In 1963 Dr. Perry Rosenthal founded the Massachusetts Eye and Ear Infirmary's Contact Lens Clinic. One challenge with early contact lenses was that the cornea is the only organ in the body that breathes by taking oxygen from the air and not from the blood; if contact lenses rest on the cornea, they must allow the circulation of oxygen. Dr. Rosenthal solved the problem in 1977, with the "breathable" plastic (actually "gas-permeable polymer") contact lens. Bausch and Lomb purchased his technology in 1983, and today Dr. Rosenthal's "Boston Lens" is the most widely used hard contact lens.

People with corneal injury or disease, however, cannot wear contact lenses which rest on the cornea. The earliest contact lenses, made in Germany of glass in the 1890s, rested on the sclera (the white of the eye); in 1986 Dr. Rosenthal made the first breathable scleral lens that could solve many corneal blindness problems. Since then he has painstakingly perfected his invention, raising the success ratio from 30% to 80%; in 1994 the "Boston Scleral Lens" received FDA approval. So far, it has restored the sight of over 300 patients. Why not more? Because no one has been able to figure out how to make it commercially viable. It costs $6,500 per patient, because each lens must be custom-made and fitted by trained experts. The Boston center is the only qualified training site, and its capacity is limited. Most visually disabled people cannot afford to pay for it, and insurance companies are not forthcoming-though they do pay 45,000 patients annually for eye transplant surgery, 15% of whom (7,000 patients) could be cured by this lens. Commercial firms basically consider the potential market--30,000-50,000 people in the US--insufficiently profitable.

The solution has to come from creative philanthropy. The question is: how can this medical-technology breakthrough be translated into a practical solution for the tens of thousands who are afflicted by this very serious but solvable medical problem? With no commercial path open to him, Dr. Rosenthal in 1992 created The Boston Foundation for Sight, which now funds the provision of these vision-restoring lenses to help the blind to see. You can help with that, and maybe even help solve the strategic problem as well!