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Hard Contact Lenses

 

 

  Hard scleral lenses

 Large 1940s 'haptic' contact lenses in a non-sterile case with rubber suction holder

The first proper contact lenses were large, rigid and complicated to make and insert. Many patients could only bear to wear them for a couple of hours before the irritation became too great. By 1937, however, Ida Mann at the Moorfields Eye Hospital could report patients able to wear carefully fitted lenses for an entire day or longer. Lens fenestration in the 1940s increased wearing time across a wider range of patients and helped avoid corneal oedema. Hard lenses grew smaller over the years and their soft alternative was often preferred from the late 1960s onwards, though even today certain patients will still benefit most from a hard lens such as a rigid gas permeable lens (RGP).

  

1887 F.A.Müller of Wiesbaden (1862-1939), an artificial eye maker, produced and fitted a blown glass contact shell (kontaktschalen) as a protective cover for a patient's eye which had been ravaged by malignant disease. It had a white scleral portion overpainted with blood vessels. The patient was still wearing it twenty one years later.

 

1888 Fick (Zurich) and Kalt (Paris) independently developed optically corrective scleral contact lenses. Fick noted the presence of a type of visual clouding or corneal 'veiling'. Kalt's first lenses were made from segments cut off the bottom of glass test tubes.

 

  Ernst Abbe memorial

 Memorial to Ernst Abbe

on his tomb in Jena

1888 Under the direction of Ernst Abbe (1840-1905), Carl Zeiss Ltd produced some very early glass scleral lenses exploiting improvements in glass technology pioneered by Otto Schott.

 

1889 August Müller (1865-1949) fitted himself with a blown glass lens accurate to within 0.50 D but he had to insert it under water to prevent air bubbles and even using cocaine as a local anaesthetic allowed him to tolerate the lens for only half an hour.

 

1892 Sulzer of Geneva fitted ground Zeiss lenses to patients with high myopic astigmatism and keratoconus.

 

1909 Müller blown glass lenses went into regular production.

  

1914 Siegrist pioneered fitting lenses from stock.

 

1927 Ground glass contact lenses were fitted by R.S. Smellie, working for Theodore Hamblin Ltd under Gerald Wingate in Wigmore Street, London. The lenses were ordered from Zeiss in Germany and took about six weeks to arrive. Smellie is pictured here demonstrating a new apparatus for inserting lenses.

 

  Zeiss fitting set   Dick Smellie   Individually ground lenses
Zeiss fitting set of the 1930s    R.S. 'Dick' Smellie Individually ground contact lenses, 1920s

 

1928 Adolf Müller-Welt applied for a patent for the fluidless blown glass lens.

  

1929 Josef Dallos of Budapest moulded scleral lenses for individual patients from the living subject using 'Negocoll' - a derivative of seaweed.

 

1929 Professor Leopold Heine of Kiel developed afocal lenses, causing their increased popularity. These were preformed ground glass lenses with corneal radii ranging from 5-13mm and scleral curves of 11, 12 or 13 mm. The visual correction was supplied by the liquid 'lens' - a solution of Holocaine 2% saline in warm water. Dallos subsequently refined the design with a third curve to reduce the water volume.

 

1930 Andrew Rugg-Gunn (1884-1972) wrote the first UK paper on contact lenses which appeared in the medical journal The Lancet. He showed an awareness of the then limitations on grinding glass to the right shape. He felt that success with blown lenses was superior but often a lucky accident.

 

         "In the last analysis it is comfort that determines whether a glass shall or shall not be worn"

 

1931 The Western Ophthalmic Hospital in Marylebone started using Zeiss trial sets of afocal spherical lenses with varying corneal and scleral curves after Rugg-Gunn brought a set back with him from Hamburg. Soon the butt of criticism from Ida Mann (1893-1983), they were only partly successful in England where many contact lens-prescribing ophthalmologists preferred to leave the fitting to dispensing opticians. Mann would later be instrumental in bringing Dallos to England. 

