Many of our patients here at Eye MD Monterey and at Ryan Ranch have at some point contemplated the idea of wearing contact lenses. For some, the motivation is practical: some patients are active or athletic and want to be able to exercise, dance, and play sports freely without worrying about their glasses falling off. For other patients, the reasons are cosmetic: for instance, not wanting the hassle of carrying reading glasses, to change their eye color, or simply be free of glasses in general for social or theatrical purposes. Whatever the case may be, now is a great time to explore the various options available to you as a potential contact lens wearer. The great news is that contact lens technology continues to advance such that even experienced wearers may find some interesting options they never knew existed. Read on to learn more about the fitting and contact lens selection process:
Clearance for good eye health
The first order of business in a new contact lens fit is to evaluate the eyes, especially the corneas (the clear domes on the front of the eyes), to make sure they are healthy enough to support contact lenses. We assess for issues such as dry eye, allergies, or other conditions that may affect (but not necessarily eliminate) one’s ability to wear contact lenses safely.
Once the ocular health check is complete, most new wearers will first decide whether they will likely wear contact lenses on a part-time or full-time basis. For new wearers, regardless of how often they plan to wear contacts, I generally recommend daily disposable lenses since they do not have to worry about cleaning and maintenance. These are contacts that are opened from a packet and worn for a day, then thrown away before going to bed. A benefit of daily disposables is that they are typically thinner and easier to adapt to as a new wearer, since most patients will feel the lens to some degree in the beginning. They also tend to work better for patients with dry eyes or allergies since there is less eye moisture absorbed by a thin lens and less opportunity to develop deposits that can make contact lens wear uncomfortable. In addition, if a new wearer somehow loses a contact lens during the insertion/removal process or simply by accident, the lens is easily replaceable by opening a new packet.
Other lens choices for new wearers are monthly or 2 week disposable lenses, which are worn daily, then removed, cleaned, and stored in disinfecting solution during the night. After the appropriate amount of time, they are replaced with a brand new pair.
Extended wear contact lenses
Some patients find they are more interested in contacts they can wear overnight. These lenses, called extended wear contacts, are able to deliver a specific level of oxygen to the eye while sleeping versus other soft lenses. While this option is convenient for patients who are forgetful about removing their lenses nightly or patients who have hectic work/sleep schedules (it is a popular choice for firefighters and new mothers), it also carries with it a more significant risk of infection.
Most patients at our office start off their fittings with soft contact lenses, as they are generally more comfortable and easier to adapt to than hard contact lenses, also known as rigid gas permeable lenses. However, depending on the amount of your astigmatism and the shape of your cornea, sometimes hard contacts are preferable because they conform more closely to your eye and therefore provide better fit and clarity than soft lenses. Occasionally, we may need a more detailed map of the cornea, called a topography, to figure out whether your eyes would be better suited to soft or hard contact lenses. Those measurements (as well as the most appropriate starting lenses) will be determined at your first eye exam or at a follow up visit shortly after.
Single vision versus Multifocal and Monovision
Usually patients under the age of 40 will only require correction for their distance vision, also known as single vision lenses. This is because most younger patients still have the capability to focus on small print when they read so they do not need any additional correction for near vision.
Some patients around the age of 40 or older, however, may start to notice that their near vision isn’t as clear as it used to be, due to the normal aging of the eye called presbyopia. These patients often need both distance and near correction, which can be addressed in one of the following ways:
1) Single vision distance contacts with reading/computer glasses over – this is where contacts lenses are fitted to correct far vision and a prescription or over-the-counter pair of glasses is worn over the contacts for reading and computer tasks.
2) Monovision – this is where one eye (usually the dominant eye) is corrected to see far away, while the other eye is corrected for computer/reading vision. The idea may sound unnatural, but the brain is fairly adept at switching between the two eyes depending on the task at hand. There is usually an adaptation period due to the change in depth perception, but most patients adjust fairly well in the first few days.
3) Multifocal/Bifocal -this is where instead of having one eye for far vision and one eye for close vision, each eye does a little of both. There is a section within the contact lens to help with distance vision as well as a section to help with near vision and with very minimal adjustment, the eye is able to find the proper area to look through. In addition, most of the current multifocal contact lenses can correct mild to moderate amounts of astigmatism. Occasionally, if a patient’s astigmatism is too high, a special lens may need to be designed or it may be preferable to try monovision first, since toric (astigmatic) contact lenses can be used.
Multifocal contact lenses we typically fit at our office come in both daily disposable and monthly options.
Usually for new wearers, the doctor will help by inserting the contact lenses for the first time. Then after the vision and fit are assessed, an optician will work with the patient to train them on how to to safely remove the contact lenses, as well as how to properly clean and store them for the night.
Trial period & Follow up
Following training, the doctor will release you for about 1-2 weeks to trial the contact lenses outside the office. The follow up visit is an opportunity to address concerns you had with the lenses such as vision and comfort. Sometimes it may be necessary to change the brand, strength, or replacement schedule of the lenses depending on how the lenses performed. If there were no complications, the prescription can be finalized so that you can begin ordering your own lenses for the year.
Although transitioning into contact lenses comes with greater responsibility for your eye health, the convenience and comfort of natural vision they provide are often a great motivator. As a long-time contact lens wearer myself, I am happy to answer any questions or concerns you may have about the process. Hope to see you at one of our offices soon!