If you’ve never worn contact lenses before, it can seem a bit intimidating. After all, you’re inserting something into your eye! Let’s ease your mind about the first step – your contact lens exam. This post will walk you through what’s involved in a contact lens exam and what you can expect every step of the way.
Your eye doctor will first determine your overall eye health and vision. This includes a discussion of your health history and then a series of standard eye tests. These tests will evaluate eye focusing, eye teaming, depth perception, color vision, peripheral vision, and the response of your pupils to light. The doctor will also measure your eye’s fluid pressure to check for glaucoma, evaluate your retina and optic nerve, and test your vision with different lenses to assess whether contact lenses can improve your vision.
If contact lenses are appropriate for you, it’s time to talk about your contact lens preferences. For example, do you want to enhance or change your eye color? Would you prefer daily disposable lenses or overnight contacts? Ask about the benefits or drawbacks of each, so that you make the best decision. If you’re over 40, your doctor will likely discuss age-related vision changes and how contact lenses can address these issues.
Contact lenses require precise measurements of your eyes to fit properly. Using an instrument called a keratometer, your doctor will measure the curvature of your eye's cornea, the clear front surface of your eye. Next, the size of your eyes pupil is measured using a card or ruler showing different pupil sizes which is held next to your eye to determine the best match.
If you have dry eyes, your eye doctor will perform a tear film evaluation to measure the amount of tear film on the surface of your eye. If your tear film is insufficient or you have chronic dry eyes, contact lenses may not be a good option for you. However, some newer contact lenses deliver moisture to the surface of the eye, making them a better choice for individuals with dry eye issues.
The final step is to fit you with a trial pair of contact lenses. Once inserted, your eye doctor will examine the lenses in your eyes to ensure a good fit. He/she will check the alignment and movement of the lenses on the surface of your eye and if the fit looks good, the last step is to ensure the prescription is correct with a few more tests.
Your contact lens exam is over, but you’ll need to come back. Your doctor will usually have you wear the trial lenses for a week. After that, you’ll have a short follow-up exam to confirm that the lenses are working well for you and you can then order a supply of contact lenses. If this is your first contact lens exam, don’t worry. Choose a qualified optometrist and they’ll answer all your questions as you go. Just be sure to let them know you’re interested in contact lenses so that they know to allow for extra time in your appointment for the consultation and any specialized tests.
Soft and silicone hydrogel lenses are the most popular options and are available for daily, 2 weeks, monthly, and planned replacement. The new generation silicone hydrogel lenses are made of highly breathable materials which allow for more oxygen transmissibility than previous lenses. This allows greater comfort and longer wearing intervals for some patients. Soft contacts are the easiest to wear and the most comfortable contact lenses.
Rigid gas permeable (RGP or GP) are made from rigid but breathable materials and provide for better vision for some people with corneal surface irregularities including keratoconus or irregular astigmatism. These lenses take longer to adapt to due to initial discomfort but provide a good longer-term solution for those whose vision benefits from the rigid designs.
Scleral contact lenses are larger rigid lenses that cover the entire cornea of the eye and rest on the sclera (outer white area.) These lenses are another alternative when corneal irregularities occur such as keratoconus, post surgery, or they also can be used in dry eye. Even though the material is more rigid, they are quite comfortable.
Bifocal or multifocal contact lenses come in soft or rigid materials. These lenses are designed to aid vision in near and distance when eyes have lost their ability to accommodate due to presbyopia. Several designs are made from different manufacturers that enable our doctors to work with you to find the most appropriate solution for you.
Monovision is actually a fitting alternative to multifocal contacts. Some patients will find that this alternative of correcting one eye for distance and the other eye for near vision is the best solution for their needs.
Toric lenses correct for astigmatism by using a directional lens that positions itself on the eye to correct for the amount of astigmatism in each eye. These lenses can be made of soft or rigid materials and have thicker areas in the lens to orient the lens on your eye to correct for your cornea or lens irregularity.
Colored contact lenses are normally worn for cosmetic reasons when patients want to change or enhance their eye color. For some situations where pupil irregularity exits or other medical reasons, colored lenses may be used to block out or reduce the amount of light entering the eyes. Note: all contact lenses require proper fitting and a prescription to be worn, even if you have no need for corrective lenses.
Hybrid contact lenses including the ClearKone from Synergeyes lens are a rigid lens set in a soft lens skirt for comfort with the vision of a gas permeable lens. These lenses are used to correct for keratoconus and irregular astigmatism.
Piggy-Back lenses are actually a fitting technique where a soft contact lens is used in addition to a rigid lens. This combination is used in specialty situations with corneal irregularities like keratoconus.
Post-Surgical contacts for patients with a history of corneal procedures like Radial Keratotomy (RK), Photorefractive Keratectomy (PRK), Laser-Assisted-In-Situ Keratomileusis (LASIK), or corneal transplant and have need for vision correction. These are lenses custom made for corneas that have been altered by surgical procedures, and are outside the normal available parameters for contact lenses.