ANNIVERSARY SECTION - 20th
Years of Pursuing Comfort, Vision and Health with CLs
JEROME A. LEGERTON, OD, MS, MBA, FAAO
year 1986 marked a time when the number of new soft lens fits surpassed GP lens
fits, GPC was the leading complication with daily wear soft lenses and the last
nail in the extended wear coffin was about to be hammered home
because of hypoxia-related infectious keratitis. It was also defined by the vertical
integration with DPAs and TPAs in optometry that coincided with changes in the way
practitioners managed lens wearers.
The late '80s framed the trend to reduce the length of follow
up for new fits and to reduce or eliminate the inspection visit after dispensing
a replacement lens. This paved the way for reduced contact lens fees and for the
advent of fulfillment businesses that mail or dispense contact lenses. These events
further coincided with high U.S. inflation rates that altogether impacted the average
profit per contact lens patient.
The next milestone was the advancement of low-cost cast molding
and subsequent launch of disposable lenses. While providing greater convenience
and preventive health benefits, disposable lenses took the inspection visit to extinction
and reinforced alternative delivery systems.
The 1990s were an exciting time in product development. The industry
directed tremendous resources to material science to improve the oxygen permeability
and surface wetting of hydrogel materials. At the same time, care product researchers
focused attention on multipurpose systems to simplify handling and enhance convenience.
The fruit of this research was the commercialization of surface-treated silicone
hydrogel lenses as well as one-step and no-rub care products.
Corneal reshaping gained regulatory approval in the late 1990s
for daily wear. The FDA approved Paragon's Corneal Refractive Therapy in June 2002
for overnight wear, paving the way for providing good vision without surgery, glasses
or waking-hour contact lens wear.
Material science advancement facilitated the development of SynergEyes
high-Dk hybrid lenses that received FDA market clearance in 2005. The GP center/soft
skirt platform is designed for a broad range of refractive errors and indications.
The final, most recent trend is a new emphasis on vision. Technology
advances in adaptive optics and precision manufacturing are ushering in an era of
"super-vision" and the promise of realizing effective contact lens correction of
presbyopia and contact lens control of myopia.
Sharpen Up for the Future
In business it's difficult to separate stimulus from response;
in fact, they dance together. In 1986 lenses were inseparable from prescribers.
The industry took a big swing during the last 20 years to high brand awareness and
direct-to-consumer advertising. Consumers now view lenses as a commodity, pulled
through the practitioner by manufacturer-sponsored advertising.
But the technology milestones appear to be taking the industry
full cycle. The focus on vision is forecast to reunite practitioners with patients.
Vision-enhancing products aren't one-size-fits-all they're more dependent
on practitioner skill and competency.
The line of tension that will define the next 20 years passes
through practitioners. We must sustain age old case history and consultation and
endeavor to connect patients' needs to vision-enhancing products. At the same time,
manufacturers will attempt to mass produce and mass merchandise super-vision. But
in the end, super-vision entails mass-customization, which requires the laying on
of hands by skilled practitioners.
Dr. Legerton practiced in
San Diego for 26 years. He is the Chief Technology Officer for SynergEyes and inventor
for eight refractive surgery and contact lens patents.
Contact Lens Spectrum, Issue: June 2006