Problem Eyes

Problem eyes, which include the conditions listed below, can make contact lens wear difficult or uncomfortable. But if you find the right practitioner who deals with more complex conditions and is able to fit you properly, contact lens wear can still be an option.

You should expect to pay more when being fitted for the types of lenses available for these particular eye conditions, but the expertise involved in finding the best lenses for your eyes, and the satisfaction in having a properly fitting, well-designed, effective lens, is well worth the money spent.

Astigmatism
A condition where vision is affected by an irregularly shaped cornea. Many people with astigmatism also have myopia or hyperopia. Toric contact lenses are designed to correct this problem.

Toric lenses can have two powers in them - one for astigmatism and the other for myopia or hyperopia. They also have an anchoring mechanism to keep them from rotating on the eye for crisper vision.

Astigmatism can be corrected with soft toric contact lenses but it may take time to find the best pair that fit properly and do not rotate too much. For those with a high level astigmatism, RGP (rigid gas permeable) lenses may be the best option for superior vision. RGP lenses allow tears to fill in the irregular areas of the cornea, smoothing out the surface of the cornea and correcting the astigmatism.

Dry eyes
Dry eye is one of the most common problems treated by eye care practitioners. It is usually caused by a problem with the quality or quantity of tears that lubricate the eye. Tears are a very important ingredient in ocular health - not only do they keep the eye moist, they also bathe the eye, removing any foreign elements. Dry eye may occur because not enough tears are produced, or they evaporate too quickly. The symptoms of dry eye include burning, itching, stinging, excessive tearing, or the feeling of having something foreign in your eye.

Dry eyes cannot be cured, but an eye care practitioner who is knowledgeable about different lens materials and how they react with the eye can fit you with the proper dry eyes contact lens products. Usually, a soft, thick, disposable lens is recommended for dry eye. Also, soft lenses that have a low water content are good for dry eye as they dehydrate less than lenses with a high water content. RGP contacts are sometimes prescribed because they do not absorb moisture from your eyes. Generally, practitioners will recommend contacts that are designed to remain moist all day.

Another way to treat dry eye is the use of artificial tears or tear substitutes. For more severe dry eye conditions, small punctal plugs may be inserted in the tear ducts to slow drainage and loss of tears.

Giant Papillary Conjunctivitis
Giant papillary conjunctivitis (GPC) is the result of an allergic reaction to chemicals absorbed by the contacts or deposits that have built up on the lens. Sometimes GPC is caused by a preservative called thimerosal found in many contact lens solutions.

Symptoms include itchiness, redness or irritation. Some people with GPC notice that their contacts seem to be pulled up on their eyes by their eyelids every time they blink. Also, large red bumps with inflamed tissue appear on the upper eyelid.

Usually, eye practitioners will recommend discontinuing contact lens use until the eyes recover. When the condition has improved, your physician may recommend using soft daily disposables since they are discarded daily so there is no time for deposits to adhere to the lenses. Your physician may also recommend RGP lenses as proteins do not attach to them as they do to soft lenses. Finally, you should switch to a contact lens solution that does not contain the preservative thimerosal.

Keratoconus
Also as conical cornea, keratoconus, is a rare condition whereby the cornea becomes thin and bulges outwards in a cone shape. There is no known cure for keratoconus and most people are not even aware they have it because it begins as myopia or astigmatism. It is a progressive disease that may progress rapidly or sometimes take years to develop.

In very mild cases of keratoconus, soft contacts may be prescribed by a practitioner. But because they take the shape of the cornea, they do not effectively correct vision on their own.

Most often, rigid gas permeable lenses (RGPs) are recommended by physicians, since the tears between the lens and the cornea help to smooth out the irregularities of the cornea to make clear vision possible again. Sometimes, keratoconic patients find RGPs very uncomfortable and it is necessary to "piggyback" the RGP over a soft contact lens, which acts as a cushion. However, the most frequently prescribed RGP lens for keratoconic patients -- the Rose K lens -- is claimed to fit better than regular lenses and be more comfortable.

Post-refractive surgery
Different procedures, such as laser vision correction or the photo refractive keratectomy, are becoming increasingly popular, and if successful, the patient will no longer need vision aids. However, these procedures have yet to be fully perfected and can sometimes result in under or over correction. When this happens, another operation may be needed or the use of glasses or contacts must resume.

Even if patients wore contacts before the surgery, a new prescription and fitting will be required due to the change in the shape of the eye and the cornea, making a fitting after refractive surgery more complicated.

If you have a level of astigmatism that is not completely corrected by refractive surgery, you may need toric lenses, which are designed especially for patients with astigmatism. Another option is a prescription for RGP lenses that smooth out the irregular shape of the cornea, providing clearer vision.

Presbyopia
Presbyopia refers to the loss of the eye's ability to change focus from near to far. What makes the fitting of contact lenses for presbyopic patients difficult is the variety of lens designs available and finding the one that best suits the individual's needs.

Multifocal lenses, available in RGPs and soft contacts, are designed for presbyopia patients - they have powers for both myopia (nearsightedness) and hyperopia (farsightedness) with a smooth transition between the two. Another option for presbyopia is monovision that involves fitting one contact for close up and one for distance.

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