Innovation that makes dreams visible

A series of interviews visiting innovative Japanese startups to explore their passion for their ventures and their vision for the future society. For the first installment, Dentsu Inc.'s Yoshihiko Kyoi spoke with two representatives from Universal View, a company making waves in the ophthalmic medical device field, particularly with its vision-correcting "orthokeratology lenses."

We want to empower children who give up on their dreams just because they have poor eyesight.

Kyoi: Universal View is celebrating its 16th year this year. It might be disrespectful to introduce you as a startup, but could you tell us about how the business was launched?

Mikawa: It began in 2001 when I started the company alone. Before that, I worked as a clinical technician at an ophthalmology clinic in my hometown of Yamaguchi Prefecture.

Typically, there are three methods for vision correction: glasses, contact lenses, and LASIK surgery. However, LASIK requires patients to be at least 18 years old. This means some children who dream of careers like piloting, which demand certain levels of uncorrected visual acuity, have no choice but to give up. I witnessed the struggles of these children firsthand in the clinical setting.

Around that time, I learned that orthokeratology lenses, which mold the cornea like bedhead while you sleep, were gaining popularity in the US. This could become a fourth vision correction method, usable even by children. Moreover, since the cornea is a metabolic tissue, studies consistently show that children, with their active metabolism and flexible corneas, respond better to this treatment. Starting early also helps slow the progression of vision deterioration. Since the Ministry of Health, Labour and Welfare hadn't yet approved these lenses as medical devices in Japan, I started an import agency business to help them.

Orthokeratology lenses are contact lenses worn overnight to reshape the cornea, allowing daytime activities without glasses or contact lenses. Universal View's orthokeratology lens "Bless O'Correct" (distributed by Toray) currently holds about 50% of the market share.

Kyoi: I sense a strong conviction in your decision to not stop at import agency work, but to use that as a springboard to start developing lenses specifically for Japanese patients. Domestic approval is a high hurdle, right?

Mikawa: Yes. Final approval came in 2012, but it required hundreds of millions of yen in funding, so it wasn't our initial target. Even as an imported lens, word-of-mouth from doctors and patients spread it to about 70 facilities nationwide within two years. However, as we listened to feedback from the field, we realized the limitations of imported lenses: their materials were hard with low oxygen permeability, and their designs were tailored to Western corneas.

Standing Out by Going Against the Grain in Both Development and Business

Mikawa: What really stood out were the concerns of the patients' parents. With hard lenses, they worried, "What if it breaks while my child is sleeping?" Doctors also felt that domestic approval would allow them to prescribe with greater confidence, reassuring parents. That's why, around 2003, we began considering domestic approval and independent development.

We absolutely needed a specific ideal material that Toray had. Though we were a tiny company, we managed to connect through contacts. When we finally met with the then-Vice President, it was a direct appeal: "For our company to bring this lens to the world, we must have your material. Otherwise, people right before our eyes who want to fulfill their dreams will be left helpless." We got approval on the spot. They agreed to provide the material for a fee for our clinical trials, and development really took off.

Suzuki: I joined around that time, in 2006, when Mikawa was struggling alone with unfamiliar fundraising. I met him through my work in medical investment consulting and was drawn to the business potential and his passionate conviction. Since then, I've handled management tasks like fundraising and building the organization for clinical trials, allowing Mikawa to focus entirely on R&D. Toray has also been an investor since 2009.

Kyōi: Mr. Mikawa, your words consistently convey a strong desire to help people. Orthokeratology is one means, but what Universal View provides is the value of "the dreams that lie beyond simply seeing," right? I think that passion has been directly translated into the business. Earlier, you mentioned "parents." Was targeting children part of the strategy from the beginning?

Mikawa: Yes, that's crucial. Personally, I can't just walk by someone struggling—like someone looking at a station map and seeming lost. I always offer help. But "wanting to help" alone doesn't make a business viable. To strike that balance, you have to think holistically.

Usually, when someone's eyesight improves or worsens, it doesn't really register with those around them. But with children, it's different. A child who used to squint and frown when looking at things will have a completely different expression once their vision improves. Then, the joy of the parents who had been constantly worried is even greater. That's why prescriptions for children yield such high satisfaction. Ophthalmologists receive gratitude, their trust grows, and—though it might sound presumptuous—doctors themselves feel satisfied, thinking, "I'm glad I treated them." This, in turn, helps spread the technology further.

