Speciality Contact Lens Fitting
We educate our patients on the proper care of speciality contact lenses.
We have vast experience in fitting specialty lenses including Rigid Gas Permeable, semi-scleral, scleral, and keratoconic lenses.
Our knowledgeable staff educate our patients and provide guidelines on proper fitting, care, insertion and removal of these lenses.
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.
For hard to fit patients that prefer to wear contact lenses however, there are options available that can provide comfortable and effective contact lens wear. This will require a specialized fitting with an eye doctor that is an expert that knows your condition and the various products available to find the right match for your specific condition. You may be considered a hard to fit contact lens candidate if you have one of the following conditions:
- Dry Eyes
- Giant Papillary Conjunctivitis (GPC)
- Pellucid Marginal Degeneration
- Post-LASIK or other refractive surgery
- Presbyopia (reduced near vision common in individuals aged 40 and over).
- Corneal Scarring
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.
Giant Papillary Conjunctivitis (GPC) and Contact Lenses
GPC is a type of conjunctivitis in which the inner surface of the eyelid becomes swollen. The condition can be caused or worsened by a buildup of protein deposits on contact lenses. Your eye doctor may either recommend daily disposable lenses or RGP lenses (which are not water based) and therefore do not have a tendency for protein buildup. Your doctor may also prescribe medicated eye drops and require you to stop 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 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 to 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.
Irregular Corneas & Scleral Lenses
Effective Treatment for Irregular Corneas
An irregular cornea generally causes problems or limitations with vision and can be more complicated to correct with standard eyeglasses or contact lenses. If eyeglasses and regular contact lenses aren’t helping you see clearly due to an irregular cornea, scleral lenses may be the perfect solution to give you sharp, comfortable vision. Eye doctors will evaluate your cornea using first-rate skill and the latest optometric technology. If we find that you are a good candidate for treatment with scleral lenses, we’ll fit you expertly with a pair of these premium, specialized contacts.
What causes irregular corneas?
A large variety of causes may be responsible for irregular corneas. Some of the most common culprits include:
- Prior eye surgeries, such as LASIK or cataracts
- Eye injuries or burns
- Scarring after an eye infection
- Corneal ulcers
- Severe cases of dry eye
- Congenital defect
- Pterygium (conjunctival degeneration)
- Pellucid marginal degeneration
How is vision corrected when you have an irregular cornea?
When the cornea is only mildly misshapen, eyeglasses may still be able to correct vision effectively. Yet when eyeglasses are no longer able to provide crisp eyesight, contact lenses are usually the next option recommended by optometrists. Soft contact lenses may be prescribed initially for mild to moderate cases of vision distortion due to an irregular corneal surface. When soft lenses are ineffective, more advanced specialty lenses, such as hybrid (soft/rigid) lenses, customizable soft lenses or scleral lenses are typically recommended as the next step.
What are scleral lenses?
A scleral lens rests like a bridge over the cornea, and not on it. A ring, termed a flange, sits on the white of your eye (the sclera) and gaps between your eye and the contact lens are filled with tears. Corneal scarring or an extremely irregular corneal surface may make it impossible to wear standard contact lenses comfortably and with a good fit. With their extra-large diameter, gas permeable scleral lenses offer a great alternative.
The unique shape of scleral lenses allows them to be used for many hard-to-fit ocular conditions, such as keratoconus, pellucid degeneration and where there is a great deal of corneal scarring. Your sclera tissue is not as sensitive as the cornea, and therefore scleral lenses are usually very comfortable – even when worn on a daily basis.
There are three main types of scleral lenses, with the differences being in size and where the lenses meet your eye’s frontal surface. Corneo-scleral lenses have a wide diameter and rest close to the seam of your sclera and cornea. Mini-scleral lenses span over your entire cornea, and full scleral lenses are the largest type, creating the greatest clearance space between the contact lens and your cornea. We will evaluate your cornea and recommend the best type for your eyes.
Who is a good candidate for scleral lenses?
In general, any individual who wants to optimize their vision with contact lenses can be a suitable candidate for scleral lenses. However, these specialized lenses are most appropriate for people with the following conditions:
- Hard-to-fit eyes: if you can’t be fit well with traditional gas permeable lenses, or lenses tend to pop out of your eye easily, scleral lenses may give you a more secure fit.
- Dry eyes: when the tear film that coats your eyes is insufficient, conventional contacts may be uncomfortable or painful. Scleral lenses have a large gap between the contact lens and your cornea, and this space acts as a place for tears to collect. More moisture thereby remains on the surface of your eyes.
- Irregular corneas: no matter what the cause of your irregularly shaped cornea, scleral lenses will usually give you much clearer vision than eyeglasses or standard contacts.
- Post-corneal surgery: surgeries, such as corneal transplants, often leave you with vision that is not fully normal. Post-surgery scleral lenses offer sharp, comfortable eyesight while simultaneously protecting the delicate eye tissues from any damage to the graft.
Benefits of scleral lenses
Many individuals report that their vision is extremely crisp with scleral lenses, in comparison to soft contacts. As rigid gas permeable contacts, they are easy to handle and highly durable, and the extra-wide design makes them less likely to dislodge accidentally from your eye. Additionally, scleral lenses are associated with a decreased risk of eye complications.
To find out if scleral lenses can help improve your vision, contact us for an appointment at our local vision center.