Contact Lenses for the Hard to Fit Patient
Many patients encounter challenges when wearing contact lenses for various reasons. Factors such as the unique shape of their eyes, specific eye conditions or impairments, or the effects of previous surgeries can make them “hard to fit” as contact lens wearers. This means that finding suitable contact lenses may require extra consideration and expertise from eye care professionals.
Patients who are considered “hard to fit” for contact lenses but still prefer to wear them have options available to them. These options aim to provide comfortable and effective contact lens wear through specialized fittings with eye doctors who are experts in their conditions and knowledgeable about various products. If you have any of the following conditions, you may be considered a hard-to-fit contact lens candidate:
- Dry Eyes
- Astigmatism
- Giant Papillary Conjunctivitis (GPC)
- Keratoconus
- Pellucid Marginal Degeneration
- Post-LASIK or other refractive surgery
- Presbyopia (reduced near vision common in individuals aged 40 and over)
- Corneal Scarring
By working closely with an experienced eye care professional, you can explore suitable contact lens options tailored to your specific needs and condition.
Dry Eyes and Contact Lenses
Dry Eye Syndrome is a condition characterized by dry, gritty, burning, red, and irritated eyes, often accompanied by blurred vision. Wearing contact lenses can sometimes exacerbate these symptoms, even for individuals who don’t typically experience chronic dry eyes.
If you have chronic dry eyes, it is important to seek treatment and relief from your eye doctor before considering contact lenses. Once your dry eyes are effectively managed, you can explore contact lens options that are more suitable for your condition.
Many soft contact lens brands and related products, such as disinfectant and cleansing solutions, are specifically designed to provide enhanced comfort for individuals with dry eyes. Your eye doctor can recommend suitable brands and products for you. Alternatively, gas permeable (GP) or rigid gas permeable (RGP) lenses, which are made from a harder material, have a lower tendency to dry out compared to soft lenses. They can also retain a certain level of moisture beneath the lens to prevent dryness. GP lenses are a viable option and can be quite comfortable for individuals with dry eyes.
In addition, your doctor may suggest a customized wearing schedule, such as limiting the duration of contact lens wear throughout the day or replacing your lenses more frequently, to optimize comfort and minimize dryness.
Toric Lenses for Astigmatism
Astigmatism is a condition that causes blurred vision or, in some cases, double vision. Unlike a round cornea, the front surface of the eye in individuals with astigmatism has two curves, resulting in two focal points instead of one. This irregular shape makes it challenging for standard contact lenses to provide an optimal fit, necessitating specialized lenses such as toric lenses or rigid gas permeable lenses (RGPs).
Toric contact lenses are specifically designed to correct astigmatism and are customized to fit the unique shape of the patient’s eye. Most toric lenses are made from soft materials that are engineered to stay securely in place on the eye. However, in instances where the lens rotation caused by blinking and eye movement cannot be adequately controlled, gas permeable lenses may be considered. These lenses, made from a firmer material, offer better stability but can be less comfortable for some individuals.
Due to the customization and more intricate fitting process required for toric lenses, they tend to be more expensive and take longer for the contact lens laboratory to manufacture compared to regular lenses. However, their ability to provide clear and crisp vision for those with astigmatism makes them a valuable option worth considering.
Giant Papillary Conjunctivitis (GPC) and Contact Lenses
GPC is a type of conjunctivitis characterized by inflammation of the inner surface of the eyelid. This condition can be caused or aggravated by the accumulation of protein deposits on contact lenses. If you have GPC, your eye doctor may recommend daily disposable lenses or Rigid Gas Permeable (RGP) lenses, as they are not water-based and are less prone to protein buildup. In addition, your doctor may prescribe medicated eye drops and advise you to temporarily discontinue the use of contact lenses until the symptoms improve.
Rigid Gas Permeable (RGP) or Gas Permeable (GP) Lenses
Rigid Gas Permeable (RGP), also known as Gas Permeable (GP) lenses, are often recommended for patients who are difficult to fit with standard contact lenses. These lenses are made of a hard, oxygen-permeable material that allows the eyes to breathe and significantly reduces the risk of infection associated with protein deposits that tend to accumulate on soft lenses. RGPs also retain moisture beneath the lens, preventing the eyes from drying out.
Rigid Gas Permeable (RGP) Lenses for Keratoconus
Keratoconus is a condition in which the cornea becomes thin and bulges forward, taking on a cone shape. Patients with keratoconus may experience discomfort and blurry vision with traditional contact lenses. In such cases, RGP lenses are often used for treatment, providing improved vision for mild, moderate, and some severe cases. RGPs can also help slow down the progression of the cone shape in certain situations. Soft contacts or eyeglasses may not be able to adequately correct vision in individuals with keratoconus.
Post-LASIK or Vision Correction (Refractive) Surgery
Although LASIK surgery has a high success rate, some individuals may experience lingering vision issues and symptoms. In particular, night vision after LASIK can be accompanied by side effects like glare or halos around lights. Rigid Gas Permeable (RGP) lenses are often effective in addressing these side effects and restoring clear vision for individuals who have undergone LASIK or other refractive surgeries.
Plastic frames offer a wide range of options for eyewear. Here are some common types:
Zyl, short for “zylonate” or cellulose acetate, is a popular and affordable choice. It is lightweight and available in various colors, including multi-colored and layered frames.
Propionate is a durable and flexible nylon-based plastic often used in sports frames. It is lightweight and hypoallergenic.
Nylon, although less commonly used now, is lightweight and strong. However, it can weaken and become brittle with age, leading to the rise of more resilient nylon blends.
Cellulose acetate, a plant-based plastic, is hypoallergenic and offers strength, flexibility, and a wide range of colors and finishes. Modern acetates are known for their durability and the ability to create complex colorations through layering techniques.
These plastic frame options provide versatility and style for eyeglass wearers.
Bifocal and Multifocal Contact Lenses for Presbyopia
Presbyopia is a common age-related condition that affects individuals typically over the age of 40, causing a decline in the eyes’ ability to focus on close objects. Many people opt to keep a pair of bifocal or multifocal glasses for tasks such as reading menus, newspapers, books, and other close-up activities. However, for those who prefer contact lenses, there are bifocal and multifocal contact lens options available.
For patients with presbyopia who also require distance vision correction, there are two primary options to consider. The first is monovision, which involves wearing a contact lens in one eye for distance vision and a contact lens in the other eye for near vision. The second option is multifocal contact lenses, which enable both eyes to provide clear vision for both near and distance tasks simultaneously. It typically takes approximately one week for the brain and eyes to adapt to either of these contact lens fitting options.
If you have presbyopia or face difficulties with contact lens wear for any other reason, it is advisable to consult with your eye doctor. As technology advances, there are increasingly more options available for patients who find contact lens fitting challenging, allowing them to benefit from the comfort and convenience of wearing contact lenses.