History Of The Contact Lens

Brief History of Contact Lenses

Adolf E. Fick, Eugene Kalt and August Müller are credited with simultaneously and independently inventing the corneal contact lens in the late 1880's. Leonardo da Vinci is often cited as being the first individual to develop the concept of a contact lens based on certain sketches this great artist and scientist produced.[1] One author suggests however that the sketches he produced dealt with the concept of image reversal and not the concept of a contact lens.[2]

Others can be considered as having developed the concept of a contact lens. In 1845, the English astronomer Sir John Frederick William Herschell, in a discussion about the correction of corneal astigmatism, considered applying in direct contact with the surface of the eye, a transparent animal jelly contained in a glass capsule. In 1886, Xavier Galezowski introduced using "plaquettes" to cover the corneal surface. These were gelatin squares that had been soaked in mercury chloride and were designed to reduce the possibility of infection after cataract surgery. This might be considered as the first use of a "therapeutic" contact lens.

Adolf E. Fick, Eugene Kalt and August Müller all produced glass scleral shells. Fick called these "Contactbrille" or contact spectacles. Müller called his "Hornhautlinsen" or Corneal Lenses and Kalt was the first to treat keratokonus by utilizing a glass shell approximating the radius of the normal cornea.[3]

Various developments in the optical industry in the early 1900's, especially by the German companies Carl Zeiss and Muller advanced the usage of scleral contact lenses. In 1931, Joseph Dallos determined that tear flow beneath the contact lens was important and published the results of a study of 120 fittings he did. He later added fenestrations at the corneoscleral junction of the lens, which provided for the flow of oxygenated tears to the underlying cornea.

Polymethylmethacrylate (PMMA), developed in 1934, was the first plastic used for corneoscleral lenses. In 1948, Kevin Touhy was granted a patent for a corneal contact lens using PMMA. The Touhy lens fit only on the cornea and not on the sclera. PMMA corneal lenses were the contact lenses of choice throughout the 1950's and 1960's.

A major development in the contact lens field was the production of the first "soft" or "hydrophilic" contact lens material. The first synthesis of a "soft" contact lens material, hydroxyethylmethacrylate (HEMA), by O. Wichterle and D. Lim (Czechoslovakian scientists) occurred in 1954. This was followed by the development of spin-casting of HEMA by Otto Wichterle, (Christmas night in 1961 using his son's erector set). Spin-casting turned out to be an ideal way to manufacture soft contact lenses.

Soft contact lenses were first introduced in the United States in 1971 by Bausch and Lomb who had acquired the rights to spin-casting and HEMA in 1966 from another company, National Patent Development Corporation, who had earlier purchased the rights from the Czechoslovakian government. Bausch and Lomb also researched the HEMA material and developed polymacon, which worked well with the spin-casting method of production. In the interim between 1966 and 1971, the Federal Drug Administration determined that soft (hydrophilic) contact lenses should be regulated. Consequently, the first FDA approved soft contact lens in the United States was introduced by Bausch and Lomb in 1971 under the trade name Soflens®.

The 1970's saw a rapid expansion of the marketplace for contact lenses as a result of the introduction of the soft contact lens. 20/20 Optical Group estimates that the wholesale contact lens market was approximately $800,000 in 1971 and had risen to $480 million by 1979. Therapeutic soft contact lenses (bandage lenses) were introduced in the mid-1970's. The first toric soft contact lenses for the correction of astigmatism were introduced in 1977. In this same year, the first silicone acrylate rigid gas permeable (RGP) lenses appeared. The next two decades saw an explosion of developments in the contact lens field.

In 1981, the first contact lenses for overnight wear (extended wear lenses) were introduced. The first bifocal soft contact lenses were introduced in 1982 (BiSoft® by CibaVision) followed by enhancement tinted soft contact lenses in 1984 (SoftColors® by CibaVision). Advances also occurred in the area of contact lens care regimens, such as the introduction of hydrogen peroxide care systems in 1984. A major new development occurred in 1987 with the introduction of disposable soft contact lenses (Acuvue® by Vistakon). In the late 1980's, a new formulation of fluorosilicone acrylate material for rigid gas permeable (RGP) lenses became available; disposable soft contact lenses were introduced, along with soft contact lenses to change eye color. Also at this time, the first multipurpose lens care products were developed.

Developments in the field of contact lens science continued throughout the last decade. In the early 1990s, planned replacement contact lenses became available on the market along with daily wear two-week replacement lenses. Disposable tinted contact lenses were introduced about this time as well. In the middle 1990's, daily disposable lenses were introduced along with RGP lenses with low silicone content and high Dk fluorosilicone acrylates. The first disposable soft contact lenses with an ultra-violet light absorber were made available in the U.S in 1996.[4]

Contact lenses used to solve a multitude of medical problems continued to be refined over the past decade. Bandage contact lenses first introduced in the mid-70's became more popular as higher Dk materials and disposability made them more practical. In RGP materials, reverse geometry lenses and plateau lenses for corneal transplants and post refractive surgery cases became popular. New lens designs for keratoconus, such as the Rose-K lens, were developed to increase options in fitting irregular corneas.

In the late 1990's new designs in bifocal contact lenses were introduced. Advances in the technology of soft toric contact lenses for astigmatism occurred throughout the entire decade of the '90's. Additional materials, more parameters and new designs all increased the number of patients being fit with toric soft contact lenses. Vistakon introduced a disposable toric soft contact lens, the Acuvue® Toric in 2000.

Direct delivery to the patient of replacement contact lenses, either through companies who provided this service or through the eye care practitioners who provided this option as a value-added service, increased significantly during the 1990's. Also, increased consumer advertising by the contact lens manufacturers occurred via both print and television, especially in the later part of the decade, making consumers more aware of the many contact lens options available to them.

A new concept in extended wear, continuous wear up to 30 nights, was first approved by the FDA in the United States on October 12, 2001. These lenses are made from a new, fluro-silicone hydrogel material that supplies 40 percent more oxygen than the minimum threshold (125 Dk/t) recognized by independent researchers for overnight wear of lenses.



CLAO

The above information is taken from the CLAO Quick Reference on Refractive Science Terminology: Contact Lenses, Optical Dispensing, Refractive Surgery. Copyright 2003, 2004, Contact Lens Association of Ophthalmologists, Inc.