John invented the first contact lenses designed for extended wear. At the time the extended wear of lenses, i.e., wearing contact lenses whilst asleep, was not considered a risk factor. Hard lens wearers would often keep their lenses in for months on end only removing if dust got trapped. It is an oft held belief that extended wear of contact lenses was never invented by opticians or
manufacturers but by the wearers themselves. Who has never fallen asleep with lenses in or forgotten to remove lenses on occasions? Indeed, the earliest use of a contact lens back in 1887 was for therapeutic use after the removal of the eyelids and the patient wore them night and day.
John was descended from the Huguenots who fled religious persecution in France in theseventeenth century. His father was an accountant with the Mirror Group of newspapers and there was no history of optics in the family. It was, however, his father that suggested a career in optics
and John qualified as an ophthalmic optician (optometrist) in 1945 from the Northampton Polytechnical College, London. As this was just at the end of the war, he had to complete his national service, which he did as an RAF optometrist for two years after qualifying. Here he had a chance to observe eye operations.
After working in a couple of different jobs in optics, John opened a practice in Bond Street, London which he continued to run until it was sold in 2002. As he was not fully occupied when he first opened the practice his thoughts turned to other things and in 1955, he designed a PMMA (Poly Methyl Methacrylate or Perspex) lens with a steeper central radius to give a bifocal effect with the liquid lens giving the reading addition. This was a simultaneous vision design, termed “Bi-Vision”. In 1959 he met with Newton K Wesley in the Savoy Hotel; London after Wesley had tried to patent a
PMMA bifocal but found he had been beaten by three months by John. Together they set up the Sphercon Lens Company, which was to be the UK branch of the Plastic Contact Lens Company of Chicago, founded by Wesley and George Jessen. When the Plastic Contact Lens Company went
public it changed the name to Wesley-Jessen. Sphercon was the main trademark of the Plastic Contact Lens Company.
At about this time John started experimenting with polymers. He had no previous experience, just got some books out of the library. What he wanted to achieve was a plastic with a higher refractive index to make a button so it could be fused to the main lens to form a fused bifocal contact lens.
Having made the material, he then had to devise a way to get it to fuse to the carrier. This he did by including some of the polymer of the carrier into the polymer of the button. Still under employed, his thoughts now turned to contact lens solutions. In about 1965-66 with Bill Muddyman, John Norton and another, who left the company very early on, John started the Contactasol Solutions Company. It must be remembered that, at the time, there were no regulations regarding the making of solutions, materials or lenses. He experimented with the viscosity of the solution by timing equal droplets of his solution and a leading rival down a mirror.
Once satisfied with the viscosity and their formulations, production was started. The solutions were made at home in the kitchen and the bottles were filled on the dining room table. Any sticky residue on the bottles was washed off with cold water in the bath. John Norton was a designer, also with the
Mirror Group, and designed some very stylish boxes and packaging. Initially the solution was sold through John’s practice but eventually it was taken on by Boots the Chemist.
In the late 1960’s, after visiting a friend in the United States, again working at home, John started working to polymerise HEMA (2-Hyroxy-Ethyl-Methacrylate). This is made into buttons and they were lathe cut into soft lenses by Peter Haynes in the laboratory over the Bond Street practice.
As some patients were wearing PMMA lenses overnight without a problem John felt a lens with a similar water content to the cornea would work better. Research in the books at the British Optical Association gave the water content of the cornea at various figures but mainly between 70 and 80
percent. He set to work to try to find ingredients that could be added to HEMA to increase water content. The Bionite lens was being talked about at the time which had a water content of 55 percent. Eventually John was successful and created Permalens with a water content of 70 percent.
Initially the polymers were cooked (heat polymerisation) in the kitchen stove in his flat in Highgate in glass test tubes. Occasionally the glass tubes broke, resulting in polymer baking on the inside of the cooker. This did on one occasion result in a neighbour becoming very concerned that the young
couple should have a gas leak in their flat. The well-meaning neighbour did not realise that the whole block of flats was “all electric” and had no gas! It was found that the glass was difficult to remove from the polymers so later polymerisation was completed in polythene tubes. The tubes were then either cut and the material released or sometimes the material could just be pushed out of the tube. It was then cut into buttons; the final lens being cut by lathe in the lab over the practice. They were not easy to make, the main reason being humidity. If it rained, production became impossible as the blanks were absorbing moisture and becoming softer. Eventually a few good lenses were produced. Oxygen testing was virtually unknown at that time, so the only option was to try them. John was not prepared to try lenses on anyone unless he had tried them first. He wore a pair for two and a half months before removal and, not to be outdone, his wife, Barbara also volunteered. He had his eyes checked by an ophthalmologist friend who reported that all was well.
At a social gathering he met Geoff Galley and eventually both of them got together with a New York ophthalmologist, Miles Gaylin and an American businessman, Roger Zoccallello, who had put up the money, to form Global Vision. The two Americans made some money and got out fairly early on,
which left Geoff and John to work on the Permalens. The monomers were not distilled before use and un-polymerised monomer was still present after
the process. This you could smell when the lens was being hydrated in saline. Initially they soaked lenses in gin, preferably Beefeater Gin as it had no aroma, to swell the lens and leach out the chemicals. Later industrial alcohol was used as it was cheaper. Later still, the monomers were distilled to remove all the impurities but at one stage they found that they had gone too far, and it was too refined. They had removed some ingredients necessary for complete polymerisation, so the lenses started to dissolve in saline and behaved more like chewing gum. This was finally sorted out by re-adding ingredients until the right consistency was achieved. Professor Montague Ruben was very keen on the lens although he was not keen on extended wear.
