Joanne wrote:
I am 25 years old, I am farsighted with a contact lens prescription of +5.25 in my RE and +5.50 in my LE.  I am just wondering how bad this is.  I am worried that I am going to go blind.  Most of my friends with hyperopia have +2.00 or around there.  I just went to the optometrist and she changed both of my eyes by .50.  I’m worried that it is going to keep getting worse.  She told me that they consider +6.00 bad.  I am not far from that.  How high do contact lens prescriptions go for hyperopia and when do they consider your eyesight to be really bad?
Thank you

ANSWER

Hello Joanne,
Please allow me to reassure you that you will NOT go blind from farsightedness.  Contact lens prescriptions can be custom made for almost any prescription (even up to +20.00), so you don’t have to worry about not being able to wear your lenses.  That being said, the likelihood of your prescription progressing to anywhere near that number is extremely low.  Although your prescription may still change a little bit, it probably won’t be very much.  Your eyes are not “bad”, and even if they progress to a +6.00, they still won’t be “bad”.  Being 25 years old, you’ve got about 75 more years of use on those eyeballs.  Keep having regular eye exams and you’ll be just fine.

Dr. Donati

Andrea wrote:
Hi
I have been doing contact lens trials. I have narrowed down my choice to dailies but am not sure of which brand / size to pick.  My trials range from BC 8.5-8.7 and diameter 14-14.2; the strength is 1.5+.  Before I commit to a year supply, I want to make sure that I am getting the best size and brand combination for my eye (I only need a lens for my right eye).  Shouldn’t I be comparing lens with the same measurements instead of variation in brand, diameter and base curvature? How do I know if the issue is the fit vs. lens brand?  For example, if the Logic 1 day (14, 8.6) feels like a better fit than 1 day Acuvue moist (14.2, 8.5) and Ciba Daily (8.7) should I try the Acuvue and Daily with the same measurements as the Logic before deciding? I find the logic 1 day least noticeable when wearing (14, 8.6). The Ciba Daily (8.7) moves around and has fallen out. The Acuvue moist is comfortable for the first 10 hours.  I won’t be able to see my optometrist for 1 1/2 weeks and only a few trials left.  Hopefully I can get a few more trial lenses before making a decision. Thanks in advance.

ANSWER

Andrea,

Each brand of disposable contact lenses comes in certain parameters.  Basically the lens brand determines the fit as each brand of daily disposable usually only has one base curve and one diameter.  To explain further you cannot try an Acuvue or Ciba daily disposable in the same parameters as the Logic 1 day because they do not exist.  The diameter and base curvature with soft contact lenses, especially daily disposables have little effect on the fit in most cases.  It’s kind of like one size fits all.  An 8.5 vs. 8.6 vs. 8.7 are of negligible difference with this type of lens.  For most people any of these base curves will fit well.  The thing that will determine the comfort is the type of material and the coatings/solution the lenses have been sitting in.  For some people one brand may be more comfortable and for others a different brand may give the best comfort.  As long as your optometrist says that they all fit well on your eye and that your vision is good, it is up to you to decide which one feels the best.  It is quite possible that more than one of them may feel good and give excellent vision.  In that case either one will be a good choice for you.

Dr. Carol Doman

Marie wrote:
I just came down with a case of viral pinkeye. I know I shouldn’t wear my contacts, but I can’t see without them. I don’t have glasses, nor can I afford them. I live alone and need to continue functioning in society - but without my contacts, I can’t. I need to wear my contacts.
How do I take care of my eyes while still managing my life?

ANSWER

Marie,

The only way to get rid of an infection is to leave your lenses off until the eye is completely healed.  The Virus / organism causing the infection can stay in the material of the contact lens and continually re-infect your eye.   You will need to start with a fresh pair of lenses once the infection is done.   I’m sorry, no one should even consider wearing contacts unless they also have a pair of glasses as a backup.

