Contact Lens History
Leonardo Da Vinci 1608 is credited with the first drawing of a device to alter vision by placing an eye in direct contact with water. In 1823-1827, astronomer John Herschel proposed making a mold of the eye to create a lens that conformed to its shape. In 1887 F. A. Mueller made the first wearable contact lens, called a scleral lens, because it extended on the sclera, which is the white of the eye. In 1888, Eugen Fick, a physician in Zurich, experimented with refractive corneal contact lenses made of glass to be worn.
In the science fiction book Dune, all the people on the other planet have blue eyes, with no white sclera, which is truly fictional.
In 1950, when I was a student in optometry school, I made a mold of my eyes and a plastic scleral lens from that mold. The lens was large and thick, so it was uncomfortable. One of my classmates, Seymour Berek, scratched his cornea putting a scleral lens on his eye and had to go to Cowell Hospital, which lessened my enthusiasm for scleral lenses.
The first corneal contact lenses by Kevin Tuohy were introduced in 1948. They were large and thick and uncomfortable. I had no instruction about these lenses when in optometry school.
My contact lens teacher at the UC School of Optometry was Robert Lester. When I was in practice in 1955, after being discharged from the U S Air Force, I took a course on fitting corneal contact lenses from him.
Merideth Morgan, while lecturing in an optometry course, said there will be many changes and advances after you leave school, so we want to train you to recognize truth and false. One clue is to evaluate the status and reputation of the author. This was an especially good prediction for the field of contact lenses, where many advances came after I left optometry school.
Throughout my practice of optometry, there were new improvements in the material and fitting techniques of contact lenses, which required study of written material and attending lectures. The faculty at Cal were at the forefront of contact lens progress, which was convenient, being in the Bay Area. Two of the best-known teachers there were Morton Sarvser and Michael Harris.
The first corneal lenses were made of polymethyl methacrylate (PMMA), which was a transparent plastic lens, and lenses made of this material were called “hard lenses”. The Tuohy lenses were followed by the sphericon lenses made by the Plastic Lens Company, owned by optometrists Newton Wesley and George Jessen. They were smaller and thinner than the Tuohy lens. At first, when I had a difficult individual patient, I wrote a letter to the Plastic Contact Lens Co. (which later became Wesley Jessen) and received a written answer in the mail, what to do. In time, we learned more about the lenses and how to fit them.
Wesley and Jessen wrote, “For many years, we have looked for a word which would describe the zeal some men (later also women) have for contact lens fitting. We think dedication plays a very important part; the word does sum up the situation very nicely for those who are so enthusiastic and successful in the field of contact lenses”.
Once at a lecture we were standing outside for a break, when David Ewell told us he had just returned from visiting the PCL laboratory in Chicago, and soon he started his Kontur lab in Richmond CA, which created many original and creative lens designs, and introduced and sold a motor driven unit with curved radii tools, to adjust contact lenes in an office.
In 1927, the Mueller-Welt in Canada and then the U.S. developed glass fluidless scleral contact lenses to be worn.
In the 1950’s corneal contact lens laboratories were started by optometrists Solan Braff in Southern CA, Donald Brucker in San Diego, Leonard Seidner in New York, his brother Joe Seidner in Phoenix, Norman Gaylor in New Providence, N.J., Jerry Hofrnstein in Los Angeles, and others across the U.S.. All these pioneers are optometrists. In 1957, there were about 15 to 20 contact lens laboratories in the U.S..
At this time, ophthalmologists had no role in contact lenses and were saying that contact lenses are not safe and are dangerous. Later, when they started fitting contact lenses, they said optometrists were not qualified, and the AMA banned ophthalmologists from teaching in optometry schools. One courageous one was Dr Tamler, MD, who taught eye disease diagnosis at the UC school of optometry, as did one other ophthalmologist. When my mother needed cataract surgery, before implants, I referred her to Dr. Tamler.
In 1958, there was little public awareness of contact lenses. The SMCOS public relations counsel, Joe Barber, organized a contact lens queen contest at the San Mateo County Fair in 1958 and 1959. It was a beauty contest of contestants wearing contact lenses. Joe selected the judges for the event. One of my patients, Mrs. Dubner, was one of the winners. There was good newspaper publicity about the event.s
The COA held an annual statewide contact lens conference in Fresno in the 1960s. Each year featured one nationally known contact lens fitter who would give the lectures, often introducing a new lens design, a new fitting technique, or other research. Most of the guest speakers were diplomates of the AAO, and many were teachers at an optometry school. Speakers included Drs. Neil Bailey, Donald Korb, Maurice Posner, Allan Eisen, Robert Morrison, and Paul Farkas. It was in the summer when Fresno was hot. My wife Carolynn and our children Ron and Diane would enjoy their day at the swimming pool at the motel, while I was at the meeting all day. We had a favorite restaurant located next to the freeway with a sign on a very high pole. Later meetings were held in San Francisco, Los Angeles, and Monterey.
In about 1970, the COA contact lens committee was renewed, Bob Lester was chair, and he asked me to be a member, which I did for 3 years. After 1 year, Roger Kame became chair. Glenda Secore was a committee member. Bob and I were in northern CA Roger and Glenda were in southern CA. We communicated frequently, planned an annual meeting. At one meeting, I introduced Jay Enoch to the large group of optometrists in the audience. He started his lecture about the visual field test for the detection of glaucoma and other diseases, and he surprised me when he used the word dayanu, which in Hebrew means “it would have been sufficient” as in the Passover song. He became Dean of the UCSO from 1980-1992.
