So you have just fitted your patient with their first pair of varifocals. You have explained and demonstrated how to use them and no doubt given reassurance that they are welcome to pop back any time should they have any problems. But that is a bit difficult when your patient is soon to be 250 miles away, vertically, orbiting the Earth at 17,500 miles per hour. This was the challenge that faced Marc Alexandre of Essilor and his team in 1994.
Alexandre had harboured the idea of putting Varilux lenses into space as a public relations coup for some time. With the help of Essilor’s US representative, Rod Tahran, and the cooperation of RL Hopping, the optometrist attached to Nasa, he was able to visit Houston in 1985 to fit astronauts with Varilux. The big break came a year later when Alexandre and his team were authorised to supply Varilux lenses to the three presbyopic astronauts among the crew of seven designated for the space shuttle mission due to launch in January 1986: the commander, Francis Scobee; pilot, Michael Smith; and engineer, Gregory B Jarvis.
Alexandre and Tahran used a modified version of the Varilux Pilot lens (Varilux Overview in the US), which had an upper addition to aid viewing of overhead controls, as well as the usual lower portion addition. The standard Pilot lens, designed for use in commercial aircraft cockpits, had an upper addition 0.50D weaker than the lower one. It was determined that the more confined space afforded the shuttle crew required the upper addition to be the same power as the lower one.
Another of the crew was Christa McAuliffe, a civilian, the first to fly as part of the Teacher In Space Program, which ensured that the mission attracted extra media attention. Sadly, the Challenger shuttle mission that launched on January 28, 1986, became famous for the wrong reasons as the craft disintegrated 73 seconds into the flight, killing the entire crew. It was a catastrophe, and the end of Alexandre’s dream, for now.
Second chance
Some years later, Alexandre was discussing his space idea with a friend, Professor Christian Corbé, who was then director of the French air force medical centre that had responsibility for the selection of French astronauts, or spacionauts, in French terminology. The current crop of spacionauts was too young to be presbyopic but, Corbé suggested, Jean Loup Chretien, who had flown two missions with the Russians, might be worth speaking to. Chretien advised that, to get anywhere with the Russians, he should not go through official channels as progress would be glacial. But Chretien was good friends with many of the cosmonauts at Star City, the cosmonaut training centre near Moscow. He could give Alexandre their private phone numbers; all he had to do was to go to Moscow and call them using Chretien’s name as an introduction. Gerard Cottet, CEO of Essilor, gave permission for Alexandre to take a team to Moscow for eight days.
Star city tour
The first two days in Moscow yielded nothing. Phone calls went unanswered, messages unreturned. A trip to a restaurant to raise spirits was called for. Transport was arranged by stopping private cars and negotiating a price with the driver; on this occasion a suitable ride was obtained by the third car they stopped, whose driver also agreed to take them on a sightseeing trip at the weekend. On meeting again, the driver asked the purpose of their visit to Moscow. Once the interpreter had explained, the driver said: ‘How about lunch at Star City?’ At the security gate, the driver spoke with the guards who let him straight through. Soldiers saluted as they drove on. Alexandre wondered who exactly this driver was. With a broad grin, he answered, ‘I am the chief of militia at Star City.’ Lunch did indeed follow, with a tantalising glimpse of the cosmonauts who were in their own restricted area of the canteen.
Frustratingly, the next morning was shaping up to be another day of unanswered phonecalls, when two men appeared at the team’s office asking who this Marc Alexandre was who had been phoning all the cosmonauts. They were Professor Anatoly Grigoriev, the director of a Moscow facility for biomedical research linked with space missions, and his assistant cardiologist. They had never heard of Varilux and were so intrigued to hear about the properties of a progressive lens that the idea of an experiment using cosmonauts found favourable ears. When Alexandre recounted the story of their surprise visit to Star City, the visitors burst out laughing. Alexandre thought this a little odd at the time, but some years later Alexandre mentioned the episode to a Bulgarian journalist friend, who posed the question: ‘Do you think you really chose that driver to transport you?’
Presbyopic cosmonaut
Chretien’s name proved an excellent introduction, as he was highly regarded at Star City, having been the first foreign military candidate to complete the 18-month training programme there and accompany a Russian team on a space mission. Alexandre’s team gained access to 14 cosmonauts for whom they made Varilux spectacles. He was also told that another, Valeri Polyakov (pictured), a doctor and the first civilian cosmonaut, was in Kazakhstan training for a mission that would last more than a year. Alexandre realised that here was an opportunity to study the effects of microgravity on presbyopia over a long period, if he could persuade his boss, Cottet, to allow him back to Moscow to meet Polyakov on his return from Kazakhstan.
Permission granted, Alexandre took with him Christian Corbé, who had met his Russian counterpart several times around the time of Chretien’s mission. Meetings took place at Grigoriev’s Institute of Biomedical Problems of the Russian Academy of Science to agree an experimental protocol for the duration of Polyakov’s stay on the Mir spacecraft. Polyakov had visual acuity of better than 6/5, but required a +2.00D addition for his presbyopia. He was supplied with four pairs of Varilux Comfort lenses with adds of +1.75D, +2.00D, +2.25D and +2.50D to cover possible variations in his presbyopia due to microgravity. Alexandre returned three months later, in December 1993, to check that the spectacles were fitting well and that Polyakov fully understood how to best use them and had adapted to them; in fact he had mastered their use within a couple of days. A monthly follow-up with Polyakov while on board Mir was built into the protocol, as was a small terrestrial control group of presbyopes with similar excellent distance acuity and of the same age as Polyakov. The control group comprised a Russian, an Australian, a Spaniard, a Frenchman and a Norwegian, also followed up monthly. It would be hard to form any hard conclusions from such a small sample size, but it was found that the presbyopic progression of the Earthbound group was slightly faster than Polyakov’s.
Marc Alexandre of Essilor with Valeri Polyakov
Blast off
The mission launched from the Baikonur cosmodrome in Kazakhstan on January 8, 1994. Alexandre returned to Moscow in May, joined by Alain Tixier, the official filmmaker of the French space agency, CNES, who arranged for them to have 12 minutes’ dialogue with Polyakov via the big screen at the Russian mission control centre. Whatever the scientific conclusions that could be drawn from the Varilux experiment, Alexandre had certainly achieved his aim of a publicity coup for Essilor. And he pressed this home by making Polyakov guest of honour at Essilor’s presbyopia symposium in Opio on the French Riviera in June 1995, followed by a European tour taking in Sweden, UK, Belgium, Switzerland, Spain, Italy, Greece and back to France.
Polyakov had spent a record 437 days in space on this mission. The wider significance of his two extended stays in space is that, at a combined 678 days, he logged enough time in microgravity to almost complete a theoretical return trip to Mars. Having studied medicine and then specialised in astronautical medicine, Polyakov had the ideal skills to both act as a subject and to carry out research in space. During his second mission, he oversaw 25 physiological projects that focused on the muscles, lungs, blood, the immune and central nervous systems, and the balance-regulating function of the inner ear. Valeri Polyakov died in September 2022, aged 80. When a manned mission to Mars finally gets under way, those spacefarers will owe a debt of gratitude to Polyakov. Some of them will likely be presbyopes.
- Many thanks to Marc Alexandre for providing detailed information on the Varilux experiment and to Elaine Grisdale for facilitating correspondence with Alexandre. David Baker is an independent optometrist.