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Hard to Fit Contacts

Contact lenses are not an easy solution for every person suffering from vision problems. Some eye conditions make wearing contacts a difficult proposition. However, it does not rule out wearing contact lenses altogether. It just means patients need to discuss options with one of the doctors in our office and obtain specialized hard to fit contacts for their specific vision problems.

WHY CONTACTS CAN BE "HARD TO FIT"

Finding contact lenses that fit comfortably and provide good vision can be made more challenging when these conditions affect your eyes:

  • KERATOCONUS
  • SIGNIFICANT EYE ALLERGIES 
  • HIGH ASTIGMATISM
  • DRY EYE

Keratoconus: This is an uncommon condition in which the normally round, dome-like cornea (the clear front window of the eye) becomes thin and develops a cone-like bulge. Keratoconus literally means "cone-shaped cornea." This irregular corneal shape causes major discomfort when wearing "regular" contacts. In addition, visual acuity is typically compromised since light enters the eye through the cornea which in the case of keratoconus is irregular. These irregularities cause significant visual distortion resulting in poor vision.  For more information: http://www.nkcf.org

Eye Allergies: There is a form of eye allergy known as Giant Papillary Conjunctivitis ("GPC"). It is typically caused by inflammation on the inner surface of the eyelid. Protein build-up on contact lenses can make this condition worse.

Astigmatism: Astigmatism develops when the front of the eye curves into a bulge or oval shape. It causes blurred vision and can be difficult to correct because regular contacts cannot account for the bulging.

Dry Eyes: When eyes become excessively dry, it leads to irritation, burning, redness and blurred vision. Contact lenses can exacerbate these conditions by making the surface of the eye feel gritty or sandy.

OPTIONS FOR HARD TO FIT CONTACT LENS PATIENTS

Wearing contacts is not impossible if you suffer from one of the above conditions. You do need to meet with an eye care professional, however, and get prescribed contact lenses that are tailored to deal with your specific vision condition.

KERATOCONUS is best treated with a custom design contact lens. The lens selected for you will depend on the degree of irregularity on the cornea.  The goal in fitting a patient with keratoconus is to avoid involvement of the irregular corneal surface.   One type of lens that does that is considered a "hybrid" contact lens which is a combination of both rigid gas permeable and soft lens materials.  

                                               

Another custom design contact lens option for these hard to fit conditions is a "scleral" lens.  Patients with keratoconus have an irregular cornea so this type of lens is measured and manufactured to actually rests on the white part of the eye (known as the sclera).  Since the lens edges are on the white part of the eye, they allow the doctor to actually "vault" the cornea when fitting this lens.  As a result, there is no corneal involvement and the lens acts as a new surface which is free of irregularities

                                                

Gas permeable lenses are a good solution for patients who suffer from severe EYE ALLERGIES. This type of lens is made of a material that will limit protein deposits from accumulating on the surface of the contact. This is very helpful in the case of allergies. 

Toric lenses are useful for correcting ASTIGMATISM. Since the lens needs to align with the bulge it is correcting, toric lenses must not rotate in order to provide stable, acceptable vision.  Many of the manufacturers have a variety of astigmatism-correcting options.

Medicated eye drops can be an effective solution for dealing with DRY EYE. They will lubricate eyes enough to make contact lenses more comfortable.  Using their experience, all of the doctors will work to increase comfort by selecting the proper degree of curvature, hydration,  and material of the contact lens.

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