Has it Been Challenging Finding the Right Contact Lens For You?

What Does it Mean to be Hard to Fit?

Being “hard to fit,” simply means that someone doesn’t have an average or typical eyeball. Despite how it may sound, it isn’t all that unusual.

In most cases, people who are hard to fit have a condition like presbyopia (farsightedness caused by age), astigmatism (abnormally curved cornea), keratoconus (a cornea with a more of a bulging or cone-like shape), or dry eyes. Having had eye surgery or conjunctivitis can also lead to someone being hard to fit and requiring specialized contact lenses, as can conditions like high myopia, sensitivity from conditions like sjorgens, and other irregularities with the cornea such as Fuchs’ dystrophy. For these people, wearing regular contacts will be uncomfortable, if not impossible to wear.

Lens Options

• Custom Soft Lenses: These are comfortable and can be made for prescriptions outside the standard range. However, if the cornea is too irregularly shaped, these may not be suitable.
• Gas Permeable Lenses: These lenses are rigid, which makes them excellent for correcting vision even with very irregularly shaped eyeballs, but they often require time to adjust to, and for some they are simply too difficult to adjust to.
• Hybrid Contact Lenses: These lenses feature a rigid center with a flexible skirt around it for increased comfort without sacrificing effectiveness at correcting vision. However, they can be more difficult to handle safely due to their unique design.
• Scleral Contact Lenses:  These are another type of gas permeable lens, and are specifically designed to vault over the whole corneal surface to rest on the sclera (the white portion of the eye.) This lets the lenses fully replace the irregularly shaped cornea with a perfectly smooth surface to correct the vision problem. These are larger than standard gas permeable lenses, but since they rest on the less sensitive sclera, they can be more comfortable. (Especially for someone with keratoconus.) Additionally, because they are designed to fit very closely to the eye, they are more stable on the eye than other gas permeable lenses.
• Piggybacking: While not a separate style of lens, piggybacking is another option available to those who are hard to fit. With this, a softer lens is placed between the eyes and rigid gas permeable lenses and can mitigate the discomfort often associated with rigid lenses. However, it may take several attempts to get the placement of the two lenses right.