What is a contact lens fitting?
There are two main aspects that our eye doctor breaks down in assessing contact lenses
- How the contact lenses fit on the eyes. Keratometry is the measurement of the curvature of the cornea (where the contact lens sits). This value is used to determine what base curve will best conform to the cornea. Once a lens is selected and placed on the eye, our eye doctor will assess how the edge of the lens lands on the sclera (the white of the eye). Different brands of soft contact lenses will have unique edge designs that are a big reason why some lenses are more comfortable than others. It is like sneakers, where you try on the same size in two different brands and they fit differently. Everyone has their preference and some people love certain brands that other people dislike. Our eye doctor is the best at helping you find which lens is best for you! Finally, the way the lens interacts with the underside of your eyelids is an aspect of the fit that can change over time. For example, during allergy season the inside of the eyelids can develop tiny bumps called papillae and secrete mucous that will make the contact lenses sticky and feel that they are sliding around or about to pop out. A more severe, chronic form of this reaction to the friction of having a contact lens in the eye for years is called Giant Papillary Conjunctivits (GPC). Luckily, there are treatments for this to make contacts more comfortable including: allergy eye drops, hydrogen peroxide based contact lens solutions, or switching to daily disposable contacts.
- The Vision. Why is my eyeglass prescription different from my contact lens prescription? One reason is that eyeglass prescriptions can be a lot more precise, especially when it comes to correcting for astigmatism. This is when the curvature of the cornea is not perfectly spherical, like the surface of a basketball, but more like the surface of a football. Some would argue that every eye has some astigmatism, the question is if it is worth correcting for it in glasses and/or contacts. We are able to correct for even the smallest amounts of astigmatism with glasses, but it has to be a significant amount before it is relevant in the contact lens prescription. Even then, contact lens prescriptions may only come in certain parameters, which limits the best corrected vision as compared to eyeglasses. You may also experience more fluctuating vision with contacts versus eyeglasses. Imagine if every time you blinked your glasses moved and rotated slightly. This is what is happening with contact lenses. The good news is that modern contact lens technology has greatly improved lens stability and we are able to correct a wide range of astigmatic corrections. Our eye doctor is an expert in specialty contact lenses. Therefore when standard soft contact lenses are not providing adequate vision, other options will be offered including: rigid gas permeable contact lenses, hybrid contact lenses, scleral contact lenses, orthokeratology, or co-managment of refractive laser surgery.
Why do I need a contact lens fitting if I already wear contacts?
Contact lenses are considered Class II medical devices by the FDA. Therefore, a current and valid contact lens prescription is required to purchase contact lenses. In Pennsylvania, a contact lens prescription may be valid for 12 months. You may purchase a supply of contact lenses up until the prescription's expiration date. After that date, it is required that you visit an eye doctor for a contact lens assessment to renew the prescription. At this visit the eye doctor not only determines if the prescription is providing the best, most comfortable vision, but more importantly checks the health of the eyes and reviews proper contact lens handling and care. Contact lens complications can range from acute infections and corneal ulcers (from swimming or sleeping in contacts) to chronic conditions that build up over years of wearing contacts including: giant papillary conjunctivitis (GPC), corneal neovascularization, eye redness, and even corneal scarring. These issues can often be avoided by regular education of proper lens care, adjusting wear schedules, switching to a better fitting lens, or adding medical eye drop treatment therapies.
Why do I need to renew my contact lens prescription every year?
Every state has different regulations for prescriptions. In most states, including Pennsylvania per PA code section 23.72, expiration dates may be no longer than 2 years for eyeglasses and 1 year for contact lenses. This means that your eye doctor could write a prescription for eyeglasses or contacts that expires sooner than 12 months, which may be because of an underlying condition or reason that it may not be safe to be in the same prescription for an entire year. Your contact lens prescription will be dated from your contact lens fitting and includes not only the prescription, but also is required to have the exact brand, model, base curve, and diameter. If you would like to purchase a different contact lens, a follow up contact lens assessment may be required to issue an alternative prescription. Often these contact lens follow up assessments are included in the original contact lens fitting fee and are to ensure that the new lens is an ideal fit for your eye.
Are contact lenses uncomfortable?
Modern contact lens technologies have improved dramatically, resulting in excellent comfort all day. Lens awareness is common, especially for someone new to wearing contact lenses. As wear time is gradually increased each day, the eyes become desensitized and lens awareness decreases. Our eye doctor describes it like wearing wool socks: the first day you put them on it is all you can think about and soon you forget they are even on, but it is still kind of nice when you take them off at the end of a long day. When soft contact lenses remain uncomfortable, it may be a sign of an underlying condition like dry eye disease, blepharitis, or allergies. By either treating the underlying condition or switching to a specialty contact lens this discomfort can be avoided.
How do I get started with contacts for the first time?
Contact lens fittings can be performed by our eye doctor in conjunction with your routine comprehensive eye exam or on it's own if you have had a recent exam with us to establish your eyeglass prescription and eye health assessment. Our eye doctor will work with you to select an initial lens that makes the most sense based on your eye measurements, eyeglass prescription, eye health, and lifestyle. From there, our doctor and staff will sit down with you and go through an insertion and removal (I&R) class. This is where you will be trained on proper lens handling, care, insertion, and removal of the contacts in a safe manor to reduce the risk of contact lens related complications. Once you successfully complete the I&R class, you will be sent home with trial contact lenses to practice at home and test drive the lenses. It is recommended to gradually increase wear time each day. For example, 2 hours on day one, 4 hours on day two, 6 hours on day three, etc. working your way up to a full day. It is required that you return for at least one contact lens follow up visit where you come in wearing the trial contacts so that our doctor can assess the lenses having settled on your eyes and make any refinements to the prescription or change to a different brand or modality. Once the prescription is finalized, then you will be able to purchase a supply! Generally, it is recommended to get a year supply of contacts in order to maximize any insurance benefit and take advantage of manufacturer rebates that my be available to incentivize consumers to purchase the lenses in bulk. Our staff is excellent at helping to review this process and aid in ordering contact lenses to that it is as comfortable as possible for you!