Contact lenses are a great alternative to glasses but they must be properly fit and their care understood to be safely worn. Unlike glasses, contact lenses come in different shapes so must be seen on the eye by the doctor to be sure they are not too tight or loose. Also the prescription for contacts is not the same as that for glasses so must be assessed with the contacts on. Poorly fit contacts and improper care can lead to severe infections and scarring of the eyes that may affect vision for years to come.
Below you will find the answers to some of the most frequently asked questions regarding contact lenses.
WHAT IS "NEW" IN CONTACT LENSES?
Contact lenses improve all the time so if you have had problems with them in the past you may want to try them again every few years. The trend now is to disposable contacts that are worn daily for 2 weeks to a month and then discarded. The advantage of this type of contact is that there is less of a chance for protein build-up so the comfort and vision is improved.
There are contact lenses for those with astigmatism called “Toric” contacts. We offer colored contacts for those who want a new look. There are bifocal contacts or mono-vision contacts for those over 45 years-old who want to be able to see far away and close up without glasses.
ARE MY CONTACTS "FIT"?
We are often asked at the end of an eye exam for a contact lens prescription, which is not the same as a glasses prescription. Contacts come in different materials, sizes and shapes, as well as powers. An improperly fit contact lens can lead to serious eye problems such as a corneal abrasion or even a corneal ulcer. A contact lens fitting is not usually included in an eye examination fee, due to the extra testing involved, but can be done at the time of a regular eye exam. Our contact lens specialist, Dr. Mark German, makes sure that your contacts are "fit."
What is involved in a contact lens fitting? The cornea is like a window in the front part of your eye. Each individual cornea is unique, much like a fingerprint for that person. When fitting contact lenses, we take several measurements from the cornea to determine the appropriate size and the curvature for the contact lens along with the glasses prescription. Many different plastics are available in contact lenses and one is chosen to provide you with the best possible comfort and vision. A contact lens material, design, power and shape is chosen at the time of the fitting and that contact lens is placed on the eye. The contact lens is then checked with a microscope to ensure that the lens is fitting properly and the vision is assessed. If a contact lens is not fitted correctly, or if a patient tries to wear someone else’s contact lenses, eye irritation or even a serious eye injury can occur.
The next part of the contact lens fitting involves education. You could have the perfect contacts but if you are not caring for them correctly you could still get into serious trouble. The wearing schedule and cleaning regimen needs to be understood. For those new to contacts, learning how to put them in and take them out may take some time. You want to leave that appointment seeing well, understanding how to care for your contacts and realizing the warnings signs of trouble that would necessitate an immediate appointment.
WHAT KINDS OF SOLUTIONS SHOULD I USE?
With the advent of more advanced solutions for disposable contact lenses, we are now faced with the question of ‘do we or do we not rub’ our contact lenses to clean the protein and germs off of them. When using ‘no rub’ solutions properly, after removing a contact lens at the end of the day, each lens needs to be squirted with the solution for 10 seconds on each side to remove debris and germs. As this takes a significant amount of solution, an alternative is to ‘rub’ the contacts for about 10 seconds with your fingers with the same solution. Either way, the contacts are then stored in a clean case that you rinsed in the morning and allowed to air dry. Also, replace the solution in the case at the end of every day.
Recently, the eye health industry has been faced with several outbreaks of vision threatening infections that have been traced back to some of these solutions. After thorough investigation, the finding is that some of these infections have occurred because the individuals were not cleaning their contact lenses properly. They were either not rubbing their lenses or were not rinsing them sufficiently. Some patients were just removing their contacts and placing them in the contact lens case. So whichever method you choose, "no-rub" or "rub", do it properly.
What can happen if your contact lenses are not cleaned properly? A corneal ulcer may result which is not only painful but sight threatening. So, take a little extra time to avoid getting into trouble with your contacts. And certainly do not sleep or swim in your contacts!
CAN I DEVELOP AN ALLERGY TO MY CONTACT LENSES?
While it sounds like quite a mouthful, giant papillary conjunctivitis (GPC) is a common eye condition. It's actually an allergy to contact lenses. It generally occurs in patients who have worn contact lenses for years. They come in concerned that their contacts are no longer comfortable and that they have a slight discharge from their eyes. "But I've worn contacts for years without problems" is their response when told of the diagnosis. It's precisely that long duration of wear that triggers the condition.
