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Home » Contact Lenses » Contact Lens Fitting Q&A with Dr. Chris Smiley

Contact Lens Fitting Q&A with Dr. Chris Smiley

Q. What is the difference between an eye exam geared towards wearers of glasses and an eye exam geared towards wearers of contact lens?

A. Both types of exams receive a glasses prescription and comprehensive ocular health assessment. The difference is that contact lens wearers have a separate contact lens assessment and fitting process to determine the best fitting contact lens for their eyes as well as determining their contact lens prescription.

Q. What can be expected during a contact lens fitting?

A. An optometrist will determine the best prescription for your eyes as well as the best contact lens wearing modality, be it daily, bi-weekly, or monthly. Patients then are educated and taught how to insert lenses and remove lenses safely. Once lenses are inserted, an optometrist evaluates the fit of these lenses on your eyes and then prescribes a cleaning solution and initial wearing schedule. Patients are then seen for a follow-up visit in 1-3 weeks after the contact lens fitting visit.

Q. What are contact lens measurements? How is that determined? Does it change if a patient has astigmatism?

A. There are many things that go into measuring for contact lenses. First, the prescription is determined by an optometrist in a test called a refraction. Then the anatomy of the eye, as well as the corneal curvature (keratometry), is evaluated. Contact lenses can be prescribed with and without astigmatism. Contact lenses must be evaluated on the eye to determine optimal fitting characteristics such as shape, curvature, and power.

Q. What kind of instruments and tests can I expect to see during a contact lens exam?

A. An optometrist will look at your eyes and current contact lenses with a slit-lamp microscope. Lenses will then be removed and a refraction is performed in order to obtain a glasses prescription. If changes need to be made, such as a lens material or modality upgrade, trial lenses are given to the patient and then assessed by the optometrist. Typically, a follow-up visit will be scheduled to re-assess the trial lenses at a later date.

Q. What are trial lenses? How can an eye doctor best determine the right contact lens prescription?

A. Trial lenses are given to patients that wish to upgrade or change their wearing experience. These lenses are given to patients during their contact lens exam and are evaluated by an optometrist. The eye doctor looks at the fitting characteristics of the contact lens, wearer comfort, and visual acuity in order to determine the correct contact lens prescription.

Q. Will I know right away if the contact lenses fit or is that something that can only be felt with the passage of time?

A. It depends on the type of contact lenses used. Most patients are given trial lenses so that they can assess their vision and comfort needs in their day to day experience before an annual supply is purchased. Optimal contact lenses provide excellent vision and comfort throughout the course of the wearing day.

Q. Why does a contact lens exam cost more than an eyeglass eye exam?

A. Contact lenses require additional eye measurements as well as an on-the-eye evaluation process that glasses do not. Contact lenses can also be upgraded and trial lenses can be given to patients which require separate measurements and an on-the-eye evaluation as well. Typically patients that receive trial contact lenses are seen for a contact lens follow-up visit which is covered by the contact lens evaluation fee.

Q. What are some advantages and disadvantages of contact lenses?

A. Contact lenses offer patients freedom from spectacle wear and are preferred cosmetically by some patients. Patients typically prefer contact lenses for sports activities and special occasions.

Disadvantages include the time commitment of learning to wear lenses as well as the need for patient motivation. Daily disposable contact lenses have reduced much of the hassles and inconvenience of cleaning contact lenses and inherently a healthier option for patients seeking the best contact lenses available.

Q. How does an eye doctor determine which contact lens brand to recommend to a patient? Whether to use daily contacts or reusable?

A. For most optometrists, daily disposables are preferred as they reduce the risk of ocular infections, provide patients with UV protection, and are typically more comfortable and better tolerated than monthly or bi-weekly lenses. Optometrists are trained extensively in contact lens materials, modalities, and parameters and they select the optimal lens for each patient’s needs and visual requirements. In some cases, made-to-order or custom contact lenses are needed. These technologies allow us to fit almost anyone in contact lenses.

Q. Are contact lenses for everyone?

A. Contact lenses can be a wonderful solution for patients that dislike wearing glasses. However, the ideal contact lens patient is one that is compliant with lens wear and care and sees their prescribing optometrist every year for comprehensive exams. If patients are unable or unwilling to care for their lenses properly, contact lenses may not be the best option.

Q. Are there special contact lenses for dry eye? Astigmatism? Presbyopia?

A. Yes! There are contact lenses that are specially designed for patients with astigmatism as well as patients with presbyopia. Dry eye patients typically do best in daily disposable lenses or custom specialty lenses such as scleral contact lenses may be used for severe cases.