A look back
at the major events and developments in the contact lens industry in 2005 and predictions
for 2006, with emphasis on advancements that have enhanced contact lens vision and
By Joseph T. Barr, OD, MS, FAAO
a great time to be involved in the contact lens field, which grew in 2005. New product
introductions continue at a record pace. There are about 36 million contact lens
wearers in the United States, and they represent about 20 percent to 35 percent
of many practices. New research indicates that contact lens patients are more profitable
for your practice compared to spectacle-only patients we'll bring you more
information on contact lens profits later in the year.
World Market Overview
Globally, approaching 90 percent of lens wearers
wear disposable and planned replacement contact lenses. Daily disposables garner
about 6 percent of wearers, with growth expected in this modality. Only 7 percent
of wearers use conventional lenses, and most of these patients wear their lenses
until they hurt or are lost or torn. GP lenses represent only about 6 percent of
the global market and approximately 10 percent to 13 percent of the U.S. market.
Extended wear, though less complicated than ever, returned mixed sales reports.
Statistics Toric lenses account for about 20 percent of the U.S. market
in sales dollars. Practitioners fit 2.5 percent of the 100 million U.S. presbyopes
with soft contact lenses; half wear monovision and half wear multifocal lenses.
But a 20-percent growth in multifocal sales dollars occurred over last year. The
average age of U.S. contact lens wearers is 38.
Overall, the U.S. contact lens
market grew about 10 percent in sales dollars in 2005. Soft contact lens office
visits were up 18 percent over the end of 2004, and fit and refit visits rose 24
percent over the same time period. Total office visits were up in the first, second
and third quarters of 2005, rising from 5.8 million in the fourth quarter of 2004
to 6.9 million in the third quarter of 2005 (Health Products Research [HPR] data.
HPR is a company that audits eyecare professional dispensing of contact lenses).
New fits and refits went from 3.3 million to almost 4.2 million over the same time
Last year about 2.8 million wearers
dropped out of lens wear in the United States, which was balanced out by about 3
million new fits over the most recent year. Determining how to regain dropouts and
to prevent current wearers from dropping out is a goal for all manufacturers, serious
practitioners and researchers.
Manufacturer Data Johnson
& Johnson Vision Care (Vistakon) led the global market share by company
of the contact lens market in 2005 at about 33 percent; CIBA Vision tallied about
27 percent of the global market share, while CooperVision had about 16 percent and
Bausch & Lomb about 15 percent. In the U.S. market, Vistakon had about 35 percent
of the market share, while CIBA Vision had about 25 percent as did CooperVision
with the acquisition of Ocular Sciences. U.S. contact lens sales at the manufacturer
level are about $1.8 billion of the worldwide $4.5 billion market.
Growth in the Silicone Hydrogel Market
Silicone hydrogel contact lens sales growth is
remarkable. Although silicone hydrogel wearers still comprise a little less than
10 percent of the wearer base, fits and refits grew from 5 percent to 25 percent
According to CIBA, data
just released from the A.C. Nielsen Company reveals rapidly expanding demand for
all types of silicone hydrogel lenses. For the bimonthly reporting period ending
in February 2005, audited U.S. retail sales of silicone hydrogel lenses increased
by 161 percent over the same period the previous year, driving total soft contact
lens sales up 12 percent. Silicone hydrogels accounted for 19.4 percent of soft
lens retail sales, compared to just 8.3 percent in January/February 2004.
The continuous wear segment
of the silicone hydrogel market also continues to expand rapidly, up 41 percent
in retail sales during the first two months of 2005. HPR released data indicating
that silicone hydrogels accounted for 29 percent of new soft lens fits in the United
States in the first quarter of 2005 compared with 17 percent the same time last
Figure 1. Transmittance (%) of B&L's Nike
Maxsight amber lens.
Vistakon launched its Acuvue Oasys
(senofilcon A, 38 percent water) silicone hydrogel lens for daily wear in late August.