Kyōi: The mechanism of orthokeratology is extremely simple—it's the idea of fitting a mold to the cornea and maintaining it. While many industries leverage technology to evolve their services, offering what might be seen as a "low-tech" solution forces us to consider the true essence of the problem.

Mikawa: Sometimes going against the grain leads to standout solutions. I believe this is crucial from a marketing perspective too.

Suzuki: Mikawa is surprisingly strategic (laughs). Before I joined, he'd hand out handmade direct mailers to the many elderly patients visiting the rural eye clinic. For some, he'd even tell their grandchildren, "There's this vision recovery treatment available." He's really good at capturing people's hearts—building a fan base, you could say.

Kyōi: So it feels like the developer was the starting point, and engagement built around a fan base developed from there.

Mikawa: With the doctors, we focused on referrals—referrals—approaching each one thoroughly. When you get passionate about one doctor, you also save face for the doctor who referred them. That's how we steadily gained allies. Thinking about it now, that was the complete opposite of using the latest promotional techniques.

Innovation through simple ideas, with huge business opportunities even overseas

Kyoi: Another product I think is truly revolutionary enough to change the world with Universal View is the "pinhole contact lens." It's a lens without a specific prescription that can correct nearsightedness, farsightedness, astigmatism, and presbyopia all at once, right?

Mikawa: Yes. The principle is also very simple. It applies the pinhole camera principle: by creating many tiny holes, it changes the depth of field, allowing a single type to focus both near and far. We're aiming for commercialization around 2018.

Suzuki: Development of these pinhole contact lenses is supported by grants from the New Energy and Industrial Technology Development Organization (NEDO) and investment from the Innovation Network Corporation of Japan. Our goal is to provide the world's first such lenses based on Japanese technology. Domestically, this holds significant market potential for those experiencing the onset of presbyopia. Globally, there's particular demand in developing countries where vision correction treatments themselves are not yet widespread. Developing countries generally lack sufficient doctors and vision diagnostic equipment. However, this lens eliminates the need for complex diagnostics and avoids the requirement to stock numerous lens powers and types. We believe this lens has high potential to bypass conventional contact lenses and achieve widespread adoption.

Kyoi: I also think the pinhole contact lens is a classic example of innovation born from a simple idea. I'm truly impressed that by shifting the fundamental perspective, rather than pushing technology to its limits, you've created such an innovative service.

Suzuki: Our corporate mission is declared as "bringing happiness to people and society worldwide through 'seeing'." If restoring vision were the sole goal, we might pursue a different direction. But since we aim to provide the dreams, possibilities, and richness that come with enhanced visual quality, Mikawa's creative thinking is perhaps even more vital. The earlier mention of overseas applications also highlights how low-tech devices, rather than high-tech ones, can be used in developing countries. Following the same principle, we're exploring future development projects like surgeries and prescriptions that can be performed by less experienced doctors, or strategies to establish operating rooms in areas lacking surgical facilities.

Kyōi: Finally, I'd like to ask: the desire to "see" feels like an incredibly strong, fundamental human urge. Currently, in the tech field, AR and VR are advancing, and seeing landscapes from unprecedented perspectives via drones could be seen as a form of visual expansion. We also hear about other companies developing contact lens-type devices. Given this, I wonder if your company could also tackle "seeing" beyond the medical field. How do you envision moving forward?

Suzuki: You're absolutely right. We believe our technology can certainly enhance the quality of "seeing" beyond vision correction and expand visual experiences. This is an area we want to pursue over the medium to long term. For example, we're currently developing contact lenses embedded with sensors for glaucoma patients who often forget their required three or more daily eye drops. These lenses can automatically prompt the patient to apply drops when they detect a drop in intraocular pressure. This technology could certainly be applied beyond healthcare. We want to expand our simple technology more broadly, with the world in mind. We also want to collaborate flexibly with other companies, bringing our respective strengths to the table.

Mikawa: I definitely see potential in combining our technology with advanced fields like IT or space to create new "visual" experiences. I'm also interested in collaborating with other companies. Tackling those areas alone would likely be difficult for me. That's because I believe my strength lies in low-tech approaches—combining existing elements or shifting perspectives. This ties back to the earlier marketing discussion; it's best to compete where your strengths lie.

However, I also believe that purely business-oriented thinking won't sustain us long-term. Our fundamental philosophy is rooted in the desire to help people by changing the quality of "visibility." It's when this philosophy and our direction align that our business moves forward. Whether the philosophy or the direction comes first doesn't matter; it's only when these are connected that we can achieve results that truly change the world.