Utilizing cutting edge technologies and techniques our eye doctors in North York, Toronto, design and fit Scleral Contact Lenses and other specialty contact lenses for hard to fit patients.
It is not uncommon for patients to have difficulty wearing contact lenses for a number of reasons. Due to the individual eye shape, certain conditions or impairments or the aftermath of surgery, some patients are considered to be “hard to fit” as contact lens wearers.
For hard to fit patients that prefer to wear contact lenses however, there are options available that can provide comfortable and effective contact lens wear. This will require a specialized fitting with an eye doctor that is an expert that knows your condition and the various products available to find the right match for your specific condition. You may be considered a hard to fit contact lens candidate if you have one of the following conditions:
Giant Papillary Conjunctivitis (GPC)
Pellucid Marginal Degeneration
Complications from post-refractive surgeries including LASIK, PRK, RK, ALK, and CK and Intacs
Presbyopia (reduced near vision common in individuals aged 40 and over).
Steven Johnson's Syndrome
Severe Dry Eye
Dry Eyes and Contact Lenses
Dry Eye Syndrome causes your eyes to feel dry, gritty, burning, red, and irritated. Dry Eye Syndrome can also cause blurred vision. Often these symptoms can sometimes worsen by the use of contacts. In fact, many people who do not normally suffer from chronic dry eyes, will experience some of these symptoms as a result of contact lens wear.
First of all, if you have chronic dry eyes, you should see your eye doctor for treatment and relief before you think about contact lenses. Once your dry eyes are treated, it is safe to try contacts and there are a number of options that can be considered.
Many brands of soft contacts and products such as disinfectant and cleansing solutions are made with ingredients that are designed to be more comfortable for individuals with dry eyes. Your eye doctor will be able to recommend some of these brands and products to you. Alternatively, gas permeable (GP) or rigid gas permeable (RGP) lenses are made with a hard material that in some cases does not dry out like soft lenses and they are able to hold a certain amount of moisture beneath the lens to keep the eye from drying out. Gas permeable lenses are a very good option and can be quite comfortable for individuals with dry eyes.
Additionally, your doctor might recommend a specific wearing schedule such as limiting the time you wear your contacts throughout the day or replacing your contacts on a more frequent basis.
Toric Lenses for Astigmatism
Astigmatism is a condition that causes blurred vision (in some cases double vision) because rather than being round, the front of the eye (the cornea) has two curves instead of one, therefore, having two focal points instead of one. This makes it hard for traditional contact lenses to fit and therefore requires specialized contact lenses such as toric lenses or rigid gas permeable lenses (RGPs).
Toric contact lenses are designed to correct astigmatism and custom made to fit the eye of the patient. Most are made of soft material designed to stay in place on the eye, however in some cases, when the rotation of the lens (due to blinking and eye movement) can’t be stopped, gas permeable lenses might be tried. Due to the customization and more complicated fitting process required for these lenses, they are more expensive and take more time for the contact lens laboratory to make than traditional lenses.
Giant Papillary Conjunctivitis (GPC) and Contact Lenses
GPC is a type of conjunctivitis in which the inner surface of the eyelid becomes swollen. The condition can be caused or worsened by a buildup of protein deposits on contact lenses. Your eye doctor may either recommend daily disposable lenses or RGP lenses (which are not water-based) and therefore do not have a tendency for protein buildup. Your doctor may also prescribe medicated eye drops and require you to stop the use of contact lenses until the symptoms improve.
Rigid Gas Permeable (RGP) or Gas Permeable (GP) Lenses
Rigid Gas Permeable (RGP) also known as Gas Permeable (GP) lenses are effective for many hard to fit patients. The hard, oxygen permeable material lets the eye breathe and significantly reduces the chance of infection due to protein deposits which tend to harbor bacteria on soft lenses. RGPs also hold moisture under the lens to keep eyes from drying out.