Dr. Joan Hansen, Optometrist for CAO

Christine wrote:
For a few years, I have been wearing Acuvue Oasys contact lenses, -2.50 in both eyes.  Late this past winter I ran out of lenses, and was forced to wear an old (but never before opened pair of Acuvue 2 lenses, which were -2.25.  When I got my eyes examined shortly thereafter, I was told that my prescription was unchanged, and I was given two boxes of my trusty Acuvue Oasys -2.50’s.  I immediately started having “dry”-feeling eyes, trouble focusing, both at my computer screen, and far distances, and I was getting daily headaches (which I never get).  After 6 weeks and three pairs of the Oasys lenses, I decided to try the last pair of unopened Acuvue 2’s (the -2.25’s) — and all of the problems disappeared instantly.  (I also had no headaches or other problems when I wore my eyeglasses).  Today I am trying some new Oasys lenses with a -2.25 Rx, but all of the same symptoms (dryness, headaches, etc.) are returning — in ONE DAY!

I was wondering if perhaps my problems were with the difference in BC measurements of the Acuvue 2’s and the Oasys lenses - the Acuvue 2’s have a BC of 8.7 and the Oasys have a BC of 8.4.  Any ideas?

ANSWER

Hi Christine,

What you are describing is very strange.  It is weird because you were wearing the Acuvue Oasys lenses successfully for a few years.  The base curves would not cause the problems you are describing.  Did you change contact lens solutions at all?  Do you suffer from any allergies?  If everything has stayed exactly the same there is no good explanation as to why you are now having trouble with the Acuvue Oasys lenses.   I would talk to your optometrist about possible changing your contact lens solution to ‘Clear Care’.   This solution cleans the contact lenses extremely well and is excellent for comfort.
Dr. Doman

Teresa wrote:
I have worn contact lenses for 45yrs and never had a problem.  However, with my last 2 prescriptions I do not see as clearly as I can with my glasses that are +5 years old. In fact I see better with my glasses. The new contacts are monovision but I believe that with my previous contacts both lenses had the same prescription. I realize aging causes changes in the eyes but I can’t help but think that the prescription and/or fit are wrong. I am 60 years old and both nearsighted and farsighted. Bifocals don’t work any better than monovision.

ANSWER

Teresa,
I am not surprised in the least that you can see better with your glasses than with your monovision contact lenses.  Monovision contact lenses are designed to have one eye see in the distance and one eye see up close.  As a result only one eye is working at a time.  Although this does work well for a lot of people, with your glasses you would be using both eyes for distance and near vision.  Two eyes working together are always going to work better and therefore see better than one eye.   I find that bifocal contact lenses in some cases will work better than monovision contact lenses because both eyes will work together, but it sounds like you have tried these and they didn’t work well for you.  There are numerous types of bifocal contact lenses on the market, so it might be worth trying a different brand.   Bifocal or multifocal contacts are not perfected, so usually the vision will never be quite as sharp as with glasses.  Do you wear soft or hard contact lenses?  If you wear hard contact lenses sometimes the corneas can become warped over time, which will affect vision.  In this case it is necessary to stop wearing the contact lenses for a period of time to allow the corneas to return to their original shape.  In certain cases people get to a point where neither monovision or bifocal contact lenses will work well and in those cases going to distance only contact lenses and reading glasses over the contacts may work better.
Dr. Doman

Peter wrote:
I have mild myopia in both eyes (-1.00) and “mild” astigmatism in my left eye. I am trialling soft, disposable contact lenses and find that middle-to-near objects are often blurry (with both -1.00 or -0.75 lenses, but with my astigmatism uncorrected as I’m told it is very mild).

My optician says there is nothing he can do as this is due to my myopia being mild combined with having the contact lens “on the eye” (unlike with glasses), and suggests I wear glasses for “near vision” work and contacts for outdoor sports, etc.

Is it really impossible for me to have contact lenses that give me good near AND far vision? I’d quite like to wear them every day for both near and far vision.

Thanks

ANSWER

Dear Peter

This is an interesting question. As a contact lens expert, I am shocked to withness in my everyday practice how eye care professionnals handle astigmatism in contact lenses. In my book, this is a major mistake to not fully compensate for astigmatism, with appropriate toric lenses. In fact these professionals should be convinced of misleading the public and of malpratice. Astigmatism distorts the vision even if the amount of astigmatism is low. To compensate for it, what your optician did (wrongly) is to increase the amount of myopia. This is called fitting with a spherical equivalent technique. THis is not helping your vision at computer distance or at near because an increase in myopic correction triggers an increased accommodation effort that  can end up with ocular fatigue and a blurred vision. This is exactly what you have experienced.

