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Over 24 million people in the United States now wear contact lenses. Contacts provide a safe and effective way to correct vision when used properly. They can offer an excellent alternative to eyeglasses, depending on your vision and your lifestyle.

What are contact lenses?

Contact lenses are small, curved plastic disks designed to sit on top of the the cornea, the clear front surface of the eye. Contacts cling to the film of tears over the cornea because of water surface tension, the same force that causes a droplet of water to stick to an outside window. Contact lenses can be used to correct the same conditions that eyeglasses correct:

bulletMyopia (nearsightedness)
bulletHyperopia (farsightedness)
bulletAstigmatism (distorted vision)
bulletPresbyopia (need for bifocals)

Special colored contacts can be used to change the color of the eyes to various degrees. Additionally, contact lenses are sometimes used in eye diseases where an irregular cornea blurs vision, such as with keratoconus or scarring.

What types of contact lenses are available?

PMMA lenses

These hard contacts were the first lenses; they were developed in the 1960s. They are made of a type of plastic called PMMA, which is very durable, but does not allow oxygen in the air to penetrate the lens and reach the cornea.
When the eye blinks, the PMMA lens moves, which allows the oxygen dissolved in the tears to reach the cornea.
While these rigid lenses are probably the least comfortable type of contacts to wear, some users prefer them for their durability and lower cost. PMMA lenses are rarely prescribed today.

Gas-permeable lenses

Newer rigid lenses made of space-age plastics combined with other materials, such as silicone and fluoropolymers, allow oxygen in the air to pass directly through the lens and reach the cornea. They are called gas permeable. Gas-permeable lenses are somewhat less durable than conventional rigid lenses but are more comfortable. Some gas-permeable lenses are extended wear, and may be worn overnight for up to seven days.

Soft contact lenses

These lenses are made of soft plastic materials that incorporate water. The water makes them flexible, as well as allowing oxygen to reach the cornea. The vast majority of contact lens wearers in the United States use soft lenses. Some soft contact lenses are extended wear lenses, which means they are designed to be left in the eye overnight. It is recommended that extended-wear lenses be removed weekly, at a minimum, for thorough cleaning and disinfection. (Note: Dr. Khater does NOT reccommend that extended wear lenses be worn overnight, because of the significant increase in risk of a blinding eye infection.) Soft daily-wear lenses are designed to be removed at bedtime, and should never be used as extended-wear lenses. Extended wear lenses can be used as daily-wear lenses.
Disposable lenses for daily or extended wear have recently become available. The lenses are discarded and replaced every two to six weeks. These lenses are convenient and since a fresh lens is replaced on a regular basis, and may reduce the chance of allergic reactions and deposit formation.

Toric contact lenses

Toric lenses are contacts that have a complex curve on one or both surfaces, and are used to correct mild to moderate astigmatism. They are available in many different materials.

What does the price include?

When comparing the price of contact lenses, it's important to consider what services are included. Does the fitting include a thorough eye examination and followup? Can you exchange lenses during the initial fitting, and is insurance for lost lenses available?

If you need treatment for an eye condition not directly related to the contact lenses, such as inflamed eyelids or dry eyes, there may be additional charges.

What are the risks of wearing contact lenses?

Rigid lenses that are not gas permeable are more likely to scratch the cornea if the lens is not inserted properly or if the lens is worn while sleeping. They are also more likely to slide off the cornea and become malpositioned under the upper eyelid. Rigid lenses traditionally have had a reputation for "popping out" of the eye. Newer lens designs have minimized the chance of losing a contact even during vigorous exercise. Some lenses may allow for protein build-up, which can cause an allergic reaction and discomfort and intolerance to the lenses. You will need special cleaning solutions to remove the protein.

Daily-wear lenses should never be worn as extended-wear lenses. Misuse can lead to blinding eye infections, scarring, and blood vessel formation causing temporary and even permanent visual loss.
People who wear any type of lens overnight have a greater chance of developing infections of the cornea. These infections are often associated with poor cleaning and lens care.

What is proper care of contact lenses?

Contact lenses must be properly cleaned and sterilized when you remove them, to kill germs and prevent infections.

At the time you insert your contact lenses, you should thoroughly rinse the case with contact lens solution and allow it to dry. All contact lens cases need frequent cleaning, including cases for disposable lenses. Soft extended-wear contacts are the most likely to have protein build-up and cause lens-related problems. Soft dailywear lenses are less likely to create these problems. Rigid gas-permeable or disposable lenses may be good choices for someone with allergies.
Homemade saline solutions, cleaning with tap water, and swimming with contact lenses have been linked to serious eye infections and should NEVER be used or done.

Additionally, any eye drops, even nonprescription ones, can interact with all types of contact lenses. Check with your ophthalmologist before you use any eye drops.

Who should not wear contact lenses?

Most people who need vision correction can wear contact lenses, but there are some exceptions. Some of the conditions that might keep you from wearing contact lenses are:

bulletFrequent eye infections
bulletSevere eye allergies
bulletDry eye syndrome
bulletA dusty or dirty work environment
bulletInability to care for the lenses properly
bulletPrevious glaucoma surgery

Are contacts for you?

Whether or not contact lenses are a good choice for you depends on:

bulletChoosing an eye care professional who is knowledgeable and experienced with eye diseases and contact lenses, and with whom you can discuss your needs and expectations;
bulletDiagnosis and treatment of conditions that may prevent successful contact lens wear;
bulletYour personal motivation to make it through the short period of adjusting to your contact lenses;
bulletAdhering to contact lens care guidelines for wear, disinfecting and cleaning.

If you have any additional questions or would like further information, ask your ophthalmologist.

 


West Texas Eye Associates
Tim Khater, M.D., Ph.D.

Lubbock's Eyecare Center for Excellence

Copyright 1999 Tim Khater, M.D., Ph.D..  For information, please contact drkhater@wtxeye.com

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Last updated January 14, 2007 .
This page designed and created by Tim Khater, M.D., Ph.D..  (yes, the doctor really created the web page, ...without any help from his kids...)

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