editor's perspective

Contact Lenses at the End of Their First Full Century

BY JOSEPH T. BARR, OD, MS, EDITOR
November 1999

If you want to get to the contact lens stuff instead of hearing about my "next millennium philosophy," go to the second paragraph now. The truth is, I'm really not interested in this millennium thing. First of all, the next millennium doesn't start until after next year, and the only thing I'm interested in on January 1, 2000 is who is playing who in the college bowl games. I don't plan to store water, buy a new gun, put a bunch of cash in my mattress or worry about my computer working at the beginning of next year, but everyone tells me, including our publisher, that this new year, next century stuff is big and that other publishers are getting excited about it and so must we. So here it goes -- I think there's no better way to discuss where we are with contact lenses than to look at where we've been...

Around 1887, Muller, Fick and Kalt first used glass to make scleral lenses. What a great breakthrough it was when PMMA was finally used in 1939 for scleral lenses! That's over 50 years to get to PMMA scleral lenses. Think about what happened in the next 50 years. Touhy's patent for corneal PMMA lenses, filed in 1948, brought the possibility of acceptable, all-day wear to the masses of potential contact lens wearers. I don't know the data on how many contact lens wearers were on the planet in the early 1950s, but it's likely that there were thousands. Compare that to today's estimated 80 million wearers (30 million in the United States alone)! The progress has been fantastic. Sure, contact lenses don't rank up there with the computer, the automobile or air and space travel in their impact on mankind, but the improvements are truly awesome.

We have come from trying to mix solutions to make gas impermeable scleral lenses biocompatible and putting holes in impermeable plastic lenses to sophisticated polymers that supply all of the cornea's oxygen needs and can be mass produced in any design for spherical, astigmatic, presbyopic and therapeutic needs. Soft and RGP lens development has accelerated since the 1970s and 1980s. The cost of producing a high quality lens in a common prescription has decreased by at least 2 log units. And that's only part of it. The body of our contact lens knowledge has expanded to the point that we know which problems to solve. Eyecare practitioners are far more knowledgeable now about how to fit, prescribe and manage contact lenses and their care. The success of contact lenses in the next century will depend not only on competitive technological advances, such as surgery and medicine for refractive error correction, but also on the further developments of contact lenses and the manufacturers' and practitioners' willingness to make them work. In our next two issues, we'll offer more details on this saga.