Patients with asthma, hay fever or animal allergies may be at greater risk of developing GPC. This condition is believed to be a reaction to protein deposits building up on the contact lenses. The name comes from what we see when we flip the upper eyelid: 1-2 mm bumps called "giant papillae".
The key to treatment is decreased lens wear time, frequent replacement of the contacts and diligent cleaning of the lenses each day. Disposable contacts help because they are discarded before the protein builds up. Sleeping in contacts has to stop. Besides the above, treatments may include allergy drops or non-steroidal anti-inflammatory drops. Once the GPC clears up, the patient may want to consider LASIK vision correction to avoid a recurrence.
HOW SHOULD I CARE FOR MY LENSES?
Contact lenses are a safe and effective way to correct your vision BUT you need to be sure you are taking care of them correctly. Poor contact lens care can lead to severe infections and scarring that could permanently impair your vision.
There are many different types of contact lenses so be sure you know how long you should wear your particular type. It varies from one day to until they are uncomfortable. With rare exceptions, you should not sleep in your contacts lenses. This is because your eyes become deprived of oxygen during the night when a contact is in. The result may be an inability to fight off an infection.
Besides not sleeping in your contacts, you also should not wear them from the minute you wake up until bedtime that night. This also is to let the cornea, the front part of the eye, breath and stay healthy. You should wear your glasses at least 1-2 hours per day.
Care products vary depending on the type of contact lens. Be sure you clean your contacts daily and replace the solution in the case each day. The contact lens case should be air dried after a thorough rinsing each day.
If your eyes are uncomfortable, take the contacts out. Let your eyes rest but if the discomfort does not improve, you need to be seen. Everyone who wears contacts needs a pair of glasses also for situations like this.
WHAT IF I HAVE DRY EYES?
While worse in the winter, dry eyes can make contact lens wear uncomfortable all year long. The symptoms of dry eyes are usually worse towards the end of the day. Many also notice fluctuating vision and redness around the iris (colored portion of the eye). Their contacts may even curl around the edges when they remove them.
The problem is due to a decrease in tear production over time and a more rapid evaporation of the tear film in dry environments. The result is a drying out of many types of soft contact lenses. But if you have been experiencing any of these problems, we may have a solution for you.
Recent technology has produced a new type of soft contact lens to prevent dry eye symptoms with contacts. These silicone soft contact lenses are designed to be healthier for the cornea (the front surface of the eye) and lessen the dryness problem.
Some of the contact lens options are: Acuvue Advance, Oasys, O2Optics, Focus Night and Day, and Purevision lenses. There are even options for those of you with astigmatism or who are wearing bifocal contacts.
Other contact lens option, other treatments for dry eye include the placement of tiny punctual plugs which decrease the drainage of tears from the eyes, the use of tear supplements and prescription products such as Restasis that increase the quality of your tears. If you have dry eyes you may have to admit that contact lenses are not for you. The contacts make your eyes more dry by absorbing your tears, leaving less moisture to coat the eye. Many patients consider LASIK vision correction when this occurs.
CAN I SWIM IN CONTACT LENSES?
Can’t see without your glasses and love your contacts, so why not swim in them? The answer is that you should NOT swim in contact lenses because it increases your risk of eye problems from mild irritation to severe eye infections. Most contact lenses are at least 50% water. So if you are swimming in a pool with chlorine, that chlorinated water is going to penetrate your contacts and stay in contact with the surface of your eye for up to an hour after swimming. This can irritate the surface of your eye and increase your risk of infection.
While mild eye irritation goes away in a day or so, a severe eye infection can result in permanent eye damage. Even in the best maintained pool or spa, bacteria can be present. In lake water, a severe pathogen called acanthamoeba may be present that causes a difficult to treat corneal ulcer. This protozoa penetrates the cornea rapidly and often requires specially formulated eye drops to save the eye. Beaches may also present the possibility of a fusarium fungal infection.
So if you want to swim and see without glasses, please consider LASIK. Wearing contact lenses in the water decreases your chance of fighting off possible infections. Should you have a severe corneal ulcer, the scarring may make contact lens wear in the future impossible and also make you a poor candidate for LASIK vision correction.