On July 11th, CIBA Vision filed a suit against Vistakon regarding Acuvue Oasys for
infringement of its "Nicolson" patents, which the company says protect its Night
& Day and O2Optix contact lens technology. CIBA sought a temporary
restraining order to prevent Vistakon from manufacturing, marketing and distributing
Acuvue Oasys. However, a U.S. district court in Jacksonville denied CIBA's motion
for a temporary restraining order to halt the launch of Acuvue Oasys contact lenses,
and Acuvue Oasys remains available to eyecare professionals. The lens has a Dk of
103 and offers Hydraclear Plus as its internal and surface wettability agent. The
lens absorbs 100 percent of UVB and 96 percent of the UVA light. This two-week replacement
lens has a Dk/t of 147. Meanwhile, Vistakon made much progress with its new Acuvue
Advance for Astigmatism, which features a unique non-prism stabilization design.
Bausch & Lomb's silicone hydrogel
lens is available in the United States once again, following the successful resolution
of a patent dispute with CIBA. The FDA also approved and B&L launched its PureVision
Toric (balafilcon A) contact lens for sale in the United States. It's indicated
for the correction of myopia and/or hyperopia with astigmatism of up to 5.00D and
is designed for monthly replacement. The FDA has approved the lens for either daily
wear or up to 30 days of continuous wear.
Table 1 (courtesy of Carla Mack, OD)
lists the parameters and properties of currently available spherical silicone hydrogel
new Biofinity silicone hydrogel will arrive in the second half of 2006 for daily
wear. Manufactured in comfilcon A, a 48-percent-water, 160-Dk/t material that requires
no surface treatment, parameters of this two-week lens will include an 8.6mm base
curve and 14.0mm diameter. This lens has higher Dk than other silicone hydrogels
of the same water content, and comparative tests show less conjunctival impingement
than some other silicone hydrogels because of its edge design.
Hydrogel Lens Advancements
CooperVision's New Lenses CooperVision
just launched Biomedics XC, a two-week replacement, aspheric, daily wear lens manufactured
in omafilcon A phosphorylcholine (PC) material (60 percent water, Dk 33, Dk/t 44)
and available with an 8.5mm base curve and 14.2mm overall diameter. CooperVision
claims that the new lens fits like its Biomedics 55 UV and 55 aspheric designs.
CooperVision reminds practitioners that this material has an FDA indication for
preventing contact lens-related dryness.
The company also introduced its CooperVision
Biomedics EP, a Balanced Progressive Technology D lens for OU prescribing, manufactured
in the Biomedics XC 60-percent water material for emerging presbyopes with up to
+1.50D add. CooperVision reports a success rate of 92 percent in selected patients
in trials with this lens.
CooperVision also expanded its line
of contact lenses with the new UltraVue PC multifocal toric lens. The new lens is
manufactured in omafilcon A PC material and uses Cooper's Balanced Progressive Technology
D lens for the dominant eye and N lens for the non-dominant eye. The company says
this method enables good stereopsis in toric prescriptions. The lens is available
in made-to-order parameters in single lens vials.
Improved Focus Dailies
CIBA's Focus Dailies contact lenses now feature AquaRelease, a moisturizing agent
comprised of a specific molecular weight polyvinylalcohol (PVA) that releases gradually
into the tear film during wear. The PVA begins to diminish at the end of the day
to ensure patient compliance with the wear schedule. Focus Dailies are made of PVA
(nelfilcon A) material and feature a handling tint.
B&L Gets Sporty
Nike MaxSight sport-tinted contact lenses by Bausch & Lomb are available in
the United States and Europe. The lenses are designed to aid visual performance
by selectively filtering specific wavelengths to reduce glare in sports. The grey-green
tint is designed for sports played in bright sunlight such as golf and running.
The amber tint is designed for fast-moving ball sports such as tennis, soccer and
football. Figures 1 and 2 show the light architecture for the amber tint and the
grey-green tint, respectively. Both tints come in plano or prescription and are
indicated for daily wear.
Menicon Enters Daily Disposable
Market Menicon Co., Ltd. launched its first daily disposable soft contact
lens, Menicon 1-day, in Japan, which is the second largest contact lens market next
to that of the United States. Menicon 1-day is made of ocufilcon D material and
is manufactured by liquid edge molding technology to produce a lens that the company
says provides stability and smooth edges.
