EYE EXAMS FOR CONTACT LENSES
Contact lenses are a great alternative to wearing eyeglasses. An often unknown fact is that not all patients wear contact lenses as their primary source of vision correction. Each patient is different, with some patients wearing contact lenses only on weekends, special occasions or just for sports. That is the beauty of contact lens wear, the flexibility it gives each individual patient and their lifestyle.
If you decide to opt for contact lens wear, it is very important that the lenses fit properly and comfortably and that you understand contact lens safety and hygiene. A contact lens exam will include both a comprehensive eye exam to check your overall eye health, your general vision prescription and then a contact lens consultation and measurement to determine the proper lens fit.
THE IMPORTANTCE OF A COMPREHENSIVE EYE EXAM
Whether or not you have vision problems, it is important to have your eyes checked regularly to ensure they are healthy and that there are no signs of a developing eye condition. A comprehensive eye exam will check the general health of your eyes as well as the quality of your vision. During this exam the eye doctor will determine your prescription for eyeglasses, however this prescription alone is not sufficient for contact lenses. The doctor may also check for any eye health issues that could interfere with the comfort and success of contact lens wear.
THE CONTACT LENS EVALUATION
The contact lens industry is always developing new innovations to make contacts more comfortable, convenient and accessible. Therefore, one of the initial steps in a contact lens consultation is to discuss with your eye doctor some lifestyle and health considerations that could impact the type of contacts that suit you best.
Some of the options to consider are whether you would prefer daily disposables or monthly disposable lenses, as well as soft versus rigid gas permeable (GP) lenses. If you have any particular eye conditions, such as astigmatism or dry eye syndrome, our optometrists have specific recommendations for the right type or brand for your optimal comfort and vision needs.
Now is the time to tell one of our optometrists if you would like to consider colored contact lenses as well. If you are over 40 and experience problems seeing small print, for which you need bifocals to see close objects, your eye doctor may recommend multifocal lenses or a combination of multifocal and monovision lenses to correct your unique vision needs.
CONTACT LENS FITTING
One size does not fit all when it comes to contact lenses. Your eye doctor will need to take some measurements to properly fit your contact lenses. Contact lenses that do not fit properly could cause discomfort, blurry vision or even damage the eye. Here are some of the measurements your eye doctor will take for a contact lens fitting:
CORNEAL CURVATURE
In order to assure that the fitting curve of the lens properly fits the curve of your eye, your doctor will measure the curvature of the cornea or front surface of the eye. The curvature is measured with an instrument called a keratometer to determine the appropriate curve for your contact lenses. If you have astigmatism, the curvature of your cornea is not perfectly round and therefore a “toric” lens, which is designed specifically for an eye with astigmatism, would be fit to provide the best vision and lens fit. In certain cases your eye doctor may decide to measure your cornea in greater detail with a mapping of the corneal surface called corneal topography.
PUPIL OR IRIS SIZE
Your eye doctor may measure the size of your pupil or your iris (the colored area of your eye) with an instrument called a biomicroscope or slit lamp or manually with a ruler or card. This measurement is especially important if you are considering specialized lenses such as Gas Permeable (GP) contacts.
TEAR FILM EVALUATION
One of the most common problems affecting contact lens wear is dry eyes. If the lenses are not kept adequately hydrated and moist, they will become uncomfortable and your eyes will feel dry, irritated and itchy. Particularly if you have dry eye syndrome, your doctor will want to make sure that you have a sufficient tear film to keep the lenses moist and comfortable, otherwise, contact lenses may not be a suitable vision option.
A tear film evaluation is performed by the doctor by putting a drop of liquid dye on your eye and then viewing your tears with a slit lamp or by placing a special strip of paper under the lid to absorb the tears to see how much moisture is produced. If your tear film is weak, your eye doctor may recommend certain types of contact lenses that are more successful in maintaining moisture.
CONTACT LENS TRIAL AND PRESCRIPTION
After deciding which pair of lenses could work best with your eyes, the eye doctor may have you try on a pair of lenses to confirm the fit and comfort before finalizing and ordering your lenses. The doctor or assistant would insert the lenses and keep them in for 15-20 minutes before the doctor exams the fit, movement and tearing in your eye. If after the fitting, the lenses appear to be a good fit, your eye doctor will order the lenses for you. Your eye doctor will also provide care and hygiene instructions including how to insert and remove your lenses, how long to wear them and how to store them if relevant.
FOLLOW – UP
Your eye doctor may request that you schedule a follow-up appointment to check that your contact lenses are fitting properly and that your eyes are adjusting properly. If you are experiencing discomfort or dryness in your eyes you should visit your eye doctor as soon as possible. Your eye doctor may decide to try a different lens, a different contact lens disinfecting solution or to try an adjustment in your wearing schedule.
HARD TO FIT CONTACT LENSES
Contact lenses are not an easy solution for every person suffering with vision problems. Some eye conditions make wearing contacts a difficult proposition. However, it does not rule out wearing contact lenses altogether. It just means patients need to discuss options with their eye care provider and obtain specialized hard to fit contacts for their specific vision problems.
