Contact Lenses for the Hard to Fit Patient
It is not uncommon for patients to have difficulty wearing contact lenses for a number of reasons. Due to the individual eye shape, certain conditions or impairments or the aftermath of surgery, some patients are considered to be “hard to fit” as contact lens wearers.
The staff at Accent Vision Specialists are trained in difficult lens fittings. In addition to common contact lens designs, the practice also offers:
- Post-surgical lenses
- Scleral lens designs
- Piggyback systems
- Keratoconus specific lenses
- Soft and rigid gas-permeable multifocal lenses
The practice is known for its expertise in scleral lenses that are notoriously difficult to fit. They’ve also had great success treating patients with irregular corneas from a disease such as keratoconus, pellucid marginal degeneration, or post-surgical complications.
How are scleral lenses different from regular contact lenses?
Scleral contact lenses are considerably bigger than other contacts and rest on the sclera — the whites of your eyes — instead of only a portion of your cornea like normal contacts do.
Scleral contacts leave a small gap of tears between the lens and your eye, which keeps you more comfortable and allows better vision. Since they are larger than regular contacts, patients find scleral contact lenses more stable and less likely to move out of place.
Patients with irregularly shaped corneas, severe dry eyes, or irregularities on their eyes that make it impossible to see well with regular contacts or glasses can benefit from scleral contacts.
What are piggyback systems for contact lenses?
Piggyback contact lenses are actually two separate sets of lenses, one rigid and one soft. Sometimes, Dr. Thibodeaux or Dr. Tachau may prescribe a piggyback lens system for conditions like keratoconus if other specialty lenses don’t yield optimal results.
The soft lenses go against the eye, with the rigid lenses on top of them. With proper use of this system, you can correct even difficult eye problems.
Dry Eyes and Contact Lenses
Dry Eye Syndrome causes your eyes to feel dry, gritty, burning, red, and irritated. Dry Eye Syndrome can also cause blurred vision. Often these symptoms can sometimes worsen by the use of contacts. In fact, many people who do not normally suffer from chronic dry eyes, will experience some of these symptoms as a result of contact lens wear.
First of all, if you have chronic dry eyes, you should see your eye doctor for treatment and relief before you think about contact lenses. Once your dry eyes are treated, it is safe to try contacts and there are a number of options that can be considered.
Many brands of soft contacts and products such as disinfectant and cleansing solutions are made with ingredients that are designed to be more comfortable for individuals with dry eyes. Your eye doctor will be able to recommend some of these brands and products to you. Alternatively, gas permeable (GP) or rigid gas permeable (RGP) lenses are made with a hard material that in some cases does not dry out like soft lenses and they are able to hold a certain amount of moisture beneath the lens to keep the eye from drying out. Gas permeable lenses are a very good option and can be quite comfortable for individuals with dry eyes.
Additionally, your doctor might recommend a specific wearing schedule such as limiting the time you wear your contacts throughout the day or replacing your contacts on a more frequent basis.
Toric Lenses for Astigmatism
Astigmatism is a condition that causes blurred vision (in some cases double vision) because rather than being round, the front of the eye (the cornea) has two curves instead of one, therefore, having two focal points instead of one. This makes it hard for traditional contact lenses to fit and therefore requires specialized contact lenses such as toric lenses or rigid gas permeable lenses (RGPs).
Toric contact lenses are designed to correct astigmatism and custom made to fit the eye of the patient. Most are made of soft material designed to stay in place on the eye, however in some cases, when the rotation of the lens (due to blinking and eye movement) can’t be stopped, gas permeable lenses might be tried. Due to the customization and more complicated fitting process required for these lenses, they are more expensive and take more time for the contact lens laboratory to make than traditional lenses.
Rigid Gas Permeable (RGP) or Gas Permeable (GP) Lenses
Rigid Gas Permeable (RGP) also known as Gas Permeable (GP) lenses are effective for many hard to fit patients. The hard, oxygen permeable material lets the eye breathe and significantly reduces the chance of infection due to protein deposits which tend to harbor bacteria on soft lenses. RGPs also hold moisture under the lens to keep eyes from drying out.
Rigid Gas Permeable (RGP) Lenses for Keratoconus
Keratoconus is a condition in which the cornea thins and bulges forward into a cone shape. Traditional contact lenses may cause some discomfort in these patients and the vision may still be blurry therefore RGPs are often used for treatment for mild, moderate, and some severe cases. Rigid gas permeable lenses may help to slow down the cone shape from worsening in some cases. Further, RGPs are able to assist in vision correction for keratoconus which is often not possible with soft contacts or even eyeglasses.
Post-LASIK or Vision Correction (Refractive) Surgery
While LASIK surgery has a very high success rate, there are vision complications and symptoms that sometimes remain. Night vision after LASIK, in particular, can sometimes give you side effects such as glare or halos around lights. RGPs are often effective in helping with these side effects and restoring clear vision.
Bifocal and Multifocal Contact Lenses for Presbyopia
Presbyopia is a common condition in those people usually over 40 years old in which the eyes’ ability to focus on close objects is impaired. Many people keep a pair of bifocal or multifocal glasses on hand for times when they have to read menus, newspapers, books, and other objects that require near vision. For those that prefer contact lenses over eyeglasses, bifocal and multifocal contact lenses are an option.
For some patients that have presbyopia and need correction for distance vision as well, one option is monovision. Monovision is a contact lens fitting process in which you wear a contact lens in one eye for distance vision and the other contact lens of your other eye for near vision. Another option is multifocal contact lenses. In this contact lens fitting process, both eyes are usually fit for distance vision and both eyes are used for near at the same time. Both contact lens fitting options usually take about one week for the brain and the eyes to adjust.
If you have one of these conditions or find contact lens wear difficult for another reason, speak with your eye doctor. As technology improves there are more and more options for hard to fit contact lens patients to benefit from the comfort and convenience of contact lens use.
Read about Ortho-K to see if you may be a good candidate for these gentle overnight cornea re-shaping contact lenses.