Menicon also now offers a complete
line of contact lens care products, with the launch of MeniCare Soft and MeniTears
this past June at the British Contact Lens Association annual conference. MeniCare
Soft with Comfortec is a polyhexanide-based multipurpose solution. Menicon indicates
that the solution provides high antimicrobial activity, low toxicity and excellent
comfort for all soft contact lenses. MeniTears, manufactured by Advanced Vision
Research, is a preservative-free lubricant eye drop, packaged in single doses. The
patented hypotonic formula is approved for all soft, GP and silicone hydrogel contact
lenses. Both products will soon be available in the United States.
Considering that at least 25 percent of the multipurpose
contact lens care solutions that our patients purchase are obsolete, inexpensive
private-label versions, it's now more important than ever to strongly recommend
or even prescribe the lens care brand we want our patients to use. B&L's ReNu
with Moistureloc and Alcon's Opti-Free Express are the market leaders, followed
by AMO's Complete MoisturePlus and CIBA Vision's Aquify. Sauflon Pharmaceuticals
also introduced its All In One Lite No Rub Multipurpose Solution, available only
through eyecare practitioners. All are manufacturer recommended for silicone hydrogel
Figure 2. Transmittance (%) of B&L's Nike
Maxsight grey-green lens.
A new solution that has just become available
is Alcon's Opti-Free Replenish Multipurpose Disinfecting Solution for use with all
soft contact lenses, including silicone hydrogels. This new formulation of the company's
original product contains Tearglyde, a wetting system that the company says keeps
lenses fresh and moist while maintaining compatible disinfection and reconditioning
based on its extensive 927 total patient studies. Tearglyde combines Tetronic 1304
and C9 ED3A to interact with the lens surface and tear film to improve surface wettability
even after 12 hours of wear, according to Alcon.
Much activity has occurred in the area
of contact lens care research including recent findings that both ReNu with MoistureLoc
and Complete MoisturePlus have greater ability to stabilize and retain lysozyme
in its natural state on the lens surface.
Surface wettability competitive data
are proliferating both for contact lenses and for solutions. It's again clear that
contact lenses, especially silicone hydrogels, need to be rubbed to remain clean.
Developments in Ortho-k/CRT and GPs
At the Global Orthokeratology Symposium, Helen
Swarbrick, Dip Opt, PhD, discussed the risk of corneal ulcer from overnight orthokeratology,
which is higher in Asia. Joe Sicari of Paragon Vision Sciences indicated that up
to 20 million people are interested in overnight corneal reshaping if it's priced
under $1,000 while 10 million are interested if it's priced up to $1,500.
Jonathan Jacobson of B&L reported that
motivation for ortho-k varies around the world, with trends toward more interest
in cosmesis in the United States as compared to relatively more interest in myopia
control in Asia. Recent data on minimal retardation of myopia progression with GP
lenses (Walline 2005 and Cho 2005) have not yet spurred the GP field substantially,
but hope remains.
Appearing in 2005
Products International introduced the Naturalens GP dispensing
inventory system. The 120-lens system has VIP (variable inverse
periphery) design in a standard 10.3mm diameter (also available in
10.8mm and 9.8mm), manufactured in Optimum Extra (Contamac, Dk 100)
material. The system allows same-day dispensing of GP lenses.
� Unilens Vision Inc. has added a
custom toric option to its line of soft lenses with the C-Vue 55
Custom Toric in made-to-order powers and axes in one-degree steps,
available with variable replacement in single-, three- and
� Art Optical introduced
Renovation, a lens designed for presbyopes who require add powers of
+2.25D or more. The company says ray-tracing technology enables the
elimination of spherical aberration and ensures proper focus
throughout all ranges of vision. The lenses are available with an
optional six-month warranty.
