About the Lenses

Paul Rose, from Hamilton, New Zealand, is the inventor of ROSE K lenses. When he finished University and started fitting irregular corneas, he realized how complicated it was to find the perfect lens for each patient. Thus, he began the development on the ROSE K keratoconus lens in the 1980s.

Hi Paul! Could you please tell us about your background? Why did you decide to study Optometry?

The year before finishing secondary school, my father who was a secondary school teacher asked me what I wanted to do for a career. I really hadn’t given it much thought but because I loved and excelled in Maths and the Sciences, my immediate response was to reply that I would become a teacher in these subjects, like my father. My Father replied” I think we should look at some other options!” He then arranged interviews for me with 6 Professions. A medical Dr, an Ophthalmologist, an Accountant, a Lawyer, a Dentist and an Optometrist. He assisted me in putting together one A4 sheet of questions which I would ask at the interviews. I remember well the final question: Given your time again, would you choose the same profession? Surprisingly the Optometrist was the only person who said he definitely would, and gave several reasons like good hours, giving people sight was very positive, not being “on call”, good remuneration, qualifications only taking 3 years, amongst a few reasons that I can remember.  

How were your days at university?

The first year at university was a general medical intermediate year, which you could then proceed to several qualifications, such as a Doctor, Vet, Dentist, Optometrist etc. I was able to do this year at my local Massey University in my hometown. By chance an Optometry course was to be introduced at the Auckland University the following year, whereas before this I would have been required to go to an Australian University to get an Optometry qualification. So, it all fell into place very easily and I moved to Auckland for my second University year doing stage 1 Optometry. Contact lenses at that stage were in their infancy, and only bi-curve corneal rigid lenses were fitted. However, the Optometrist (Alan Bott) who ran the contact lens clinic was innovative and particularly motivating, and I related to him extremely well.  In subsequent years we became close friends and he continued to motivate me to develop a contact lens focused practice. So, after graduating I worked for one year in Auckland, completing two other degrees, before Alan rang me and said there was a practice for sale in Hamilton. Within 14 months of graduating, I had my own practice at the age of 21. It opened on July 20^th, 1969, the day the men landed on the moon! A big challenge but looking back no regrets and I was my own boss at a very early age. 

Where does your interest in contact lenses come from?

It became clear that the region I was practicing in had a high Maori population, which also had a high incidence of keratoconus. A recent survey in NZ shows this figure is about 1 in 200, much different to the generally accepted current figure of 1 in 1000. So, I immediately started to see many keratoconus patients. I had very little knowledge of how to fit these patients as I had only fitted two cases in my first year out of university. We had several different keratoconus designs and over a period of about 10 years I started to understand these designs and why some designs worked better at different stages of the disease. So, in the early 80’s I started to design individual lenses for each case and by the mid 80’s had built up a very significant practice and reputation for fitting the irregular cornea. However, this was very time consuming and often I fitted 3 or 4 lenses to get the correct final fit. I decided there had to be a better way to fit these cases, so with a local lab on board, I started to try and develop a model and fitting system which reduced the variables (such as not having to state the secondary curves and optic zone which was confusing for all but very experienced fitters), so that fitters could relatively easily follow “the system” and achieve a reasonable success rate even if they were not experts. After 12 different designs, I finally came up with a design I was confident with, and it was introduced to the NZ market in 1990 and very quickly became accepted widely by NZ Optometrists so within a year of being launched had become the most widely used keratoconus design in NZ. About a year later I was approached from an Australian lab for distribution in Australia, and then a lab in the USA so by 1995 Rose K was selling in several countries. I then formed Rose K International with a close friend and together we received FDA Approval to market the design in the USA. That was the start and from there the design moved to the UK and Europe so that today it is now sold in over 90 countries. Never in my wildest dreams could I have ever predicted this. 

What was the beginning of ROSE K lenses like? What was your motivation?

I have probably covered some of this off above, but my main driver was to make keratoconus fitting much easier than it currently was and this would lead to less remakes and significantly reduced chair time for fitters and patients. Keratoconus was fitted typically only by a few experts throughout NZ whereas I wanted any fitter who could fit a corneal lens to be able to fit keratoconus. Happily, I can now say that I have achieved this goal in NZ and although we still have some expert fitters who end up dealing with the most complicated cases, most practices in NZ fit keratoconus, so patient access has significantly improved as we are a country with a low population which is spread out over a land mass similar to the UK. 

The development of these specialty contact lenses must have been a very interesting journey; could you please talk about it? What challenges did you face?

Certainly not a quick fix and this happened over about 6 years. I struck several obstacles along the way which at times made me give up for a year or so. Secondary curves in the early 80’s were polished on by hand which lead to many variable results. I was looking for micron changes and repeatable lenses but was unable to get this simply due to the way lenses were manufactured at that time. However, this all changed in 1989 when the local lab invested in a computer lathe, the first in NZ. This changed everything and I was able to make small changes which were repeatable. It only took about a year then to finalize my design. 

Now that you can see the results of your efforts, how do you feel?

Very blessed. How satisfying for me to know my designs are assisting people throughout the world to see better and hopefully then be able to live normal lives. I still receive today some lovely emails from both patients and fitters which have kept me motivated over the last 25 years to continue to produce new designs for different types of irregular cornea even though I know each time I do a new design it will only be applicable for a smaller and smaller percentage of irregular corneal fits. The original design ROSE K (1) was designed for oval cones which represent around 60 to 70 % of all irregular corneas, whereas the ROSE K2 NC design for example will only be applicable for a maximum of around 10% of fits. 

And today, what’s your motivation?

I enjoy designing lenses and doing the trials on new designs on patients who typically have failed with other options. It is very reinforcing for me to be able to succeed in getting these patients able to wear lenses. Typically, they are very difficult patients to achieve a successful fit on, so if I can get them able to wear lenses this is very motivating. 

Could you please tell us a bit about your future plans? 

Continue to be a consultant to assist fitters and labs around the world using my designs and to have a complete range of lenses so that nearly all cases of irregular cornea can be fitted from one of my designs.