LYNDA MCGIVNEY NOLAN is a Dublin-based optometrist and the professional and optometric advisor to the Association of Optometrists Ireland. So who better to ask about who exactly came up with the idea for contact lenses?

“Leonardo da Vinci is credited with the initial concept,” she says, “but it was 1887 before German opthalmologist Adolf Fick constructed and fitted the first successful contact lens.

“They were made of blown glass, covered the whole eye and could only be worn for a couple of hours at a time. The first commercial forms of contact lenses became available in the 1940s.”

Lynda’s father, Denis, was the first optometrist in Ireland to fit these blown-glass contact lenses.

TEARS BUILDING UP

“He went to London in the 1960s to train,” Lynda says. “Prior to that, fitting was only done by specialists and contact lenses didn’t have mass appeal.

“The eye had to be anaestethesized so that an impression of the cornea could be taken using a cup-shaped mould. The lenses, when they were made were difficult to get in and out and there were also problems with tears building up behind them. He often talked about how he had to drill little holes in the lenses to allow fluid exchange.”

A new material called PMMA (polymethyl methacrylate) was invented in the 1960s which allowed contact lenses to fit more snuggly onto the cornea.

“The big problem was that PMMA didn’t allow oxygen into the cornea,” Lynda says. “The cornea relies on getting oxygen from the environment and from your tears so if it’s deprived of oxygen it gets swollen and cloudy and there’s the risk of infection.”

Rigid gas permeable lenses were introduced next – in the late 1970s.

“They were the first really successful lenses. I still have patients wearing them who like them and have little or no problems with them,” she says.

Soft lenses came on the market next and were popular in the 1980s because they were so comfortable to wear.

“They were made from hydrophilic gel material. Because they were soft there was a much bigger chance of bugs getting into the lenses and into the cornea, however. They also ripped more easily and had to be replaced every year and there was a big cleaning procedure with all the older types of contact lenses – steeping, rinsing,neutralising every night and deproteinising once a week.”

The 1990s brought the first generation of fortnightly disposable lenses.

“Initially these were marketed for sleeping in overnight but that idea went out pretty quickly because some nasty infections were seen in the 2000s among people who did sleep with them in. They are still widely available but are not recommended for overnight use.”

DISPOSABLE LENSES

The biggest improvement in contact lenses came with the introduction of silicon hydrogel materials, she says.

“These allowed the eye to breathe better than ever before. They were also more comfortable for people who suffer with dry eyes. Women are particularly prone to dry eyes during period time, pregnancy or in menopause as the cause is hormonal.

“It can be an ageing thing too, for both men and women as the tear cell can be poor. These new lenses had increased oxygen permeability and therefore didn’t dehydrate.”

REVOLUTIONARY

Disposable lenses coming on the market really revolutionised contact lens wear, she believes.

“You can have several options – throw out once a month, every two weeks or every day. Contact lenses are also so much cheaper now. In the 1980s they cost about two months’ salary so if one was lost there was huge drama until it was found.”

MULTIFOCALS

Toric lenses have come in since. These are for people with astigmatism (rugby ball shaped eyeball rather than round).

The latest development is multifocal lenses, she says. “Initially you were only able to get contact lenses for short-sightedness (myopia) but now you can also get them for long-sightedness (needing them for close up work like, for example, reading/threading a needle).

It’s only in the last three or four years that these newer types have come onto the market so there are lots of options for people now.”

So does she think lenses will ever be totally overtaken by laser surgery?

“No, not everyone wants laser surgery – they just don’t like the idea of it, and not everyone is a suitable candidate for it. With contact lenses it’s also easy to change them if your prescription changes over time,” adds Lynda.

JENNY’S STORY

Jenny is 53 and has been an on-and-off contact lens user since she was eighteen. Recently she has found what she’s looking for. She tells us her story:

“I’ve been wearing glasses since I was 11,” she says. “Had laser surgery been available when I was in my 20s, I would probably have had it done but it didn’t exist then. I’ve tried contact lenses at different stages of my life.

“Hard ones didn’t work for me – they were too uncomfortable and I went back to the glasses (or went around short-sighted a lot of the time. Missing buses was a common occurrence).

“I tried soft lenses after that. These had a huge cleaning ritual around them too and you had to build up tolerance – again I more or less gave up on them because of all the bother.

“More recently I’ve found the daily disposables good, wearing them at weekends or days when I’m not doing too much screen work.

“It was the best of both worlds, then, until long-sightedness kicked in a couple of years ago. That upset the seeing applecart again. While I now wear varifocal glasses very successfully (and they don’t have a big dot in the bottom, thankfully) suddenly, even if I wore my contact lenses, I needed over-the-counter reading glasses with them to read the paper. Not good! And it defeated the whole purpose of wearing the contacts in the first place.

“The answer came at my last eye check-up – multifocal contact lenses had come on the market. I now have contact lenses that give me good distance vision and close-up vision as well so I have the option of being glasses free when I choose to be.

“It would be a bit expensive to use them every day and glasses are better during the week when I’m working but having the choice is great. I call them my multifocal marvels.”

S OUT AT ‘SHORT-SIGHTED’ HSE POLICY

Eimear Grennan and Coleman Condron from Rahan, Tullamore, Co Offaly want their son, Cole, to have the best possible chance in life. Born profoundly deaf 11 months ago, Cole had a cochlear implant operation on 7 February in Beaumont and is doing well after it.

One implant is not going to give him the best chance, however. That’s why his parents and others like them have begun a “Happy New Ears” campaign to battle for their children to have bilateral cochlear implants – an implant in both ears.

“The HSE policy of just doing one implant is penny wise but pound foolish, I believe,” says Eimear. “If Cole doesn’t have the second cochlear implant done, he will need speech and language therapy and a special needs assistant at school.

“He will have problems with surround sound and this will also hold him back educationally as he will be exhausted trying to listen with one implant. Stereo sound (having both implants) would mean that he would be able to pick out someone’s voice from background noise.”

International best practice is for both implants to be done at the same time, she says.

Cole being suitable for an implant was a real light at the end of the tunnel, says Eimear. “But without the second implant he will be limited. He will want to be out on the farm with his daddy as he gets older but this will be far too dangerous with only one implant as he won’t be able to tell where the tractor is or where the animals are until it would be too late.”

With the HSE only funding one implant, parents have no option but get it done privately, she says.

“This means you have to travel to the UK for the operation and for two years afterwards for follow-up care (tuning). This makes it next to impossible for parents as affording it is so difficult (an estimated €60,000). Even if you have the money, how would you get the time off work if you’re lucky enough to have a job?”

There are 350 children waiting on a second implant in Ireland, she says.

“The clock is running out for them. In Cole’s case the nerve in his other ear will die before he is five so the implant would then be pointless. The money the Government would save in the long run would be huge as these children wouldn’t need so many supports later on in life.”