� Metro Optics released its
ComfortKone lens fitting system six-month guarantee with a 20-lens
fitting set, available for any stage of keratoconus. Metro also
introduced MetroSoft Toric in a planned replacement four-pack
� Paragon Vision Sciences now
offers through various GP labs its plasma treatment to enhance GP
� Con-Cise Contact Lenses launched
New Natural Vision Bifocal with no jump upsweep design with thinner
lenticulation. The company also launched the GBL design with
assistance from Loretta Szczotka-Flynn, OD, MS, FAAO. This lens is
designed for difficult cases of irregular corneal problems and is
available in diameters ranging from 10.6mm to 11.6mm. The lens is
approved for use in Boston EO, XO, EX and Menicon Z materials, and a
reverse GBL design is also available.
� CIBA Vision launched its Cibasoft
Progressive Toric featuring a double slab-off, front-toric design
with a center-near multifocal add.
� PolyVue Distribution Inc.
upgraded its Polyvue Presbyopic System with the addition of its HDX
Progressive soft lens.
� Lagado Corporation's Tyro-97
(hofocon A) GP material is now available for daily wear in
spherical, aspheric, toric and bifocal designs. TYRO-97 is a
fluoro-silicone-acrylate GP lens that features a hydrophilic
surface, according to Lagado. It has a DK value of 97 and a wetting
angle of 23 degrees. The lens can be manufactured in blue, green,
gray, blue-green and clear tints, with or without UV protection.
They're available from custom contact lens labs worldwide.
� Westcon Contact Lens Co., Inc.
launched its answer to contact lens-related dryness in the form of
its Horizon Oasis lens in toric, sphere and bifocal designs. The
hioxifilcon A material has the highest Dk value of any other
hydrogel material, according to Westcon. The company also claims
that the lens remains nearly 100 percent hydrated during wear.
B&L offered eyecare professionals
a Web site (www.bausch.com/vst) that provides online training and certification
necessary to fit the company's new Vision Shaping Treatment (VST) for overnight
orthokeratology. VST is a system involving several ortho-k lens designs fit both
empirically with keratometry or diagnostically with topography and software. The
lenses are made of Boston Equalens XO GP material and come in four designs: BE retainer
(Precision Technology Services, Ltd), Contex OK E-System (Contex), DreamLens (DreimLens,
Inc.) and Emerald (Euclid Systems Corp). Contex offered its own meetings to train
practitioners in fitting overnight ortho-k.
The Contact Lens Manufacturers Association
(CLMA) met in October in Las Vegas. Meeting highlights included a keynote address
by Editor Joe Barr, OD, MS, FAAO, who recommended that CLMA emphasize expanded use
of workshop training on GP and specialty lens use. Earl L. Smith III, OD, PhD, and
Patrick J. Caroline, FAAO, gave an outstanding lecture that focused on the link
between peripheral blur and myopic progression and offered contact lens strategies
New Hybrid Lens Technology
SynergEyes, Inc. received approval from the FDA
to market its SynergEyes A hybrid contact lens for correcting hyperopic, myopic
and astigmatic refractive errors, as well as presbyopia. The new lens is designed
with a high-Dk (Paragon HDS 100) rigid center (8.2mm wide) with a hydrophilic, non-ionic
soft skirt (30 percent water, 14.5mm diameter) to treat ametropia from –20.00D
to +20.00D with up to 6.00D of astigmatism. The company says its HyperBond junction
technology creates a durable interface between soft and rigid portions of the lens,
which has been a problem with previous hybrid lenses.
Investigating Corneal Infiltrates
While reports surfaced that silicone hydrogel
lenses do not seem to reduce the rate of microbial keratitis in extended
or continuous wear but may reduce the severity, researchers from the University
of Manchester examined the incidence of vision loss for contact lens patients who
presented to a hospital with corneal infiltrative events (CIEs). They also looked
at the incidence of CIEs with different lens types and materials. Over a 12-month
period, no patient suffered significant vision loss as a result of a CIE. The researchers
concluded that the risk of developing CIEs is eight times greater for patients who
sleep in their lenses compared with those who wear their lenses only during waking
hours. The study (Efron 2005) also found that silicone hydrogel lenses are the best
option for patients who choose to routinely or intermittently sleep in their lenses
because CIEs are less severe with silicone hydrogels than with other lens materials.
