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About Contact Lenses
Yes, our office emphasizes vision therapy and preventive vision care, but general optometry including contact lenses is not forgotten. |
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What are contact lenses? Webster defines them as a thin lens designed to fit over the cornea and usually worn to correct defects in vision. What does that mean to you? I get to comfortably wear lenses against the outer surface of my eye and partially under my lids so I do not have to wear glasses to achieve clear comfortable vision. I have a cosmetically pleasing look, a full wide range of vision, lenses that do not fog up, I easily play all sports, and can perform the same tasks I did with glasses. I have the responsibility of cleanliness, storage, and maintenance of very small lenses.
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How are they different from glasses?
The obvious difference is the size and fragility of the lenses. They can be easily lost, torn, dried out, and require more maintenance. |
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Further:
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1. I have to be aware of bacteria and keep hands and lenses clean. |
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2. The lenses must be kept within liquid in a case. That cleans , stops build up, and prevents infection. |
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3. I have to adhere to a rigid wearing schedule that can have serious eye consequences if not followed, especially with the most common form of soft extended wear lenses. Over wear can cause a very uncomfortable corneal ulcer requiring 24 hour treatment.
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4. The optical power of your glasses does not match the optical power of your contact lenses, requiring more power if farsighted and less if nearsighted. This is because of simple optics that requires a different computation of power because the contact lenses are closer to the surface of your eye than glasses.
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5. Glasses magnify or minify the objects you view while contact lenses do not. This is very important if you have a significantly different prescription in each eye. |
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How many kinds of contact lenses are available? Many are available for varying uses, but 90% are soft lenses replaced monthly. All bifocal contact lenses are limited in near vision power and all utilize a form of mono - vision that disrupts eye teaming. See below.
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What methods do doctors use to fit contact lenses?
At first glance the first four methods of the five below seem strange, but they do exist.
At first glance the first four methods of the five below seem strange, but they do exist.
1. Lazy & Irresponsible The doctor simply writes your eyeglass prescription on a prescription pad and tells you to order any contact lenses to match.
1. Lazy & Irresponsible The doctor simply writes your eyeglass prescription on a prescription pad and tells you to order any contact lenses to match.
2. Lazy but responsible. The doctor writes your eyeglasses prescription and tells you to take it to someone who fits contact lenses.
3. Minimal effort with some responsibility. The doctor hands you contact lenses from his stock based only from your eyeglasses prescription and sends you out the door.
4. Some effort with responsibility. This is the same as above but the doctor follows up in a week to be sure the lenses are satisfactory after wear.
5. Effort and responsibility: After your basic examination, the surface of your eye is measured with a keratometer, and your prescription and fit is determined through your immediate wear of diagnostic lenses. You are taught how to handle and care for the lenses and then given a wearing schedule and scheduled in a week to determine the lenses’ success. The next visit determines if they were successful. If not, new diagnostic lenses are given with a week visit. This continues until successful wear.
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How do we fit contact lenses? We use the 5th method with extra caution.
We first determine if contact lens wear is advisable for you by reviewing your entire vision system and your habits, vocation, and hobbies. Some hobbies and jobs preclude contact lenses(field work and jobs where hands are dirty and greasy) while others are advantageous for contact lenses (sports and law enforcement). |
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Contact lenses are available for all vision conditions, but some make contact lens fitting difficult (highFarsightedness farsightedness and extreme astigmatism) and some are better treated with contact lenses (eyes with differing powers [anisometropia] and extremely strong prescriptions). You are then given an estimate of cost and our fee policies.
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Secondly, we emphasize that contact lenses take more time and responsibility (cleanliness, storage, extra solutions, and over wearing) than glasses and that cosmetics are the main driving force for wear.
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Thirdly with your approval, after considering your vision condition, we measure the surface of your eye with a keratometer to determine the curvature of the contact lenses and long term wear of the outer surface of your eye(cornea).
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Fourth we select a diagnostic lens to teach the insertion removal and care of your lenses. Our assistants assist you to place the lenses on your eye and the doctor evaluates the fit and power of the lenses. If the diagnostic lenses seem correct, we follow up in a week to be sure the lenses endure long time wear. You leave with a wearing schedule and necessary supplies. If not, you take the diagnostic lenses home with supplies only to practice insertion and removal. At the same time we order new diagnostic lenses from our laboratory better designed for your wear. At that moment your entire bill is paid. The above process takes place until final fit is concluded.
