Contact Lenses Care

This is the most exciting stage for any new contact lens wearer. At last the moment has arrived when you get to know how they really feel, and what a thrill it is to see—and see yourself —without glasses. If you’re being refitted, you’ll be anticipating increased comfort and improved vision over your old pair of lenses.

You may be surprised to learn that fitting is an art in addition to being a precise science. Contact lenses do not fit your cornea like a second skin or the way a lid fits tightly on a jar. That would prove as uncomfortable as an overly snug garment or a tight pair of shoes; it would also prove unhealthy for the cornea. Rather, the lens must float on just the right amount of tears, which must flow freely under the edge of the lens. As you’ve seen, the tears not only cushion the cornea like a pair of socks cushion your feet, they also clean it and provide it with vital oxygen and nutrients. You may remember the grade‑school experiment whereby a glass tumbler is placed over a lit candle, forming an air-tight seal. Eventually the oxygen is consumed and the flame flickers and dies. A cornea deprived of oxygen suffers too—by becoming swollen and clouded. So a lens must fit “loosely” enough to move slightly with each blink, which allows the free exchange of oxygen and carbon dioxide in the tears to occur.

On the other hand a lens must fit snugly enough so that it doesn’t slip around too much. Such slippage would result in blurred vision, possibly irritation, and a lens that may pop out. Your feet are just as unhappy in too-loose, blister-causing shoes as they are in too-tight toe-pinchers. This is where the “art” begins to come in: the fitter must seek a delicate balance between tightness and looseness to achieve optimum wear.

To facilitate the fitting the doctor will place a pair of trial contact lenses on your eyes. These will closely approximate your final prescription, but they are not your final contact lenses, so don’t be unduly upset if your vision isn’t crystal clear at this point. Since this is probably the first time you’ve voluntarily allowed anything solid to be placed in your eye, it may be a tense encounter. Novices should just try to relax and let the doctor do his job; soon you’ll be inserting them yourself without giving it a second thought.

Fitting doesn’t stop with the insertion of trial lenses. Even after measurements have been made and the most suitable lenses tried, other fitting factors come into play. A high minus lens, for instance (for myopia), tends to ride high on the eye because of the shape of the lens that the prescription dictates. A high plus lens on the other hand (for hyperopia) tends to fall slightly downward once placed on the eye. Such decentered lenses may cause discomfort in addition to less-than-perfect vision. To correct this phenomenon a lens may need to be smaller or larger, heavier or lighter, steeper or flatter, or some combination of these factors.

After about a half hour of wearing your trial lenses, the doctor will examine your eyes while the lenses are in place. In addition to testing the refraction, he will examine your eyes with the slit lamp in order to check the size and fit of the lenses in relation to the cornea.

From the information gathered from the trial lenses the practitioner will then order the exact lenses you’ll need. If you are being fitted for hard or gas-permeable contact lenses, your lenses will be “custom-made”: that is, the exact prescription can be permanently carved into the plastic, as well as the exact size and curvature made for each lens. Unfortunately the time has not yet come when soft lenses are completely custom- designed for the individual, though minor modifications can be made in stock lenses that approach custom-made in fit and performance.

When your lenses have arrived, you will return to pick them up, and have them inserted and evaluated while they’re in the eyes. You’ll also be taught the correct way to handle, insert, and remove the lenses. Usually a highly trained technician performs this function, shows you films, and supplies you with pamphlets that instruct you in the proper procedures. Make sure that before you leave the office, you understand and have practiced these procedures. You’ll also receive a wearing schedule and whatever equipment and products are required to clean and maintain your lenses. Once the technician is satisfied that you have practiced care techniques enough to have mastered them, and that you are familiar with the products, you’ll be allowed to depart with your lenses.

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