Contacts: Are they right for you?

May 8, 2013


Choosing Contact Lenses

Contact lenses continue to grow in popularity, thanks to lengthened wearing times and improved fit, design and materials.  If you like the way you look without glasses or are just tired of wearing them, contacts may be a good option to consider.

You will find some real benefits to wearing contacts.  Since they move with your eyes, you always look through the centers of the lenses where vision is best.  If you are very nearsighted or farsighted, objects will appear more normal in size with contacts than with glasses.  Contacts don’t fog in cold or humid weather, and they are a great convenience for active sports.

Contacts do have some drawbacks, however, and to wear them successfully you must be motivated enough to overcome the slight discomfort in adjusting to them and the nuisance of daily care, scrupulous cleanliness, and regular examinations.  Then, if the idea of having something in your eye doesn’t bother you and you are otherwise a good candidate, your chances for success are very good.

 How Do Contacts Work?

Contact lenses are small plastic saucers that contain your visual correction on the front surface, while the back surface is specially fitted to the size and shape of your cornea (the eye’s main focusing surface).  They float over the cornea on a layer of tears, held in position by surface tension unless they are forcibly slid off, picked off, or knocked loose.  Don’t worry:  a lens cannot ever get “lost” behind the eye.

Are They Safe?

When properly fit and cared for, contact lenses are generally safe.  As with any foreign material on the surface of the eye, however, there is always the risk of a scratch or an eye infection, or an abrasion if the lenses are worn too long.  More serious problems are also possible.  But if you carefully follow all instructions as to proper lens disinfection and stay alert to possible symptoms, just about any problem can be prevented or successfully treated.

 Types of Contact Lenses

No single type of lens is “best” for everyone.  Each has advantages and disadvantages, and the right one for you will depend on your life style and type of eye problem, as well as on the eye itself.

Hard lenses give the sharpest vision but have some characteristics that make this older style of contact lens uncomfortable to wear; they may be poorly tolerated by many eyes.

A major drawback is that adequate oxygen (needed by the cornea) cannot pass through them.  An improved hard (rigid) lens made of porous materials is called Rigid Gas Permeable (RGP).  These lenses provide excellent vision, though they are generally not as immediately comfortable as soft lenses.

Soft lenses are comfortable to wear, easy to get used to, and permit passage of some oxygen through them.  They are a good choice for sports because they are not easily dislodged, and dust cannot get under the lens to irritate the eye.  However, vision with them is sometimes less sharp, and astigmatism (an irregular shape of the front of the eyeball) requires special "toric" lenses.   Soft lenses are fragile and can tear easily or become worn from handling.  Because the lenses are moist and soft, bacteria and other impurities can adhere to the surface, making it necessary to disinfect them daily.

Extended-wear lenses are soft lenses that allow more oxygen through so that you can sleep in them.  They have more serious potential problems, such as infections of the cornea, than daily-wear soft lenses.  Disposable extended-wear lenses, because they are used for only a week or so, may have less risk of infection.  In Dr. Gold’s best medical judgment, sleeping in contacts lenses is incredibly dangerous.  “I have personally cared for one patient who went blind from abusing extended wear contact lenses, with no hope of ever recovering her vision,” he relates.

How are Contacts Fitted?

You will have a thorough eye and vision examination.  Your corneas will be carefully examined under high magnification to determine if you have any conditions that might make the wearing of contacts inappropriate or hazardous, and your eyelids will be examined for degree of tightness and the presence of infection.

Without touching the eye, the corneal curvature will be measured with an instrument called a keratometer.  A series of trial lenses may also be used in determining the best size and fit, before your custom-made lenses are ordered.

Cost Comparisons

In general, hard lenses are least expensive, last the longest and cost the lease to maintain.  However, gas permeables, which are more widely used today, are almost as durable and cost only slightly more.  Soft lenses cost about the same but require more maintenance and do not last long.  Extended-wear soft lenses are more expensive and their life is even shorter.  The most expensive lenses are the disposable “throw-aways,” but there is no maintenance cost.  We will be happy to discuss all these lenses and their specific costs with you.

*Excerpted from Triad Notes with permission

Dr. Jeffrey D. Gold is the medical director of Liberty Vision in Hamden, CT. He is an award winning surgeon who specializes in Epi-LASIK vision correction. To date he has performed over 11,000 laser vision correction procedures.