 

  Ida Mann   Josef Dallos   Zeiss Haftglas lens
 Ida Mann (1893-1983) Josef Dallos (1905-1979)   A Zeiss Haftglas lens

                        

 

1931 ICI invented ‘Plexiglass’.

 

1931 Professor C.H. Sattler described corneal 'veiling' .

 

1932 Hans Hartinger developed various Zeiss lens designs.

 

1932 K.O. Dunscombe studies at Zeiss in Jena and brings the techniques learned home to the family firm in Bristol.

 

1936 Theodore Obrig of New York introduced lenses moulded from acrylic resin rather than glass.

 

   

  Fluorescein applicators 1963
Fluorescein Test

  

In 1936 Obrig discovered that by introducing a cobalt blue filter into a slit lamp it was possible to illuminate a dye in the eye, thus revealing where the lens rested on the surface and where there was clearance. Dallos, however, did not use the technique, preferring to rely on his own close observation. In this he was unusual. Obrig estimated that the increased comfort that this test made possible would result in making contact lenses a viable option for some 85% of the spectacle-wearing public. It was one of many early predictions of the death of spectacles not borne out by events.

 

1937 The ophthalmic instrument designer C.H. Keeler (1903-1993) and the optometrist Edmund Plaice FBOA of Clement Clarke Ltd studied manufacture and fitting of contact lenses under Professor Weve in Utrecht.

 

1937 Theodore Hamblin Ltd invited Dallos to work in London, founding the Contact Lens Centre in Cavendish Square.

 

1937 Istvan Györffy stays behind in Hungary to continue Dallos' work and makes the first PMMA scleral lens.

  

Glossary:

 

PMMA - i.e. 'perspex'. A hard or 'rigid' plastic, Polymethyl methacrylate was not a purpose-designed lens material and thus had had the disadvantage of negligible oxygen transmission and a relatively hydrophobic surface.

 

1938 Moorfields Eye Hospital opened a Contact Lens Department.

 

1939 The engineer Cyril Winter of C.W.Dixey Ltd made the first lathe for PMMA scleral lenses.

 

1939 On a trip to the USA Frank Dickinson met Keith Clifford Hall on the Queen Mary liner. They went on to become the most distinguished optometrists to fit contact lenses.

 

 

  Edmund Plaice   Dallos Hamblin advertisement Moorfields Eye Hospital CL Dept  
Edmund Plaice  1930s trade advertisement

 Moorfields Eye Hospital Contact Lens Department c.1955

 

Frank Dickinson, FBOA (1906-1978)

  

  Frank Dickinson
This internationally renowned contact lens practitioner (and wearer) from St Annes began studying contact lenses in 1935 and made two research visits to the USA (rather than Europe) before the Second World War. Here he met key figures such as Obrig and Feinbloom. One of the greatest early communicators on the subject, he combined his clinical and professional knowledge with a prodigious output of published work covering some fifty years from 1929 to a posthumous article of 1979.

 

He collaborated with his fellow optometrist Keith Clifford Hall on the first British textbook, An Introduction to the Prescribing and Fitting of Contact Lenses (1946), contributing the more technical aspects to the book. In the late 1940s he was accredited with introducing contact lenses to South Africa.

 

In 1952 he was Founder Secretary of the International Society of Contact Lens Specialists (ISCLS) established in Munich in collaboration with Wilhelm P. Söhnges and Dr John C Neil of Philadelphia, USA. He earned the Contact Lens Diploma of the British Optical Association in 1948 and was President of the Association in 1961. For many years he taught optometry courses at the Manchester College of Technology (now UMIST). On his death his collection of historic contact lenses, cases and other historic material was donated to the BOA Museum.

Keith Clifford Hall (1910-1964)

 

'KCH' pioneered many aspects of contact lens practice. He began fitting them in 1934, three years after qualifying as an ophthalmic optician and established the first UK practice specialising in contact lenses at 139 Park Lane in 1945 later moving to larger rooms next door and attracting an international clientele. He exported his talents to Norway and Denmark on a regular basis. His technique used scleral fitting shells which were modifed with wax prior to machining.

 

  Keith Clifford Hall
He was technical adviser on contact lens matters and lecturer and demonstrator of the fitting and prescribing of contact lenses at the London Refraction Hospital on Newington Causeway (today the Institute of Optometry). With Frank Dickinson he wrote his student text book, contributing the more practical chapters, at the suggestion of the Secretary of the British Optical Association, George Giles, and he incorporated many suggestions and line drawings of Arthur Bennett, then of Stigmat Ltd. (Bennett later became Honorary Assistant Curator of the BOA Museum and the ophthalmic lens collection is named after him). The BOA Museum also contains a number of items associated with Hall. The collection might have been even better but for the fact that Hall lost his entire fitting set in 1941. He set about rebuilding it from scratch, incorporating several examples of the most advanced ground lenses of the 1940s. By 1948 he was predicting both soft lenses and disposable lenses.

