Five years ago, I was told I have odd-shaped eyes and hard to fit for contacts. Are new options available today?
This is one of the most common questions I get from patients. Contact lens manufacturers are constantly conducting laboratory and clinical research to improve current contact lens technology. Recent innovations in lens materials, designs, and optics have led to the release of many new contact lens options over the past several years. In addition, as established contact lens designs perform well in the market, available prescription ranges may expand over time. Patients with high amounts of nearsightedness, farsightedness, and/or astigmatism with previously limited lens options may now have an expanded menu of lenses to select from.
Even if the standard soft contact lens brands do not fit your eyes or match your prescription range, there are options for custom soft contact lenses, rigid gas permeable lenses, and newer scleral lens designs that may be an option for your eyes. Patients with irregular astigmatism caused by keratoconus, refractive surgery, or injury often experience better vision from specialty design contact lenses.
With that being said, contact lenses are not for everyone. Certain factors may limit contact lens success such as ocular surface disease (such as dry eye), variations in eye anatomy, and issues with lens handling. It is important to discuss these limitations with your eye care provider.
What is the difference between an eye exam for those that wear glasses and those that wear contact lenses?
Whether you are primarily a glasses or contact lens wearer, all eye examinations consist of an evaluation of your refractive error (eyeglass prescription) and assessment of your overall ocular health. This includes screenings for defects in your peripheral vision, neurological function, and binocular vision system, as well as evaluation for eye diseases such as glaucoma, macular degeneration, cataracts, and retinal conditions.
Contact lenses are medical devices that are applied directly to the ocular surface to correct your vision. Due to the variability of eye shapes between patients and varying properties of contact lens materials and shapes, a contact lens exam is inherently more complex compared to a standard eye exam. If you are a contact lens wearer or are interested in wearing contact lenses, some specific testing may be required in addition to those previously described.
For new contact lens wearers, your doctor will need to acquire curvature maps of the front of your eyes to select the best contact lens size and shape for you. A careful examination of the ocular surface is essential to ensure contact lenses can be worn safely and comfortably. Once the lenses are applied to your eyes, your doctor will fine-tune your prescription. New wearers must also be trained on safe application and removal of their contact lenses as well as proper wearing and care regimens. Many problems that occur with contact lenses do not manifest immediately in the exam room. Since the fit of the contact lens changes over the course of daily wear, it is essential to return to your doctor for follow-up visits as directed.
For established contact lens wearers returning for your annual prescription renewal, your doctor will need to carefully evaluate your eyes to ensure the contact lenses are not negatively impacting your eye health. While the risk of complications with contact lenses is generally rare, long-term use of contact lenses can lead to complications such as neovascularization (growth of news blood vessels on your eye), eye infections, and in some cases changes to the curvature of the eyes. In fact, many early contact lens problems do not result in symptoms and can go undetected unless evaluated by your eye doctor. In addition, the strength of your eyes can change over time and your contact lens prescription may need to be updated accordingly. Since contact lens brands and materials are constantly changing and improving, talk to your eye doctor about new innovations in materials and designs that may be better suited for your eyes.
What the difference is between monthly and dailies contact lenses and are they made of different materials?
Contact lenses are offered in a variety of wearing modalities including monthly replacement, biweekly replacement, and daily disposable lenses. Monthly replacement contact lenses are worn during the day and cleaned between uses for up to one month (up to 2 weeks for biweekly replacement lenses). These lenses are designed to maintain a consistent lens shape, power, and surface quality over multiple cycles of cleaning and day wear and thus are often thicker compared to daily disposable lenses for added durability. Since the thickness of the lens impacts the amount of oxygen that reaches the surface of your eye, modern monthly/biweekly replacement lenses are made of hyper oxygen-permeable materials to maintain sufficient oxygen to the eye over many hours of wear.
Monthly/biweekly replacement lenses require proper disinfection and storage to be worn safely. These lens materials are designed to be compatible with lens care solutions. Patients with sensitivity to preservatives and cleaning agents found in multipurpose lens care solutions are advised to switch to peroxide-based cleaners or daily disposable lenses.
For daily disposable lens wear, a fresh pair of lenses are applied to the eyes each day and thrown away at the end of the day. Since disinfection with cleaning solutions is not required, many patients report increased convenience with this lens modality. These lenses are a great option for patients wearing contact lenses on a part-time basis and for frequent travelers. Daily disposable lenses, by comparison, are much thinner than monthly/biweekly replacement lenses which may contribute to improvement in comfort and fewer symptoms of dryness.
Daily disposable lenses are not intended to withstand the wear-and-tear of multiple wearing cycles. Attempting to re-clean and wear the same lens for multiple days may cause damage to the lens material and result in reduced comfort and visual quality. In addition, lens materials of daily disposable lenses may not be compatible with lens care solutions used to clean monthly/biweekly replacement soft contact lenses.
Consult with your eye doctor to determine the best lens wear modality for your lifestyle.