The fraction 20/20 is one eyecare practitioners and patients have been familiar with since Dutch ophthalmologist Hermann Snellen established the visual acuity standard in 1888. Looking at those same numbers in a different form, here's the direction researchers and companies see the contact lens industry headed for by the year 2020 -- a mere 20 years into the future.

Retinal sensitivity mapping. Former Wesley Jessen president and current chairman of the National Eye Research Foundation is 82-year-old Newton Wesley, O.D. He's been an optometrist for some 60 years and says, "Software will make all the difference. I believe the industry will add retinal sensitivity mapping to its technology to better understand the rod-cone relationship to vision." This, he adds, is a natural step from topography measurements of the cornea.

Myopia on rise. "The number of myopes will keep on increasing due to our lifestyles and increased near work," comments ortho-k's co-founder Chuck May, who has been practicing and performing research to reduce and eliminate myopia for nearly 40 of his 52 years as an optometrist.

Comfort and hybrid lenses. B&L's Dom Ruscio predicts a "revitalization of the contact lens industry that will be driven by comfort, and the benefits of extended wear will develop hybrid soft contact lenses."

Adds Ruscio, "The importance will be on maintaining ocular health, of course, and will be based on the biocompatability of the lens surface to have the eye feel as if it is not wearing anything." This, he believes, will be accompanied by high oxygen permeability soft lenses with consideration for movement and design of that contact lens.

Old and young. The contact lens wearer base also will increase, predicts B&L's Gary Orsborn, O.D. at both ends of the age spectrum. He says the market will expand by the year 2020 when the ratio will increase from 4:1 to 2:1 for those aged 25-64 to those 65 and older.

Bifurcated market. Ciba Vision's Worldwide Lens Business Unit President Stuart Heap says, "The market will be bifurcated because patients want the daily convenience of being able to sleep in extended wear contact lenses without any lens care and those who want to wear a daily lens."

Education role. Vistakon sees education as a key role for vendors in the future, providing such sources as a speakers' bureau at optometry schools, setting up new O.D.s with trial lenses, and add more CE to its Web page for practitioners.

Web doctors. Ciba's Heap adds that consumer education will also be critical. "We will become 'Web docs' to educate the 70 million Internet users who currently seek health care information."

Globalization. Globalization is now closing the information gap as we move from walls to Web sites. Manufacturing labs and companies apply the findings of worldwide research, as well as the resources of other markets.

They're also expanding beyond contacts. Both Ciba Vision and Vistakon are affiliated with pharmaceutical magnates. Some RGP manufacturers are producing soft contact lenses as well, while others in the industry have branched out into spectacle lens and ophthalmic surgical lens manufacturing.

Experts say the contact lens industry will follow other business trends in the 21st century, which will include more mergers and acquisitions. While the contact lens market is clearly focused forward on the coming millennium, it's also important to note that several pioneer contact lens practitioners are still providing optical care... after some 50 years in practice. And, just as important, they are now joined in those pursuits by their second- (and sometimes third-) generation optometric children.

The cycle continues. EB