Rigid Gas Permeable (RGP) Lenses for Keratoconus
Keratoconus is a condition in which the cornea thins and bulges forward into a cone shape. Traditional contact lenses may cause some discomfort in these patients and the vision may still be blurry therefore RGPs are often used for treatment for mild, moderate, and some severe cases. Rigid gas permeable lenses may help to slow down the cone shape from worsening in some cases. Further, RGPs are able to assist in vision correction for keratoconus which is often not possible with soft contacts or even eyeglasses.
Post-LASIK or Vision Correction (Refractive) Surgery
While LASIK surgery has a very high success rate, there are vision complications and symptoms that sometimes remain. Night vision after LASIK, in particular, can sometimes give you side effects such as glare or halos around lights. RGPs are often effective in helping with these side effects and restoring clear vision.
Bifocal and Multifocal Contact Lenses for Presbyopia
Presbyopia is a common condition in those people usually over 40 years old iin which the eyes’ ability to focus on close objects is impaired. Many people keep a pair of bifocal or multifocal glasses on hand for times when they have to read menus, newspapers, books, and other objects that require near vision. For those that prefer contact lenses over eyeglasses, bifocal and multifocal contact lenses are an option.
For some patients that have presbyopia and need correction for distance vision as well, one option is monovision. Monovision is a contact lens fitting process in which you wear a contact lens in one eye for distance vision and the other contact lens of your other eye for near vision. Another option is multifocal contact lenses. In this contact lens fitting process, both eyes are usually fit for distance vision and both eyes are used for near at the same time. Both contact lens fitting options usually take about one week for the brain and the eyes to adjust.
If you have one of these conditions or find contact lens wear difficult for another reason, speak to your eye doctor. As technology improves there are more and more options for hard to fit contact lens patients to benefit from the comfort and convenience of contact lens use.
Scleral Contact Lens
We design and fit scleral contact lenses by incorporating advanced technology such as OCT(Optical Coherence Tomography), Corneal Topography, and Bio-microscope. When combined with our expertise in fitting specialty contact lenses, these advanced technologies help us to achieve more accurate and comfortable contact lens fitting outcome. Scleral contact lenses can be the best option for many patients with keratoconus , post LASIK, RK, and other refractive surgery cases. Scleral contact lenses also can be the lens of choice for some other corneal disease such as Pellucid Marginal Degeneration, Irregular cornea, post corneal graft, Dry Eye , Steven Johnson syndrome, and other ocular surface diseases. If you have failed in contact lenses for keratoconus and other corneal disorders in the past, make an appointment with us to see if scleral lenses can be the right solution for you.
The following conditions can be managed with scleral contact lenses.
- Astigmatism - Some patients with irregular astigmatism benefit more clear vision correction from scleral lenses.
- Sjogren's Syndrome- Sjogren's syndrome is an autoimmune disease that causes extreme dryness in many parts of the body, including the eyes. Scleral contact lenses provide relief by creating a reservoir of fluid between the lens and the cornea that keep the cornea moist and reduce dryness and discomfort.
- Dry eye - Sever dry eye can be worsened by some regular corneal contacts, while scleral lenses provide a tear reservoir comfort and prevent corneal ulceration. They improve better vision, comfort and quality of life and productivity at work
- Graft vs. Host disease (GVHD)- Ocular manifestation of post graft complications can cause dry eye and other ocular surface disease , and corneal irregularities. Scleral lenses can be the best option to restore vision and comfort.
- Corneal Dystrophy-Corneal Dystrophies are a group of inherited eye disorders that affect the cornea and can lead to corneal irregularities, causing patients to experience blurred vision. Scleral lenses offer the perfect solution, as they vault over the cornea, provides comfort and clear vision.
- Keratoconus - Keratoconus or conical cornea is a progressive degenerative corneal disease. Eyeglasses and regular contacts can't provide a clear vision in Keratoconus.
- Post- Corneal Surgery - Those who has LASIK, a corneal transplant, or other corneal surgery, scleral contacts lenses can provide optimal vision correction and reduce the risk of corneal irritation or infection.
- Steven Johnson's Syndrome