2005 also saw its share of legal battles, legislation
and continuing repercussions from the 2004 Fairness to Contact Lens Consumers Act
(FCLCA). Dk battles are being waged in the marketplace (see Editor's Perspective
on page 13) and silicone hydrogel patent battles are being waged in the courts.
FCLCA and Nonprofessional Sellers
1-800 Contacts CEO Jonathan Coon blames a third-quarter dip in profit margins on
restrictions on contact lens distribution. Mr. Coon specifically mentions a legislative
resolution (See "Senate Proposes Less Restriction on CL Distribution" below) that
the company expected to close what he calls the "doctors only loophole" in the FCLCA.
"The effect on a consumer trying to use a 'doctors only' prescription for purchase
from a non-ECP seller is the same as if the prescription had never been released,"
said Mr. Coon. He further explained that, "Addressing the threat of 'doctors only'
lenses must be our top priority," adding that the company will divert advertising
spending to fund initiatives towards this goal.
1-800 also made claims that the verification
practices of one of its competitors, Coastal Contacts, had also played a part in
the company's declining profits.
The FTC issued a formal warning to
an unnamed leading contact lens seller for violating the FCLCA. The enforcement
action was prompted by American Optometric Association member complaints. FTC's
October warning cites prescribers not having adequate opportunity to respond to
requests by the seller for prescription verification.
Although not named in this statement,
1-800 Contacts has been the subject of many complaints regarding busy fax and phone
lines and autodialer mechanism issues. In related FTC actions in New York and Pennsylvania,
a test shopper program revealed that prescribers were writing prescriptions regularly
and no further action was needed in this test. You can contact the FTC at www.ftc.gov
or by calling (877) FTC-Help (382-4357). Our recent Contact Lens Spectrum
survey indicates that too many prescribers are not filling prescriptions (see December
2005 Editor's Perspective).
Senate Proposes Less Restriction
on Contact Lens Distribution At one time in 2005, pending legislation in
the U.S. Senate would have required contact lens manufacturers to guarantee availability
to alternative suppliers, regardless of whether the supplier is affiliated with
any prescriber. HR 2744 is entitled, "Agriculture, Rural Development, Food and Drug
Administration, and Related Agencies Appropriations Act, 2006." Robert F. Bennett
(R-Utah) had proposed an amendment (S10314) that would prevent the use of any federal
funds for the review, clearance or approval of any contact lens unless the manufacturer
certified that its lenses are distributed in a non-discriminatory manner, directly
to alternative channels of distribution. This would have restricted the FDA from
reviewing any applications from companies that do not make lenses available directly
to all channels of distribution such as mail-order houses, Internet retailers, pharmacies,
buying clubs, and other distribution alternatives.
The author of the proposed amendment
noted that this should not be interpreted as waiving any obligation of sellers under
the FCLCA, which would also have been amended to reflect this change. Under such
new requirements, a prescription would still be necessary for patients to obtain
contact lenses, but manufacturers would have to sell to just about anyone. This
could increase contact lens availability without a prescription.
You may wonder what prompted such legislation.
Certainly it wasn't an interest in increased public health and healthy contact lens
wear. It was certainly economically motivated. At the close of 2005, the legislation
did not contain the mandatory distribution clause but it's believed this
issue isn't dead.
Cosmetic Costume Lenses are
Now Medical Devices A few days before Halloween, the U.S. House of Representatives
passed S. 172, a bill that amends the Federal Food, Drug and Cosmetic Act to protect
patients from eye injuries resulting from the misuse of decorative contact lenses.
The act now carries the stipulation that all contact lenses are medical devices.
The Senate approved the bill in July and President Bush signed it into law. Since
2003, the FDA has issued warnings to consumers and acknowledged receiving reports
of corneal ulcers, infections and loss of vision associated with decorative lens
B&L, CooperVision and other manufacturers
are offering lenses that reduce spherical aberration. Look for more wavefront correction
lenses to come your way in the months and years to come.
Hydrogel Sphere Properties
To obtain references, please visit
and click on document #122.
Dr. Barr is a professor and associate dean
for clinical services and professional program at The Ohio State University College
Contact Lens Spectrum, Issue: January 2006