A couple are in a restaurant and the man says, "Let's make a toast. Here's to the most..." Then the woman says, "Wait, John, before you do, there's something I have to tell you..." As she wipes off her lipstick and pulls off her wig, she stammers, "You see, I have astigmatism!"
The twist is in the expectation that she was going to say she's a man.
The young man responds, "So do I!" The narrator then describes Focus contact lenses, designed for astigmatism, as the woman orders them by phone. The ad closes with them at dinner again and she says with double-entendre, "I am so glad I got that off my chest. Cheers!"
Created with the assistance of MTV, this ad aired only on that network but is amazingly positive and puts an unexpected spin on the "revelation" -- making it astigmatism.