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PROS AND CONS OF CONTACT LENS
What is transparent, plastic, about the size of your pinky fingernail, and able to stop traffic when it is lost? Over the last four decades the contact lens has been employed more and more as a substitute for eyeglasses. People with impaired vision often use contacts to conceal their need for visual aid.
Leonardo da Vinci is credited with the original concept of lenses directly in contact with the eyeballs. But his idea lay dormant for several centuries until a Swiss eye doctor prescribed a glass shell in 1887 for a patient with a cancerous eyelid.
Today, refinements and innovations have come swiftly on the heels of each other to render the contact lens of a decade ago obsolete. Recently a lens made by the Dow Corning Corporation has received the approval of the FDA to market the first silicone-based lens for extended wear by cataract patients. The extended wear lens, like others approved by the Federal agency, can be worn for up to a month.
Silicone is a combination of inorganic silicon, the basic component in glass, and organic (carbon-based) materials. Researchers have long believed the material would be ideal for use in contact lenses because oxygen passes freely through it. The eye needs to receive oxygen from the air because the portion covered by the typical contact lens has no blood circulating through it, and the amount of oxygen getting through the lens is a key factor in safety and comfort.
Bausch & Lomb, Inc. and Wesley-Jessen, Inc., a subsidiary of the Schering-Plough Corporation, introduced their 13.5-millimeter bifocal contact lenses in the fall of 1981 but without FDA approval. In January 1982, the agency ordered sales halted until the products could be tested. The FDA says a company trying to sell bifocal soft contact lenses must monitor their use by at least one hundred patients for at least three months to show that they are safe and effective.
Unlike monofocal contact lenses, which are made of round hard glass with equally distributed corrective power, the bifocal lenses are made of soft plastic with separate power ranges. The top of Wesley-Jessen’s almost square-shaped bifocal lens, for instance, is designed for distant sight while the bottom has corrective power for reading, or near vision. These soft bifocals are produced with the same manufacturing process as the monofocals, using the same material and employing the same design. The FDA disagrees with their use, and even in 1984, has refused to allow the marketing of soft contact bifocals.
The Ciba-Geigy Corporation and American Hydron, a subsidiary of the National Patent Development Corporation, are waiting to see what will happen. They are also ready to introduce soft bifocal contact lenses. It is estimated that 35 million Americans are potential customers for such lenses, which could mean a market totaling about 250 million dollars. .
But, like so many other advances of medicine, contact lenses are a mixed blessing. While they grant freedom from annoyances and limitations of spectacles and in many cases provide superior vision, they can threaten the very thing they are meant to help. If improperly fitted or mishandled, contact lenses can harm your eyesight.
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