REASONS FOR HARD TO FIT CONTACTS
Finding contact lenses that fit and wearing contact lenses in general can be made more challenging when these conditions affect your eyes:
- Astigmatism
- Dry eyes
- Giant Papillary Conjunctivitis (GPC)
- Keratoconus
- Presbyopia
Astigmatism: Astigmatism develops when the front of the eye curves into a bulge or oval shape. It causes blurred vision and can be difficult to correct because regular contacts cannot account for the bulging.
Dry Eyes: When eyes become excessively dry, it leads to irritation, burning, redness and blurred vision. Contact lenses can exacerbate these conditions by making it feel like a foreign object is stuck in your eye.
GPC: This form of conjunctivitis is caused by inflammation on the inner surface of the eyelid. Protein buildup on contact lenses can make this condition worse.
Keratoconus: This is an uncommon condition that causes major discomfort when wearing contacts. Keratoconus happens when the cornea becomes thinner and allows the eye to bulge forward. The bulge forms into a cone shape.
Presbyopia: Eyes tend to have a tougher time focusing on close objects as they age. This condition is known as presbyopia. It typically affects people aged 40 or older.
SOLUTIONS FOR HARD TO FIT CONTACTS
Wearing contacts is not impossible if you suffer from one of the above conditions. You do need to meet with an eye care professional, however, and get prescribed contact lenses that are tailored to deal with your specific vision condition.
Gas permeable lenses are a good solution for patients who suffer from GPC or Keratoconus. A GP lens will limit protein deposits from accumulating which will reduce GPC symptoms. It is also effective in containing corneal bulging and relieving pressure on the tissue for a Keratoconus sufferer.
Toric lenses are useful for correcting astigmatism. Since the lens needs to align with the bulge it is correcting, toric lenses must not rotate in order to fit on the eye. They are typically custom made to correct a specific astigmatism. For that reason, this type of lens takes longer to make and costs more than a traditional contact lens.
Bifocal and multifocal lenses can help remedy presbyopia. Monovision lenses are another option for presbyopia. This type of lenses can have one fitted for distance vision and the other for seeing close objects.
Medicated eye drops can be an effective solution for dealing with dry eyes. They will lubricate eyes enough to make contact lenses more bearable, although a punctal occlusion also must be done to plug the ducts in some extreme cases. GPC symptoms can also be lessened through medicated eye drops. They flush out protein deposits and reduce inflammation.
HAVE YOU BEEN TOLD THAT YOU ARE NOT A CANDIDATE FOR CONTACT LENSES?
Have you tried to wear contact lenses only to end up wearing glasses as you suffered too much discomfort? Is your vision worsening due to Keratoconus or other corneal conditions?
Thousands of people who suffer vision loss as a result of various corneal conditions can now see clearly once again through scleral lenses. Those who couldn’t wear contact lens due to eye conditions or discomfort are able to correct their vision safely & successfully. Say goodbye to the old days of contact lenses that didn’t work for you. You no longer have to suffer discomfort or simply being forced to live with poor vision. De Jongh Optometry provides advanced custom contact lens fitting for even the most hard-to-fit-patients.
WHAT IS KERATOCONUS?
Keratoconus (ker-uh-toe-KOH-nus) occurs when your cornea — the clear, dome-shaped front surface of your eye — thins and gradually bulges outward into a cone shape.
A cone-shaped cornea causes blurred vision and may cause sensitivity to light and glare. Keratoconus usually affects both eyes, though it often affects one eye more than the other. It generally begins to affect people between the ages of 10 and 25. The condition may progress slowly for 10 years or longer.
In the early stages of keratoconus, you might be able to correct vision problems with glasses or soft contact lenses. Later, you may have to be fitted with rigid, gas permeable contact lenses or other types of lenses, such as scleral lenses. If your condition progresses to an advanced stage, you may need a cornea transplant.
A treatment called corneal collagen cross-linking may help to slow or stop keratoconus from progressing, possibly preventing the need for a future cornea transplant.
SYMPTOMS
Signs and symptoms of keratoconus may change as the disease progresses. They include:
- Blurred or distorted vision
- Increased sensitivity to bright light and glare, which can cause problems with night driving
- A need for frequent changes in eyeglass prescriptions
- Sudden worsening or clouding of vision
RISK FACTORS
These factors can increase your chances of developing keratoconus:
- Having a family history of keratoconus
- Rubbing your eyes vigorously
- Having certain conditions, such as retinitis pigmentosa, Down syndrome, Ehlers-Danlos syndrome, hay fever and asthma
THE ADVANTAGES OF SCLERAL LENSES
Scleral lenses are specialized custom contact lenses that make contact lens use possible for many people for the first time – and they have many advantages over normal contact lenses as well including, fit, comfort, and visual acuity.
A scleral lens gets its name because it sits on the sclera, or the white part of the eye, rather than the iris (the colored part of the eye). Because a scleral lens sits on the sclera, it stays off the more sensitive areas of the eye. Friction and discomfort are virtually eliminated.
Ortho-K lenses works while you sleep. Now you can have perfect vision during the day and let your contact lenses work at night.
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