In the past, astigmatism was undercorrected or spherically compensated because of the bad quality of soft toric contact lenses. They were not accurate, not stable in the eye and did not provide better vision compared with spherical lenses. This is not true anymore. Modern design of contact lenses are available and they are really stable, even for small amount of astigmatism. I strongly recommend Oasys Acuvue for Astigmatism, Air Optix Torics or Cooper’s Biofinity Toric as very good products. There is no rational to not use them on a day-to-day basis. At least, every eyecare practitionner should at least propose trying toric contact lenses and let the patient to decide if this is a better option than a spherical lens. I had patients with major myopic correction and small astigmatism who said WOW when i fitted them in toric contact lenses (for the first time) but I had also some patients who were low myopes with higher astigmatism who did not find any difference in their vision comparing spherical and toric contact lenses. Since there is no way to know in advance what the outcome will be, the only rational approach is to try it (toric vs spherical) and to let the patient experience the difference.

If your optician is not familiar with toric contact lens correction, or denies the value of it, consider consulting an optometrist that is skilled in contact lens fitting and ask to try toric lenses. There is no reason to not see clearly at near and intermediate distance with these lenses except if you are 45 years old and over where presbyopia can come in play. Even then, astigmatism should be considered to correct your vision in contact lenses. We can use monovision strategy or to use multifocal toric contact lenses as well.

Good luck,
Langis Michaud, OD, MSc, FAAO
Associate Professor, U de Montréal

Jo wrote:
Hello

I was at the optometrist 1 month ago, and they give me a sample pair of regular contact lenses of both -6.50 which are to be worn night and day for a period of 1 month.
I have astigmatism and got the original lenses 1 week ago, Bausch and Lomb Purevision toric night and day.
My ophthalmologist prescription was:
RE: -7/ -1.5 axis: 15
LE: -7.25/ -1.75 axis: 170

On the optometrist prescription was following:
RE: -6.50 /-1.75 axis 10
LE: -6.50 /-1.75 axis 170

The axis for the LE went 5 less, I don’t understand why.

Both are 8.7 radius and diameter of 14.00.
I feel there is a blur sometimes on the nasal corner of both eyes which comes and goes with time and the vision feels blurry. I checked the lenses and there is something written on them with a small mark. Is there a particular way to put them in? The optician didn’t say anything about this.

When I order my next pairs of contact lenses could I maybe order the axis of 15 instead of 10 for the RE?
Thank you in Advance.

ANSWER

Dear Jo

The prescription for spectacles and contact lenses is often a bit different as contact lenses sit on the cornea (front of the eye) - depending on how the lenses fit, thus causes changes both to the power and axis of the astigmatism.  You will always see better with your spectacles rather than contact lenses as lenses need to move for good tear exchange. So, every time you blink you will have a loss of focus for a second or two.  There are marks on the contact lenses to check how they sit and fit to your eye.  Due to gravity and the built in prism ballast, the marks usually point downwards.  If you can orientate the marks to point down before you put the contact lenses in it will settle faster.  If you are having problems with the contacts it is a good idea to have a contact lens check before you order new ones.

Miroslav wrote:
New RGP lenses very blurry right after being worn

I’ve been wearing soft contact lenses for about 5 years. During the period I had problems with infections with them because of my eye’s dry nature. My doctor recommended me to switch to RGP’s. I accepted that, and however, I got used to the feel of comfort, but at first I saw there’s some blur in my eyes when I wear them. As the time goes on, and it’s now six weeks after I started wearing them, it gets slowly even more and more blurry. I care for the lenses very strictly, I stick to the maintenance instructions very well, but still, when in the morning I put out my lenses from the cleaning solution and rinse them in saline, they look very clean, but once I put them in my eyes they start to blur immediately. Just after I drop them from the eyes, I see greasy deposits all over the lens. Even washing it in the concentrated cleaner doesn’t help much. I do use protein removal effervescent tablets once weekly.

