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HomemicontactStirring the Pot… Again

Stirring the Pot… Again

There’s nothing like a robust debate to get people thinking and discussing important issues, especially when it comes to issues surrounding vision care.

Emeritus Professor Nathan Efron COA is well known for stirring the pot. Years ago he predicted the demise of RGP lenses. He even took to the stage in dramatic fashion at the Netherlands Contact Lens Conference in 2010, dressed up as the Grim Reaper and chanting an obituary for rigid lenses. His prediction sparked numerous reactions in a variety of journals and trade magazines that carried on for a number of years. I penned a few articles on the topic that were published in New Zealand and Europe. As mentioned in a recent micontact column, no one was happier than me when Nathan was proven wrong.

Nathan has once again got the dander up among all sorts of contact lens specialists, by questioning the relevance, safety, and efficacy of a variety of contact lens modalities.

He quickly raised the hackles of among others, orthokeratologists, invoking a bit of sledging on social media

In the article, published in the June edition of the Contact Lens Spectrum journal, titled, Current and Future Controversies in Contact Lenses,1 Nathan said, “ …I have always taken great delight in writing controversial editorials and articles. I don’t do this because I am a nasty person, but rather, I like to get colleagues thinking about issues.”

Nathan goes on to say, “I have decided to focus on 10 ‘controversial’ contact lens topics – five of which are relevant to contact lens practice today, and five of which look more to the future. I invite you to mull over these controversies with me.”

Within the gamut of current controversies he asks, “Is contact lens wear intrinsically inflammatory?” He states that orthokeratology (OK) is not worth the bother, questions whether silicone hydrogels are superior to traditional hydrogels, and wonders whether daily disposable wearers only require aftercare every two years.

He quickly raised the hackles of among others, orthokeratologists, invoking a bit of sledging on social media.

I’m not going to get into this in detail as I am sure OK specialists will get stuck in, which is exactly what Nathan wants: robust and healthy debate with evidence to back it up. It seems to me that OK is efficacious and enjoyed by many wearers who love being able to see during the day, free of spectacles and contact lenses. The bonus spin-off of the initially unplanned myopia control benefit of OK seems to be justifiable.

As Nathan says, “Let the debate begin!”

There are some things Nathan and I agree on, in particular the benefit of daily disposables. We do however, strongly disagree on the demise of RGP lenses… Until next time Nathan!


In this hyper connected world, most of us live in places where we take Wi-Fi, mobile coverage, and high speed Internet for granted. Having recently completed 18,000km of travel through the most remote parts of Australia, I can tell you first hand that most of Australia has no connectivity at all. Although we travelled thousands of kilometres parallel to buried fibre optic cables, one could be just metres from the NBN but have no connectivity. Yet just down the road, a mine would have full connectivity. One of the tricks to getting cell coverage is to park on a hill near a mine and piggyback onto their cell tower. It was frustrating not being on the grid as far as work was concerned. Even when we did have occasional cell coverage, it was often a poor 3G connection that made poor quality calls possible, but did not have enough grunt to even load a basic webpage.

On the upside it’s great being off the grid, away from the madding crowd. We didn’t see a single child fixated on an iPad, unlike the majority of kids we see in Sydney and other main centres. Rather, the children in campsites were screaming around on their bikes, swimming in fantastic gorges, and playing outdoors. I guess there’d be less myopia in this cohort…


  1. www.clspectrum.com/issues/2018/june-2018/currentand- future-controversies-in-contact-lenses