Q: What is the difference between an eye exam geared towards wearers of glasses and an eye exam geared towards wearers of contact lens?
A: There is quite a difference as contact lenses are a medical device placed directly on the eye. Fitting a patient in contact lenses requires a number of considerations that are unique to each individual.
Before undergoing a contact lens fitting, patients must have a comprehensive eye examination to determine their glasses prescription and establish that their eyes are healthy overall and healthy enough for contact lens wear. Once that has been established, I will proceed with a contact lens fitting and follow up care to determine the best contact lens for the patient.
Q: What can be expected during a contact lens fitting?
A: During a contact lens fitting, I analyze the patient’s individual eye health, prescription, corneal curvature (front part of the eye), and ocular surface to determine if contact lenses are an appropriate option. When I have determined that contact lenses are an option for a patient, I will then advise the patient which lens is the best option for them. From there, I have the patient wear diagnostic contact lenses so that I can assess if the lenses are performing correctly. This requires that the patient have clear vision, the lenses align properly on the cornea, and are comfortable.
Q: What if a patient hasn’t previously worn contact lenses?
A: If a patient is new to contact lens wear, they will undergo a contact lens fitting and additional training on how to handle and care for their lenses properly. An optician will teach them how to apply and remove contact lenses safely and how to care for the lenses. This training typically takes about one hour.
Q: What are contact lens measurements? Does it change if a patient has astigmatism?
A: All contact lenses have a base curve, a diameter, and power (prescription). When I am fitting a patient with a contact lens I measure the curvature of their cornea and select a contact lens that will align properly on the patient’s eye. I also insure that the diameter (size of the contact) is appropriate for the patient’s corneal diameter and eyelid architecture.
The prescription for contact lenses is typically different for each patient than their glasses prescription, so I also determine which contact lens power will optimize the patient’s vision.
For patients that have astigmatism, the process is the same, but the prescription is more complicated. Astigmatism prescriptions have two additional components compared to prescriptions without astigmatism. Fortunately, there are many excellent contact lens options for patients with astigmatism, however it may take trying a few lenses to find the right fit.
Q: Will I know right away if the contact lenses fit or is that something that can only be felt with the passage of time?
A: The only way to judge if contact lenses fit properly is to have an eye doctor examine the lens performance on the eye under a microscope. When I evaluate contact lenses, I am insuring that they are centered on the eye properly and that they move slightly when a patient blinks to facilitate tear exchange (fresh tears moving underneath the lens). Patients may have a contact that fits too tightly on their eye that feels fine to them but could cause long-term problems.
From a patient’s perspective, it can take up to four days to adapt to a new contact lens brand or new prescription, so I always encourage my patients to give it some time and let their visual system get used to the change.
Q: How does an eye doctor determine which contact lens brand to recommend to a patient? Whether to use daily contacts or reusable?
A: Daily disposable, single-use contact lenses are, in my opinion, far and away the best option for anyone. Patients have a clean, sterile lens every day and don’t have to worry about cleaning the contacts; the lenses are simply thrown away after wearing. Patients report that they have better comfort with daily disposables and they enjoy the convenience of not having to disinfect their lenses each day. Both Dr. Gustafson and I wear daily disposables on our own eyes, as we both believe they are the best type of contact lenses.
Some patients will need to wear a frequent-replacement contact lens due to their prescription or if they have a need or desire to sleep in contact lenses. For these patients, I will make a decision if two week or monthly disposable contacts fit their needs best.
Q: Are contact lenses for everyone?
A: Contact lenses work for most people but are not for everyone. Patients who have usable vision in only one eye, people with medically diagnosed dry eye, or patients with corneal disease are not good candidates for contact lens wear.
Q: Are there special contact lenses for people that need reading glasses or bifocals? Astigmatism?
A: Fortunately, there are many varieties of contact lenses that will fit nearly any prescription or lifestyle need and the technology has vastly improved.
Patients that use reading glasses or bifocals can wear multifocal contact lenses. These are lenses that allow a good range of vision from distance to near and typically result in the patient only needing reading glasses a small minority of the time. This is a technology that has advanced markedly in the past few years.
Patients with astigmatism have far more options now than they have in the past. Most patients with astigmatism can now wear a daily disposable, single-use lens and enjoy the comfort and convenience of a daily. Patients with higher amounts of astigmatism could only wear rigid (hard) contact lenses in the past and now most can wear a soft, disposable contact lens.