The new "it" contact lenses on the market today are silicon hydrogel lenses. As the word implies, hydrogel is a gel that holds water while silicon allows more oxygen to reach the cornea of the eye, thus preventing eye infections.

Research shows more than 30 million Americans wear contact lenses and the two basic types are rigid gas permeables (RGPs) and soft hydrogel lenses. The new silicon-derivative lenses, which won Food and Drug Administration approval in 2001, hit the market in full force in 2003.
Consequently, some vision benefits analysts and optometrists contend that the anticipated market demand for silicon hydrogel lenses might spark some employers to consider greater flexibility with their vision benefits offerings and allowances.

Market penetration

"About 30% of the market is wearing lens made out of silicon hydrogel, which allows the eyes to breathe better. Therefore, the eye will stay healthier, especially if you want to sleep in them," says Dr. Jack Schaefer, chair of contact lenses and cornea section at the American Optometric Association, a Missouri-based group representing the optometry profession. He adds, "We know that eyes need a lot more oxygen during sleep."

Schaefer further explains that silicon hydrogel lenses are well suited for employees who spend a lot of time at the computer because the material does not dehydrate as much as hydrogel lenses. As a result, the lens wearer tends to blink less and have fewer occasions of dry eyes.

Many optometrists believe silicon hydrogel is a major breakthrough in contacts lenses, especially for extended and daily wear. They also add that clinical advances are underway with bifocal contact lenses created from silicon hydrogel, a development that would greatly increase the use of such lenses, which have gotten thinner over the years.

However, the hi-tech lenses are more expensive than regular contact lenses, but are covered by most vision benefit plans. In some cases, participants might have to cough over, until market prices neutralize and patents expire, additional funds to cover the lenses.

There are about five manufacturers of silicon hydrogel lenses, says Dr. Robert Bass, a VSP network doctor based in Virginia. "Each brand is proprietary and is made a little differently from the other," he says, adding that silicone-based lenses were originally used to protect the eyes of infants who had to undergo eye surgery.

Covering the new lenses

Employers need to be mindful that workers want contact lens benefits that reflect their personal needs and do not restrict them in terms of brand and the type of contacts, says Dr. Gene Sherman, senior VP of business development at AlwaysCare Benefits, a Louisiana-based vision insurance provider.

"When you give people allowances, I think the benefits keep up quite well. The only adjustment is you have to monitor the claims for [silicon hydrogel] contact lens and adapt. The way vision benefits are designed makes it easy to adjust with relative speed to the clinical innovations with contact lens," he says.

Erich Sternberg, president at AlwaysCare Benefits, says rapid and extensive clinical advances in contact lenses may initially increase costs for the consumers, resulting in a slight increase in vision benefits allowances.

"But that gives the consumers a little bit more flexibility because they are buying more complicated lenses that require spending more time at the doctors due to fitting services," he adds. Consumers will get a better result from the product and are more likely to continue to purchase the lenses, "even though there's a little bit higher acquisition cost and more time involved up front."

Research and development units at contact lens companies are always looking to extend their markets and improve contact lenses so that they appeal to more consumers, says Melody Healy, director of commercial marketing at VSP. "Our goal is to always cover the latest and greatest on the market," she adds.

Still, Healy and other visions benefits analysts believe that despite scientific advances in contact lenses, freedom of choice and continuous care are the cornerstones of vision benefit programs.

Businesses want a program where workers can have a good relationship with "a private practice optometrist who can then provide them with the right contact lenses for that patient, giving them full choice and not requiring them to select specific lenses," says Healy.

Mike Colhoun, a vice president at Aon Consulting, however, has a different take.

"Employers are still viewing vision care benefits fairly similarly to how they have been doing it for the last couple of years. They see the value of vision benefits, and we are finding more employers are offering it," he says.

Colhoun believes many organizations have not made the move yet at specifically examining clinical advances and research on eyewear for their members and saying, "We need to enhance our offering because there's been this study, finding or new approval by the FDA."

Employers will mostly likely rely on the advice of vision benefit providers and insurers when it comes to covering innovative lenses.

"That said, I can imagine this coming up more frequently over the next couple of years because employers are moving, overall, medical plans to a consumer-driven environment," Calhoun continues.

"I can see employers wanting to provide the best tools to members, which will lead to the uncovering of enhancements that are available."