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 is caused by an irregular shape of the cornea – the clear part of the eye that covers the iris and the pupil. The cornea is usually smooth, round, and spherical but in an astigmatic eye, the cornea turns into a shape that is not spherical and develops a second curve. One of the primary duties of the cornea is to focus light onto the retina which enables you to see clearly. When the cornea is out of shape and develops two curves, this created two focal points therefore causing blurred vision.
The irregular shape of the eye makes it hard for traditional contact lenses to fit and provide clear vision and therefore requires specialized contact lenses such as toric lenses or rigid gas permeable lenses (RGPs).
What are Toric Contact Lenses?
Toric contact lenses are designed to correct astigmatism and custom made to fit the eye of the patient. Rather than having a perfectly spherical surface like standard contact lenses, toric lenses have a more oblong shape made to accommodate the shape of the astigmatic eye. Toric lenses can be made of either soft or rigid gas permeable (RGP or GP) lens material, however the soft toric lenses are more common.
Toric contact lenses are also designed in such a way that the lenses stay in place on the eye to maintain proper vision. Sometimes as the eye moves or blinks the lens can rotate considerably on the eye. If this rotation continues with a soft toric lens, a rigid gas permeable lens might be more effective. Rigid gas permeable lenses have a longer initial adjustment time, but once this has passed they are usually just as comfortable as soft contact lenses and they are often easier to care for.
Toric lenses are available in every wearing schedule from daily disposable to long-term wear. In some cases you may even find colored toric contact lenses. Due to the customization required, toric lenses tend to be more expensive and may take more laboratory time to make than traditional lenses.
If you have astigmatism, finding the right fit for your contact lenses is essential. Speak to your eye doctor today for a full assessment to determine which type of toric lenses will work best for you to help you see and feel your best.
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 iin 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.
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.