Activist hedge fund Jana Partners has called on Cooper Companies to replace its chief executive and consider strategic alternatives, including the potential sale of its core businesses. The demands were detailed in a letter sent to Cooper on Thursday.

Albert White, who has served as Cooper’s CEO since 2018, leads the medical-device maker known primarily for its CooperVision segment, which produces contact lenses and vision-care products. Jana Partners cited what it described as the company’s “chronic underperformance,” pointing to issues with inventory management and capital expenditures as key areas requiring attention.

In addition to urging the appointment of a new CEO, Jana recommended replacing the company’s board chair. The hedge fund also encouraged Cooper’s leadership to initiate discussions with potential buyers as part of a broader review of strategic options intended to enhance shareholder value.

Cooper Companies has not publicly responded to the activist’s proposals as of Friday. The company’s management and board will now face pressure to address the concerns highlighted by Jana Partners amid a challenging environment for medical-device manufacturers.