Letters: May 26

The world's first daily disposables

 In response to Tim Bowden’s letter (May 5, 2006), we would like to thank him for bringing to our attention some of the confusion around launch dates for various products around the world and would like to help clarify the various dates and claims.

The Danalens was launched as a two-weekly replacement extended wear disposable contact lens in Denmark in 1982. The rights to the technology used to manufacture the Danalens were purchased by Johnson & Johnson in 1984 and after years of refinement which included new packaging, new material and lens design, Acuvue was launched around the world from 1987 and initially positioned and promoted as a weekly disposable extended wear contact lens. Hence the statement in the recent Veys & Meyler publication ‘Weekly disposable lenses were first introduced in 1987 by Johnson & Johnson Vision Care (Acuvue, etafilcon A)’ is correct and accurate.

With regard to daily disposable lenses,1-Day Acuvue was first launched in Omaha and Las Vegas in June 1993 (Optician, June 18 1993). This was followed by the launch in the Western US in August 1994* and then Nationwide launches in US, Japan, Canada*, and UK in February 1995 (Optician, March 3 1995).

This resulted from years of research and $100m of investment in developing new Maximise technology production lines. In fact Johnson & Johnson Vision Care received FDA labelling approval for daily disposable indication as far back as July 1987. No doubt there can be some confusion when different dates appear in the literature but this is usually due to different launch timings for different markets around the world.

In 1990, Philip Mullins authored an article ‘Hands-off technology’ (Optician, September 7 1990) and the process of combining manufacturing with packaging was described as developed by Bill Seden and Ron Hamilton. Award plc then announced in June 1992 that it was holding talks with UK, US and Japanese companies interested in manufacturing and/or distributing a daily disposable lens (Optician, June 5 1992). Award plc stated it would be ready to produce and distribute lenses in Autumn 1994 and the ‘Premier’ lens was being sold by 20/20 Optical shop in London in 1994 (Optician, November 25 1994) followed soon after by Boots Opticians (Optician, March 31995).

World’s first claims are normally based on when products are launched and made commercially available to prescribing eye care professionals and consumers as opposed to when production lines are set up and the first product produced. Just as it is well accepted that the first silicone hydrogel lenses were launched in 1998 even though production and testing of various iterations would have happened many years before this, it remains accurate to say that 1-Day Acuvue was launched and made commercially available to eye care professionals and consumers before any other daily disposable in the world.

In fact, following the purchase of Award plc by Bausch & Lomb, a press release confirmed that ‘Award launched the world’s first (sic) daily disposable contact lens outside the USA in September 1994’ (Optometry Today, February 26 1996) which acknowledges that the Premier daily disposable lens was not the first daily disposable lens in the world to be launched commercially to eye care professionals.

It is hoped this letter helps to clarify the timings for the availability of various products in different parts of the world.

*Mertz G, Development of Contact Lenses Chapter. Hamano & Kaufman Corneal Physiology and Disposable Contact Lenses. Published by Butterworth Heinemann, 1997.

John Meyler
David Ruston
Bracknell




The dangers of 'click to fit'

I read with interest your April 21 article regarding Daysoft selling contact lenses directly to patients and the follow up letter on May 12 from founder Ron Hamilton.

I am a US optometrist and I recently spoke at a series of road shows throughout the UK designed to help independent practices communicate the value of their professional services. As a practice building and management consultant to hundreds of independent optometrists, I advised UK practitioners to ensure they have an internet presence for their patients who desire convenience. However, the Daysoft internet pathway will hurt the optometric profession, not help independent practices as they claim.

Daysoft’s website ‘Brand Matching Feature’ switches patients from their prescribed lenses to a Daysoft product. By clicking on their existing type of contact lenses, patients are given a Daysoft substitute. While the internet can be a great practice building tool, this ‘click to fit’ feature certainly undermines the patient’s ability to ensure they have a proper fitting lens.

To imply that these substitutions can happen this easily flies directly in the face of the professional care and fitting skills needed to ensure long-term patient eye health and safe lens wear. An analogy to other prescribed products illuminates the danger of this approach. Should patients be able to go to a website called www.lower-my-blood-pressure.com and choose a medication different than the one their doctor has prescribed?

While this may serve Daysoft’s needs, it takes the professional completely out of the eye health loop. Practitioners can not justify professional expertise if it is acceptable to switch lens types with no prescription or fitting assessment of the chosen lens. This process devalues the role of the optometrist, especially independent practices that compete on high level services, not low price.

Next, what will happen when a patient who has gotten lenses without a prescription has a problem? Where does the legal liability sit, with Daysoft or their practitioner? Several ethical and legal questions arise when Daysoft pays practitioners. What would happen if every manufacturer switched patient’s lenses without practitioner supervision? The logical conclusion would be contact lens and cornea Armageddon.

Mr Hamilton says by offering lower prices he is helping independents. In real world economics, without a commensurate astronomical uptake in volume of sales, lowering margins never helped any business’s bottom line. Additionally, most patients shop online for convenience, not only price.

Competing on price is a dangerous strategy for independent practices. The deep pockets of large chains will always be able to offer lower prices than private practitioners.

 Having been through regulatory changes in the US in 2003, I can confidently say the way forward for independents is not to devalue the role of the fitter as the Daysoft initiative does. Practitioners add value through their services and by offering the best products for each individual patient.

That is the best way to ensure a thriving independent practice.

Dr Gary Gerber
The Power Practice
Franklin Lakes




Beware offer

 Ron Hamilton’s letter (May 12) at first glance does indeed give a lift to the morale of the small independent. But the offer of rebates for online orders are discretionary for no fixed period. Also those who order direct from Daysoft are building a database for Daysoft consisting of your patients over which you have no control.

I am sure Daysoft have honourable intentions at present but under current trading conditions how long will it last? Independents beware.

Max Davison
Worcestershire/Somerset




Home Vision

Thank you for coverage of my new business ‘Housebound offered “low cost” eye care’ (News, May 19).

Please note, however, that Home Vision Care is not in any way associated with Specsavers. I was a Specsavers joint venture partner from 1991 to 2003 when I left on good terms; I presume that my GOC register entry reflects that.

Since leaving Specsavers I have done self-employed locum work for various opticians including Specsavers and also independent opticians, but I must emphasise that I am not in any way connected with Specsavers and would not wish to create any impression to the contrary.

Chris Gould
Home Vision Care
Prestatyn 




Testing times

Moneo should try harder (Optician, May 12). I do 99 tests in the interest of the patient’s eye health care. It’s the 100th that is eluding me, And boy oh boy, have I not tried? The desperate search for it has given me raging red eyes and the wool provided by these marathon examiners, to pull over my eyes, only hurts.

Ah well. Back to the incomplete ‘routine’ eye examinations. And I thought only the Da Vinci Code was difficult to decode.

Kusoom Vadgama
London NW11