Contact Lenses: Are They Right for You?

I get asked a lot of questions about eye health, eye surgery, and vision correction options by my patients. Some of the most commonly asked questions are "Do you think contacts will work for me?", usually followed by a "What do you think of LASIK surgery?" Questions like these make it clear that patients are always interested in finding some way to get out of their prescription eyeglasses. I won't be discussing LASIK surgery here, but I will try to answer the question about contacts in the same way I would try to explain it to a patient in my exam chair.

"Will contacts work for me?"

The initial answer I choose to give many times is: "It depends." There are several factors that must be considered when deciding on whether to pursue contact lens wear. I pose many of these factors to my patients as questions for them to consider. The two most important are:

• Eye health - If your eye is not healthy - you're prone to infections, your eye is very dry, or you have some anatomical eye or lid abnormality, just to name a few - you probably aren't a good candidate for contact lenses. If your eye doesn't appear to me to be healthy enough to wear contact lenses, I will tell you. On the other hand, it makes my job easier if you are truthful about any problems you have, that may not be present at the time of the exam, that could make contact lens wear difficult, or even impossible.

• What benefits do you see in wearing contact lenses versus eyeglasses? I use this question to delve into the "Why" of a patient's interest in contacts. If a patient has unreasonable expectations, we discuss them. It's very common for patients to misunderstand, or totally misinformed, on how contact lenses work and what they are used for.

What are "reasonable" expectations?

Reasonable expectations include:

• Less dependence on prescription eyeglasses. If you manage to stay out of your prescription eyeglasses for most of the day, that's a success.
• Less dependence on reading glasses. I've dashed many potential contact lens wearers' hopes with this one. If you need reading glasses, or bifocal/progressive lenses, you will, in many cases, still need some reading help. There are plenty of contact lens options available that may get you out of your glasses at least some of the time, but none of them are perfect. There's a definite sacrifice in distance vision, near vision, or both that has to be made to reduce eyeglasses dependence.
• Better overall vision. In many cases patients feel they see much better, and much more naturally, with contact lenses on their eyes, rather than with eyeglasses on their face. Patients almost always note improvement in peripheral vision, which helps with activities such as sports and driving.

So, it looks like contacts will work for me, but what are my contact lens options?

There are several, and your eye doctor will go over the options he feels are best for your eyes and visual needs. They include:

• Soft Spherical Lenses - These lenses will meet the vision needs of most patients. You may be excluded from wearing these if you have a very high prescription, more than a moderate amount of astigmatism, or an irregular cornea.
• Soft Toric Lenses - These lenses are designed for patients with moderate-to-high astigmatism. They are ideal for primarily astigmatic patients, who in the past might not have been able to wear soft contacts, giving them the option of wearing a comfortable lens with great vision.
• Soft Multi-Focal Lenses - These lenses are designed for patients who need near vision help. While they usually do not provide vision as good as bifocal/progressive eyeglasses, most patients find they can tolerate the slight blur well because it reduces their dependence on eyeglasses.
• Rigid Gas Permeable Lenses (RGPs) - Often referred to as "hard lenses" - These lenses are ideal for patients who simply cannot wear any of the lenses noted above. The trade-off with this type of lens is reduced comfort for better vision. Patients who have had eye surgery effecting their corneas, or naturally irregular corneas, will often benefit from these. In some cases, these lenses actually provide significantly better vision for patients with eye problems than eyeglasses alone. RGPs also come in all of the flavors of lenses noted above - spherical, toric, and multi-focal.
• Hybrid Lenses - These lenses are the best of both worlds. They consist of a central RGP Lens for optimum vision correction, with a "skirt" that provides the comfort of a Soft Lens. These lenses are the answer that many previously unsuccessful contact lens wearers are looking for. Unfortunately, the premium price point may be a deterrent.

There are many options out there for potential contact lens wearers. It's in your best interest to be armed with the correct information when speaking with your doctor. If you have any questions, don't be afraid to ask. We, as eye care practitioners, want to provide you with the best possible vision and health, and the more we understand about your needs, the better able we are to steer you in the right direction!