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After three follow-up visits and your care is not complete, the doctor discusses your chance for success. If you wish to quit, half your fee is applied toward future care for you or your family. If not, we are obliged to continue the process until successful fit. Your only change in fee would be the difference in cost if a more expensive lens is needed. There is no refund from that point. Normally, if fit goes beyond three months an additional $50.00 fitting fee is applied. However with current supply chain delays that has been suspended.
Now, for some special considerations (some of which bear repeating from above.
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Contact lenses have many advantages if you have a high prescription, either nearsighted or farsighted, have one eye of a different prescription (anisometropia), or you simply feel you look better without glasses, contact lenses is the answer. Sports activities are another area contact lenses are an advantage. Even children can wear contact lenses.
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Bifocal contact lenses are another story. As we are concerned with both binocular vision and presbyopia, we do not advise bifocal contact lenses. All bifocal contact lenses compromise binocular vision and are limited in the number of near vision powers. For middle ranges like looking at price tags or computer screens, all bifocal contact lenses use mono vision for that distance with one eye set for regular reading distance of 16 inches and the other for computer distance of 22 inches. That will lead to eyestrain, general fatigue, and mistakes. Thus, you are only using one eye for the computer screen and the other eye for the note you are reading!
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Designing contact lenses with mono-vision is hypocritical if you take time to think about it. First, when you were a teen and had each eye of a different prescription(anisometropia), the eye doc told you contact lenses are better for your binocular vision.. Then in your middle forties when you have trouble focusing your eyes up close (presbyopia), the doc tells you to simply to remove one contact lens for close vision. As a teen you were told it was essential to use both contact lenses. Now, the doc ignores how valuable both lenses were before! Thus, by now removing one lens resulting in mono-vision, you end up just like you did as a teen. The doc must hope you don't remember when you were told it was bad for your eyes. Yes, Mono-vision interferes with your eyes, health, and safety.
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Warning about the purchase of on-line contact lenses:
1. We charge our cost for contact lens materials. Thus, by going on line you save only a few dollars. 2. We guarantee all the lenses we provide and any office visit within the year is included in your yearly contact lens fee. Errors from on-line purchases are not included. 3. Usually, the lenses are equal in quality to the lenses we provide. |
4. They will supply you with as many lenses you wish, even more than a year's supply.
5. They will provide lenses even if your prescription is out dated.
6. If there is a mistake in your order, we can do nothing about it. They send us an e-mail to verify your prescription and include an e-mail for us to answer. They never respond to the e-mail we return. The contact lenses they provided could be wrong but they ignore our answer or block it.
7. For you who use our alternate wear program, we can provide you individual lenses but on line you must purchase a package of at least six. .
8. Not all lenses are available on line (most are), and one brand we use is not available on-line
5. They will provide lenses even if your prescription is out dated.
6. If there is a mistake in your order, we can do nothing about it. They send us an e-mail to verify your prescription and include an e-mail for us to answer. They never respond to the e-mail we return. The contact lenses they provided could be wrong but they ignore our answer or block it.
7. For you who use our alternate wear program, we can provide you individual lenses but on line you must purchase a package of at least six. .
8. Not all lenses are available on line (most are), and one brand we use is not available on-line
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Our government's current federal and state mishandling of trucking and the supply train has now hit contact lenses. We used to have overnight delivery from our contact lens lab in Richmond. Now we have delays of three days and even two weeks in the more specialized lenses. It is even getting worse and some take a month! Fortunately for you who have alternate wear lenses, our supply in office is well stocked.
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History of Contact lenses: For those who may be curios
Contact Lenses Timeline:
1508: Leonardo da Vinci sketches and describes several forms of contact lenses.
1632: Rene Descartes of France suggests the corneal contact lens.
1801: Thomas Young develops Descartes' idea -- a quarter-inch-long, water-filled glass tube, the outer end containing a microscopic lens -- and uses it to correct his own vision.
1827: English astronomer Sir John Herschel suggests grinding a contact lens to conform exactly to the eye's surface.
1887: Glassblower F.E. Muller of Wiesbaden, Germany, produces the first eye covering designed to be seen through and tolerated.
1888: Two independent researchers, A. Eugen Fick, a Swiss physician, and Paris optician Edouard Kalt, almost simultaneously report using contact lenses to correct optical defects.
1929: Joseph Dallos, a Hungarian physician, perfects methods of taking molds from living eyes so that lenses can be made to conform more closely to individual sclera.
1936: William Feinbloom, a New York optometrist, fabricates the first American- made contact lenses and introduces the use of plastic.
1945: The American Optometric Association (AOA) formally recognizes the growing contact lens field by specifying contact lens fitting as an integral part of the practice of optometry.