ANSWER

Miroslav,
If the blur is happening immediately after you put them in, it could be that the lenses are not wetting well.   Infrequently, RGP lenses are not polished properly when they are manufactured, which leaves material on the lens that repels water and makes the vision blurry.  They can usually polish the lenses to remove this material, which improves vision.  Without looking at the lenses I cannot tell if this is the problem or not, so I would definitely recommend returning to your optometrist for them to look at the lenses.
Dr. Doman

Serdar wrote:
Hi,
I have a question regarding legality. This is my first time I’m buying contact lenses. My opto told me that I need a training period. I did this 2 months ago and I paid $55 for this training since my lenses are customized toric. Then I had to go out of town for about 1.5 months. When I came back and I asked the price of lenses for 6 boxes, they told me a higher number. So, I asked them for my lens prescription in order to get advice from another opto but they didn’t give me my lens prescription. I only have my eyeglasses prescription, which I know little bit different than contact lens prescription. Are they allowed not to give me my prescription? Do I have to buy from that optometrist?
Thanks

ANSWER

Hi Serdar,
Customized toric lenses are a specialized product and do cost more than regular disposable contact lenses.  Generally if the contact lens fitting is completed then the prescription for contact lenses can be released.  However if the fitting was not completed then the contact lens prescription is not released as there is no final prescription.  To have the fitting complete all of the follow up visits must be attended to and the contact lens fit and vision through them need to be satisfactory to the optometrist.  If all of these things were not completed the fit is not finalized.  If you are going to visit another optometrist they are likely going to do a new fitting on you, as they will want to ensure that everything is satisfactory with the contact lenses before you purchase them.  You would just need your glasses prescription in that case.
Dr. Doman

Dawn wrote:
I would be grateful for some advice.  I have worn GP lenses for years along with my glasses.  This past 2 years I have been experiencing some real problems, which has left my optician unsure what the problem was. Initially, I thought it was over wear and he agreed too, so I wear my glasses more than 70% of the time now.  The problem is that when I put in my GP lenses they are fine until I blink, then a big greasy like blob seems to be on the lens.  I am constantly taking them out to clean them with specialised cleaner sometimes 2-3 times in the morning, so I can try and see to get my make up on. My eyes feel swollen at the end of the day and my head can sometimes hurt through the constant putting my lenses out and in.  I am long sighted with +5 in both eyes.  I have noticed that maybe for a couple of weeks out of 6 weeks my eyes are fine and the lenses feel great with no problems,  My optician also thinks it could be hormonal. I am at my wits end as wearing my lenses gives me so much more confidence. I do sometimes wear daily lenses and have no problem with them at all.  Should I just stop wearing my GP’s?  They are only 5 months old.  I have asked many people and looked at a lot of websites and I can’t get any answers. I hope you can shed some light on the problem.
Thank you

ANSWER

Hi Dawn,
There could be a number of reasons for your problems.  Contact lenses, especially rigid gas permeables (RGPs) need to be wet to provide good vision.  It sounds like you are having a problem with the lenses staying wet.  This would make it look like you were looking through a film or how you describe it as greasy.  Certain materials are more ‘wettable’ than others.  RGPs can be made out of a number of different materials.  Did you happen to switch materials in the past two years from what you were wearing before?  Some materials work better than others for certain people and certain materials are known to wet better.   I would check to see if you are wearing the same material as you have in the past.  One cause of the problem could be that your eyes are not producing as many tears as they used to.  This is a common occurrence, as we get older.  Using contact lens rewetting drops, suck as ‘Blink’ would help this problem, but this is more common to happen at the end of the day as opposed to when you first put them in.  So, I am not sure if this would be the problem in your case.  Sometimes the cleaning solution could be leaving a film on the lens.  You may want to try changing your cleaning solution.  My other suggestion is if you have no problem at all with the soft daily lenses that you sometimes wear you could switch to those on a full time basis or even switch to a monthly disposable.   I would also recommend seeing your optometrist, as they should be able to solve the problem for you.  I hope this is helpful.
Dr. Doman