He was one of the first to highlight the increased risk of microbial keratitis in wearers of extended wear lenses. He reckoned that Permalens gave eight times more oxygen than HEMA. John is not sure how this was measured but Monty was “God” in those days, and you did not ask! John had
noticed that after periods of wear, if the lens was blotted dry, it had a frosty appearance and Monty Ruben identified these deposits as protein. At the time, biological washing powders were new and all the rage. Experiments were set up to see if these would work to clean the lenses. They did work
to an extent, but the lens absorbed too much of the solution and became very uncomfortable afterwards. They settled on the use of enzyme cleaners but did not patent the process simply because they never thought to do so.
John started fitting these lenses in 1971 and the lenses were specified by their dry radius as at that time they had no way of measuring the lenses in the wet state. Since that time, he has fitted extended wear spherical, toric and bifocal soft lenses to patients from all around the world, the average patient wearing the lens for about three months before removal.
Global Vision was bought by CooperVision soon after this. The CooperVision UK of this era was later bought by Pilkington, who were bought by Wesley-Jessen, now CibaVision. In 1978 the Permalens lenses were being made by Knox Laboratories Ltd, Contact Lens Division, at The Firs, Whitchurch,
Aylesbury, Buckinghamshire. Tony Crampin was the marketing manager, R V Jurich (USA) was managing director with P S Golding and A K Nilson also from the USA. Later, the company moved to Solent Industrial Estate, Hedge End, Southampton.
Subsequently, John joined up with Geoff Galley again, and also Ron Poole and Ian McDermott, in the formation of Aspect Contact Lenses. This was a sales company with lenses being made by Precision Contact Lenses, a company run by Geoff and later with lenses supplied by Mike Sealey of MJS, also ex CooperVision.
At about the same time as the work on Permalens, John noticed that certain chemicals would make a soft lens become rigid. He worked on the idea of producing a lens with a rigid centre and a soft edge. He hoped this would be a good alternative to using soft toric lenses. He was not successful in
this although lenses of this type have been produced, such as the Saturn lens, Softperm and SynergEyes.
Before development of the Permalens was started, Galley organised a seminar at the Washington Hotel in Curzon Street, London to check out the safety of the lens and the state of the existing patients. There were hundreds of patients because John had been fitting them for years in his own practice. Invitation letters were sent to all the patients and over two hundred booked appointments to attend the meeting. Several American optometrists and ophthalmologists were also invited to inspect each patient who were asked to complete questionnaires to see what kind of performance they had with extended wear lenses. One female patient, who had worn the same pair of lenses in her eyes for nearly four years, caused great interest as it was thought her eyes might drop out when the lenses were removed! Nothing of the sort happened so Gally and de Carle proceeded with the project.
Some problems did arise however, one being that of deposits. The lenses were developing little white spots which would inflame the palpebral conjunctiva. This was found largely to be due to hairspray which contained poly vinyl pyrrolidone, which reacted with the N vinyl pyrrolidone in the
contact lens and formed deposits.
Eventually extended wear fell out of favour because there were quite a few incidences of problems, especially infections, which could be severe. However – in their first year of FDA approval, revenue for the lenses exceeded $50 million. One of the very early successes was with aphakic patients where the only other option was very heavy cataract spectacles ( this was before the era of successful implants).
When Johnson & Johnson selected the design for its Acuvue Bifocal lens it found, when they tried to patent it, that John had got there before they had. The patent was sold to Aspect, which became part of the new CooperVision. John only received part of the royalties paid by Johnson & Johnson,
the rest being retained by CooperVision. In all John has held twelve patents including the one for Permalens. Of those twelve, he claimed to have only made money from the original bifocal, Permalens and also the multi zone lens later used by Johnson & Johnson with the Acuvue bifocal.
A sign of his inventiveness: –
Sometime in the early 1970’s John had some soft lenses made up with a recess on the front so that the rigid lens could centre better. This was for a patient with an irregular cornea from an industrial injury but John is not exactly sure about the dates or whether he published this. In 1984 he made a
sandwich cosmetic lens for a 20 th Century Fox film being shot in Minich called Enemy Mine in which the aliens had to have cat-type eyes. Sclerals could have been used but the film makers and the actors were not enamoured. He therefore used corneal size RGP lenses, with the colour laminated in the middle, but these tended to move too much on the eye and also rotate. As the pupils had to be vertical, they initially used a girl to manually rotate the lens back in place during the shooting! He tried using 15mm plano bandage lenses underneath the RGP lenses which reduced the movement but still tended to rotate. He therefore fitted another soft lens on top so the actor had three lenses in each eye which worked much better. John presented a paper regarding his recessed soft lens, for the centration of an RGP, then covered with a further soft lens, at the conference of the International Society of Contact Lens Specialists in Venice in September 1985.
In 2007 John was still very active working on a new soft bifocal with a lab who wishes to remain nameless. He felt that this design would improve the low-level lighting response of the Acuvue Bifocal. Initially his new lens was a conventional soft lens but he was in discussions with several manufacturers of disposable lenses with a view to producing the lens as a disposable bifocal lens.