 

The museum’s collection is complemented by the BOA Library’s Keith Clifford Hall Collection, a reference collection of books and other literature (including lecture notes) established to commemorate his work. The collection continues to be supported by the BCLA and books received for review in the Association's journal Contact Lens & Anterior Eye are added to the collection.

 

 

1942 C.W. Dixey & Son Ltd announced the perfecting of a grinding technique for plastic lenses.

  

1942 Obrig published the first book on contact lens fitting.

 

1944 Dallos and Bier independently produced fenestrated haptic lenses to combat veiling but Bier was awarded the patent the following year. The fenestration (a small hole) worked by trapping a small bubble of air between the lens and the cornea.

 

1947 Contact Lens Research Group formed at the London Refraction Hospital - early members included Lew Sasieni, Euin Steele and D.W.A. Mitchell who experimented on each other's eyes, taking impressions with the dental material 'Zelex'.

 

1947 Gunther Wingate (later to co-found Omega Contact Lenses) and Norman Bier went into partnership.

 

1947 Wesley-Jessen company founded when George Jessen designed corneal lenses to fit Newton K. Wesley's kerataconus.

 

Late 1940s The manufacturer Newbold & Co Ltd of London would lend out three-part lens fitting sets comprising 73 lenses in all. Opticians could hire the set for a period of four days. In those days only the most specialist contact lens practitioners amassed their own fitting sets.

 

  Newbold fitting set   Kelvin catalogue
 Newbold Fitting Set   Kelvin catalogue

 

1948 Kevin Tuohy in the USA "invented" the corneal lens. (Patented 1950). Keith Clifford Hall was an early British user of the original design.

 

1948 Heinrich Wöhlk produced moulded corneal lenses.

 

 

Kelvin Lenses Ltd

  Kelvin factory
 Kelvin Lenses Ltd factory
  

The proprietor of Kelvin Lenses Ltd, R.K. Watson, designed a lens with a conical transition (developing the 'Feincone' idea of Feinbloom in the USA), making it more a comfortable lens than the Zeiss. An elaborate manufacturing set-up using metal moulds meant that in 1947-8 the company could sell more than 120 fitting sets containing fifty lenses in each set. The tools to make them, all of which were hand polished, included some fifty main tools with fifteen inserts and over a hundred buttons.

 

Kelvin introduced contact lenses to Holland, Belgium and parts of Scandinavia. From its factory in Denton it was also to become the UK's largest manufacturer of corneal lenses because its moulding techniques were more consistent than those to be found in factories using lathes.

 

 

1950 Butterfield of Oregon designed a corneal lens formed to the eye’s shape.

 

1950 Frederick Williamson-Noble (1889-1969), an ophthalmic surgeon, described a practical bifocal contact lens - with a central near zone surrounded by a distance vision annulus. Three years later he was fitted with a pair himself.

 

1950 Clifford Knott became the first travelling representative for a contact lens company when he began such work for C.W. Dixey Ltd.

 

1951 A collaborative effort by three optometrists produced the 'Microlens' - an improved corneal lens due to W.P. Söhnges, of Germany, John C. Neill of America and Frank Dickinson of England. The Microlens was a PMMA lens just 9.5mm in diameter with a single posterior curve and a very small edge bevel. It could thus be fitted some 0.2 to 0.3mm flatter than any other lens hitherto available. Named by Muriel Dickinson the lens was announced to the world in 1953. Later enhancements to the back surface design and modern gas-permeable materials have given us the hard lens of today.

 

1955 John de Carle, London Optometrist, produced a bifocal corneal lens.

 

Glossary:

 

Corneal Lens - A lens resting only on the cornea of the eye;

these days more commonly called simply a 'contact lens'

 

Scleral Lens - A lens resting only on the sclera or white outer portion of the eye. Also known as a 'haptic' lens

 

 

  Peter Madden
A whole generation of British customers (i.e the opticians who would then supply the lenses to the public) received a carnation from Peter Madden who made the flower his trademark. He was a highly successful sales manager for Sphercon from 1957 and later founded Belgravia Optical (1962) and a partnership with the optical technician Randolph Layman (1970). He was also a visiting lecturer on the London Course of Optometry through which many overseas students were introduced to contact lenses for the first time. If you visit the BOA Museum you can see a full colour portrait photograph that used to hang in his boardroom. Note that despite his firm's product he himself was always pictured wearing spectacles.

 

 

 

 


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