When Henry Ford launched the Model T in 1908, he joked that it comes in any color you want, “as long as you want black.” The Model T was the first mass-produced automobile, and the only way Ford could build it at high volume was to limit consumers’ choices. Contact lenses had arrived 20 years prior, but wouldn’t be mass-produced until the early 1970s. For more than 80 years, they were a highly customized product—what today might be called artisanal or bespoke. They were also highly fragile and fraught with problems. Practitioners had to be specialists to get it right.
Standardization made contact lenses accessible to millions. It also made this clinical service available to thousands of ODs who otherwise might not have had the background and motivation to offer it.
Fast forward to today. Contact lens fitting is under siege by online sellers who interrupt the doctor-patient relationship so they can swoop in with cheap (perhaps knock-off) products. Experts say it’s not that hard to push back if you play up your skills as a contact lens specialist and offer specialty contact lenses that can’t be easily substituted online.
This brings up two questions: what is a contact lens specialist, and what is a specialty contact lens? It’s commonly accepted that a contact lens specialist is someone who can fit GPs, and lately sclerals, plus custom soft lenses—in addition to the mass-market soft lenses.
More problematic is the definition of a specialty lens. It feels like the terminology didn’t keep pace with the technology. Standardization and decades of refinements by manufacturers have made toric and multifocal contact lenses closer to single vision lenses in fitting ease. Granted, they do have limitations that require compromise by the patient—just as Ford’s Model T did—but that enables more people to benefit from them. Yet they continue to get the ‘specialty’ tag. Doing so perpetuates the belief that these are niche applications reserved for those doctors so enamored of contact lens practice as to call themselves specialists.
Enough already. There’s no good reason why these shouldn’t be mass-market lenses. There are millions of astigmats, presbyopes and even astigmatic presbyopes out there. To mentally cordon these people off as ‘specialty lens patients’, as so many still do, sets yourself up for failure and missed opportunities. The barrier to success here is an artificial one, more mental than practical. You wouldn’t call a PAL or a single vision eyeglass lens with cyl ‘specialty ophthalmic lenses’, would you?
Those who receive our publication Review of Cornea & Contact Lenses will see that this month’s issue is our annual compendium of every contact lens product on the market. We’ve given it a clean and colorful new look this year. We also grouped the lenses a little differently, breaking the soft lens listings into two main categories: general use and special use. We intentionally put into the general-use category a few lens modalities that some might be surprised to see there: you guessed it, torics and multifocals. Just go with it—Henry Ford would.