Compared with spectacle lenses, contact lenses are barely of age. The history books report that in the 1920s, some 5,000 pairs of contacts were manufactured -- most by Zeiss in Germany, and only a few in the United States.

Despite early starts and stops with glass lenses in the '30s and early '40s, large-scale successes didn't begin in the United States until closer to 1950. In terms of product introductions, those successes began with the introduction of PMMA material, followed by HEMA, non-HEMA, and RGP materials. Fifty years later, the U.S. market now boasts 33 million wearers and generates $1.5 billion annually in sales.

It's a story that combines researchers who invented advances with suppliers who brought the products to market. For this article, we've spoken to both.

Researcher Contributions

1930s. In 1937, recalls Richard Feinbloom, O.D., president of Designs for Vision, "my father, William, developed a cast contact lens process to make the first plastic lens. I still have the steel dyes he used to put plastic into a press and then into an oven for 12 hours to turn the liquid solid."

1940s and 1950s. In 1946, Doctors Newton Wesley and George Jessen formed their partnership, using a sewing machine for grinding and polishing (see sidebar).

In the ensuing decade, Dr. Wesley's promotion of contacts greatly increased the number of fitting practitioners. So did optician Kevin Touhy's PMMA lens that he introduced in 1948 and received a patent for in 1950. In 1946, 50,000 pairs of contacts were sold in the United States. Just three years later, thanks in great part to these pioneers, sales were 200,000 pairs.

The market had begun to explode and research began in two directions -- hard materials and soft.

Otto Wichterle

Working from his kitchen in Czechoslovakia during the early '50s, chemist Otto Wichterle developed HEMA, a hydrophilic plastic.

And, optometrist Len Seidner's 1950s research was to find a more oxygen permeable material than PMMA to reduce corneal edema. The results? A total of 15 RGP material patents.

1960s. In 1962 Boston O.D. Don Korb's research attributed unsuccessful contact lens fittings to severe corneal edema which caused central corneal clouding (CCC). That same year California O.D.s Stu Grant and Chuck May found myopia reduction among PMMA patients. They began to design and use PMMA lenses for that purpose and originated orthokeratology.

By 1967, Wichterle's equipment was capable of manufacturing a contact lens. The first soft lens patients? He and his wife.

1970s. By 1971, Wichterle's HEMA lens was being manufactured in the United States.

At about the same time, Dr. Korb found that by increasing lid-lens adhesion, he could improve wettability. The Korb Technique soon became the recommended fitting method for PMMA lenses. A few years later, in 1978, his RGP lens design was introduced.

The Supply-Side Story

From 1950 until 1971, PMMA manufacturing labs dominated the contact lens industry. In 1957, according to the Contact Lens Manufacturers Association (CLMA), there were between 15 and 20 labs. While the rigid segment of contact lens materials met practitioners' design needs on an individually designed basis, that segment grew at a slower pace than the soft lens materials companies.

There are currently a total of 200 labs, several of which are owned and managed by rigid lens researchers. That rigid lens market share is now just 16 percent -- with one percent of contact wearers in PMMA and 15 percent in RGPs.

Soft Lens Breakthrough

"A breakthrough in immediate comfort without an adaptation base occurred with Bausch & Lomb's introduction of the first soft lens in l971 after acquiring manufacturing rights to Wichterle's lenses," says B&L's then-chemist Dom Ruscio, who is now director of polymer development.

And one year later? "By January, 1972, there were already $10 million in sales from 50,000 soft contact lens wearers," recalls Gary Orsborn, O.D., director of technical marketing for Bausch & Lomb.

Opaques' Overnight Success

In late 1986, 40 years after its founding, WJ's introduction of soft contacts in opaque colors brought "instant success, making it a major contact lens company in just one year," recalls Dwight Akerman, O.D., director of professional relations for WJ.

It also delivered new patients: "Approximately a third of them were near emmetropic or plano," adds Akerman. Opaques -- which were launched in bifocal format just last month -- have also brought many Hispanic and African-American wearers into the market.

The Disposables Decades

Thanks to innovative technology from Denmark, reproduceability -- that is, the ability to reproduce a lens so it was always the same -- made disposables a possibility.

"It offered patients a healthier and more convenient way to wear affordable contacts," recalls Phil Keefer, president of the Americas for Vistakon, which introduced the first Acuvue -- a disposable minus lens with one base curve -- in 1988.

The contact lens market may be 50 years young, but it has learned some hard lessons along the way. Recalling the disastrous downward price spirals of the '80s, Keefer says: "Creating (and maintaining) a sense of value for patients when they visit the practitioner is critical. That's why discussing the results of the eye exam is so important." And so, agree suppliers, is creating new products that add value...for both practitioner and patient. EB