Robert Lester (1916-2000) had a practice upstairs in an office building in downtown San Francisco. He started the contact lens clinic at the U C School of Optometry (UCSO) in 1949 and was chief of the clinic until 1962. He continued as a clinician in the clinic at UC and retired in 1996. Michael Harris said Bob had a special knack for making people feel so comfortable in his presence with a smile on his face and a twinkle in his eye. He educated and trained three generations of optometrists to be skilled contact lens practitioners. By example, he also taught them to be kind and caring human beings”. He received many awards from optometric organizations. He wrote papers and gave lectures about fitting contact lenses, many of which taught me. One time, I took his lecture on how to abbreviate writing by a system of omitting all vowels. Once, when Carolynn and I visited Yosemite on the way to a contact lens conference in Fresno, unknown to us, he was also there on his way to Fresno, and our waitress said he wanted to buy us a drink, which he did. I would like to toast his memory now..
Otto Wichterle and D Lim, both PhD in chemistry, in Czechoslovakia, read an advertisement for biocompatible plastic for human tissue replacement, and six months later, they had synthesized the first hydrophilic plastic known as PHEMA, which was flexible, oxygen permeable, and clear. Wichterle in 1955 thought this plastic was suitable for contact lenses; he produced about 100 contact lenses made from molds. Raymond Ewell, a PhD in chemistry, a professor in Buffalo, in 1963, went to Prague and brought back prototype lenses of this new plastic. He sent some to Allan Isen, an optometrist in Buffalo, who went to Prague for more information. In 1964, Raymond wrote a now-famous letter about the plastic to his brother, David Ewell, who was manufacturing contact lenses in Richmond, CA. Allan Eisen had sent samples of the lenses to David Ewell. Robert Morrisons of Harrisburg, PA., was informed of the new HEMA plastic by a French optometrist, Perre Rocher. Robert visited Prague ten times. Robert began fitting his own soft lenses for his patients. Marvin Pollack, an attorney who owned the National Patent Development Corp. with Jerome Feldman, visited Prague and worked on a patent for the HEMA plastic in the U S. He offered it to some small contact lens laboratories who were not interested, but Bausch and Lomb (B&L) was interested.
In 1971, B&L secured a license for the US, made soft lenses of this material, called them the soflens, and introduced a fitting set at a COA convention. I had written a letter to B&L titled “soften your soft lens policy,” which was printed in the COA Journal, which appeared at the same convention and got lots of attention. I felt the number of lenses was too many and too expensive for a practice like mine. However, I bought one of the fitting sets and proceeded to fit these new soft lenses.
The next improvement was gas permeable (RGP) lenses, which were rigid but allowed more oxygen to pass through the contact lens to the eye. They could not be modified in the practitioner’s office. Leonard Seidner developed and marketed the RGP lenses, called polycon, which he later sold to Syntex.
1987 - introduced disposable soft lenses, and in 1996, daily disposable soft lenses, which no longer needed cleaning and were an improvement in hygiene.
2002 - silicone hydrogel contact lenses were introduced, allowing more oxygen through to the eye, better for eye health and comfort.
In an odd turn of events, in the year 2000, the scleral lenses, which had been abandoned in 1955, had new designs and new materials introduced, and scleral lenses were used for specialty fitting of some difficult eye problems.
When I was in optometry school, one basis of the education was that Myopia was not a disease, but was caused by a larger eye size during the growing years. In the 2000s, there was a complete reversal, as myopia was increasing and was an epidemic, and many optometrists started a variety of treatments to reduce it. I still receive Journals and have not seen research to confirm this, only claimed results.
One of the most important events in my career was my participation in the American Academy of Optometry (AAO). An applicant had to submit 10 case reports about patients in the practice and take a written exam. In 1970, I was accepted to be a Fellow of the Academy. A certificate states, “These letters being a testimony that he is qualified in the art and science of optometry”.
In 1973, I became a diplomate of the contact lens section of the AAO. after taking a written examination and a private interview by a panel of other Diplomates. One who interviewed me was Benice Flom, the wife of Merton Flom, who had been my lab partner in the vision training laboratory in optometry school, and who went on to be a professor at an optometry school in Texas. I remember Morton Sarver brought his slides, which he projected and instructed each applicant to identify in writing eye diseases and other items. A certificate is signed by Henry Peters, John Schoen, and Solon Braff. I personally knew 2 of the 3. The certificate states, “Norman G Licht has passed a comprehensive examination in theory and clinical practice given by this section and is being recognized as a Diplomate of this section”. I, with Carolynn, attended some annual meetings of the AAO, held in December, usually in a city near an optometry school: San Francisco, Oakland, Los Angeles, Boston, Columbus, Minneapolis, and Portland. We also went to two smaller group contact lens meetings in Jackson Hole and Quebec City. We also attended conventions of the AAO, held in June: Los Angeles, Houston, Miami Beach, and Oahu.
Through my activity in the COA and the AAO, I met optometrists from many states. I met an optometrist who practiced in New Jersey; he invited me to his son’s bar mitzvah to be held in Israel. Carolynn and I went, and there we met Barry Weissman, who we saw again when he was studying for his Ph d at UCSO at Berkeley. He went on to chair the contact lens department at the Jules Styne Eye Institute at UCLA, and then to the faculty of the Southern CA College of Optometry (SCCO).
The CA state board examination granted a license to practice optometry. My application to the academy was purely voluntary, but the recognition, and by doing so meeting distinguished optometrists from all of the United States, was a very satisfying accomplishment of my career.