1950: Dr. George Butterfield, an Oregon optometrist, designs a corneal lens, the inner surface of which follows the eye's shape instead of sitting flat.
1960: Otto Wichterle and Drahoslav Lim experiment with contact lenses made of a soft, water-absorbing plastic they developed.
1971: The soft lens became available for commercial distribution in the United States.
1978: The first toric contact lens was approved for distribution in the United States.
1979: The first rigid gas permeable (RGP) contact lens made of co-polymers PMMA and silicone became available for commercial distribution. Many silicone- acrylate lenses are now available.
1980: A tinted daily wear soft lens became available for commercial distribution.
1981: Extended wear soft lenses became available for commercial distribution.
1982: Bifocal daily wear soft contact lenses became available for commercial distribution.
1983: The first tinted RGP lens became available for commercial distribution.
1986: An extended wear RGP lens became available for commercial distribution.
1987: Disposable soft contact lenses became available for commercial distribution and acontact lens to change eye color for commercial distribution;and first multipurpose lens care product,.A new formulation of fluorosilicone acrylate material for RGP lenses became available for commercial distribution.
1991: Planned replacement contact lenses now available on the market.Daily-wear two-week replacement lenses now available on the market.
1992: Disposable tinted contact lenses available on the market.
1995: Daily disposable lenses available on the market; RGP lenses with low silicone content / high Dk fluorosilicone acrylates became available.
1996: First disposable lenses using ultra-violet absorber are available in the U.S.
1998: First multifocal disposable soft lenses available.
1999 New generation extended wear soft lenses introduced
Author: John Dreyer Optometrist Bsc(Hons), MCOPTOM, DipCLP Created: 3 Jun 2016, Last modified: 31 Jan 2022
1508: Leonardo da Vinci sketches and describes several forms of contact lenses.
1632: Rene Descartes of France suggests the corneal contact lens.
1801: Thomas Young develops Descartes' idea -- a quarter-inch-long, water-filled glass tube, the outer end containing a microscopic lens -- and uses it to correct his own vision.
1827: English astronomer Sir John Herschel suggests grinding a contact lens to conform exactly to the eye's surface.
1887: Glassblower F.E. Muller of Wiesbaden, Germany, produces the first eye covering designed to be seen through and tolerated.
1888: Two independent researchers, A. Eugen Fick, a Swiss physician, and Paris optician Edouard Kalt, almost simultaneously report using contact lenses to correct optical defects.
1929: Joseph Dallos, a Hungarian physician, perfects methods of taking molds from living eyes so that lenses can be made to conform more closely to individual sclera.
1936: William Feinbloom, a New York optometrist, fabricates the first American- made contact lenses and introduces the use of plastic.
1945: The American Optometric Association (AOA) formally recognizes the growing contact lens field by specifying contact lens fitting as an integral part of the practice of optometry.
1950: Dr. George Butterfield, an Oregon optometrist, designs a corneal lens, the inner surface of which follows the eye's shape instead of sitting flat.
1960: Otto Wichterle and Drahoslav Lim experiment with contact lenses made of a soft, water-absorbing plastic they developed.
1971: The soft lens became available for commercial distribution in the United States.
1978: The first toric contact lens was approved for distribution in the United States.
1979: The first rigid gas permeable (RGP) contact lens made of co-polymers PMMA and silicone became available for commercial distribution. Many silicone- acrylate lenses are now available.
1980: A tinted daily wear soft lens became available for commercial distribution.
1981: Extended wear soft lenses became available for commercial distribution.
1982: Bifocal daily wear soft contact lenses became available for commercial distribution.
1983: The first tinted RGP lens became available for commercial distribution.
1986: An extended wear RGP lens became available for commercial distribution.
1987: Disposable soft contact lenses became available for commercial distribution and acontact lens to change eye color for commercial distribution;and first multipurpose lens care product,.A new formulation of fluorosilicone acrylate material for RGP lenses became available for commercial distribution.
1991: Planned replacement contact lenses now available on the market.Daily-wear two-week replacement lenses now available on the market.
1992: Disposable tinted contact lenses available on the market.
1995: Daily disposable lenses available on the market; RGP lenses with low silicone content / high Dk fluorosilicone acrylates became available.
1996: First disposable lenses using ultra-violet absorber are available in the U.S.
1998: First multifocal disposable soft lenses available.
1999 New generation extended wear soft lenses introduced
Author: John Dreyer Optometrist Bsc(Hons), MCOPTOM, DipCLP Created: 3 Jun 2016, Last modified: 31 Jan 2022