Contact Lens Fitting

Glasses are easy. A quick little exam, choose your frames, and have one of our talented opticians make precise measurements, all in order to make sure your new glasses fit perfectly. When you take that first step out of our office, you can walk confidently knowing your glasses are going to fit properly and comfortably. But glasses are only half the battle.

Contact lenses are also important for us to get just right, with some unpleasant side effects if we don’t do our due diligence. If your contacts don’t fit properly, they can be uncomfortable to wear and can even be more detrimental than just ill-fitting glasses. We take contact fitting seriously. No point in skirting around the issue! So today we’ll explain what goes into contact fittings, how we determine the best way to fit contacts, and how we make sure you walk away feeling comfortable and seeing great in your new contacts.

We specialize in contact lens fitting and evaluations, even helping with those hard-to-fit contact lenses. If you’re new to the world of contact lenses, let’s start with a refresher course:

There are five (5) different kinds of contact lens overall, all made from different materials and can be used for different purposes. Soft lenses made from silicone hydrogels, for example, are the most popular type of contact in the US for their immediate comfort and breathability. They tend to be great for regular wear, and a lot of daily wear contacts will be made from these soft hydrogels. Meanwhile, gas permeable (GP) lenses are more rigid, while they also allow oxygen to pass through like their soft lens cousins. GP lenses usually provide a sharper vision than soft lenses due to their structure, but take a little more chair time getting the correct fit and also getting used to the feel of them in your eye. In addition to those two popular choices, the three other types of contact lenses include a hybrid of the two (GP with soft skirt), silicon-free hydrogel lenses, and now-obsolete and rarely prescribed PMMA lenses (polymethyl methacrylate) which don’t breathe at all. We also offer many types of specialty lenses for patients with special conditions and that is where things get very interesting.

Contacts can also be differentiated by how long they’re meant to be worn. Daily wear lenses are meant to be inserted in the morning and removed at night before going to bed to be cleaned and stored overnight; you do not sleep in them. This includes most contact lens modalities such as daily disposable, 1-2 week disposables, and even monthly lenses. Extended wear contacts, on the other hand, can be worn for longer than a single day, meaning overnight. Some lenses are even approved for overnight wear for up to six or seven days, then removed to be disinfected and cleaned before being used again. Although they are approved for overnight wear, extended-wear contacts put added stress on your eyes and therefore can lead to increased risk of infection and/or irritation.

For those individuals with more irregular work schedules or other conditions that complicate regular disinfecting routines (such as Parkinson’s or Rheumatoid Arthritis to name a few), extended wear lenses may be a better option. While we believe all contacts should be removed and cleaned every night to minimize the risk of infection/irritation, your doctor will recommend an appropriate wear schedule for you. Additionally despite whether the lenses are daily-wear or extended-wear contacts, they should be fully replaced as directed. The GP/rigid lenses are generally replaced on an annual basis, while still removing them, cleaning, and storing them nightly.

With contacts, comfort and good to great vision is always the prime objective. No matter what – if you get soft lenses or gas permeable lenses, or if you choose multifocal or standard vision contact lenses – we always want to get the prescription just right so you’re comfortable while wearing them.

Getting contacts that are just right for you starts like any other comprehensive eye exam. Using equipment like our Optomap, we first take a look at your retinas and look for signs of eye diseases like retinal degeneration, retinal tears/breaks, and glaucoma. After the Optomap, if necessary, we’ll use our OCT machine to take a cross-section picture of your eye, which we can then study to look for any retinal diseases. However, because contacts sit directly on top of your eye and not on the bridge of your nose like glasses, they need a different kind of prescription than your standard pair of glasses. For this reason, we have a secondary, contact lens-specific exam that is in addition to your comprehensive eye exam. We use a TopCon Autorefractor/topographer/keratometer to take additional measurements of your eyes that usually help us determine the appropriate size (base curve and diameter) for your eye shape as well as the type of lens (spherical, toric, etc).

Identifying this prescription starts with our keratometer, which measures the surface of your eye and your cornea, helping us find the right size for your contacts. We may also use a biomicroscope (usually known as a slit lamp) to evaluate the health of your cornea. We might even test how well you can produce tears to ensure your eyes won’t get irritated while wearing contacts. Usually, this is done with pictures of puppies, but lately, we’ve been using more medically advanced ways to measure tear production.

Once this examination is complete, we can talk about what interests you about contacts, whether you’ve worn them in the past or not, and any difficulties or obstacles in wearing lenses in the past so that we may try different options and find what works best for you. It’s important to keep in mind: the technology in contact lenses is constantly evolving! Even if you tried contacts in the past and didn’t like them, the contacts of today are eons better and more comfortable than ones introduced even ten years ago.

Based on those tests and our conversation, we can begin the fitting process; once the appropriate fit and prescription are found we can write a prescription for contacts. But first, we will usually start you off with a trial pair for you to wear for a few days or a week. If you are new to contacts, then we will also perform training on how to safely insert, remove, clean, store, take care of your lenses. Once properly trained with the do’s and don’ts, we have you insert the lenses. Seeing that the front surface of the eye is very sensitive, we need to take baby steps in order to desensitize it and build up your wear time. The first day you start off with a shorting wear time of continuous hours and will slowly build up day by day. This way, you can get used to wearing contacts without the irritations of over-doing it. We’ll ask to follow up with you after a week or so to make sure your contacts are working for you, and we can make adjustments in your prescription if needed. Once it’s been determined they fit without issue, a contact lens prescription is finalized and you can return to your standard annual appointment and enjoy your new eyeglass-less lifestyle. It is also important to note that because contacts are considered a medical device, all states require that you must have a contact lens evaluation every year to determine the eyes are tolerating the lenses well and are still healthy to continue wearing contacts and reordering of lenses.