly option. It also changes the shape of the risk: the risk of the procedure is single and bounded in time, that of lens wear is low but renewed every day. Cost nonetheless remains a secondary criterion: only the medical indication, established after a full assessment, justifies a procedure. Laser refractive surgery is performed at the Clinique Laser Victor Hugo and the ICL phakic implant at the Clinique Sainte-Geneviève, after an assessment at the Cachan practice.

This article is informative and educational in purpose. It does not replace a medical consultation. The practice’s package prices are those in force on the date of publication; the contact lens and glasses budgets are orders of magnitude observed in France. Allowance amounts, waiting periods and cover conditions depend on each complementary health insurance policy and do not constitute insurance advice. Only a personalised assessment can establish an indication and a quote.