Hard to Fit Contact Lenses

While the process of getting contact lenses is simple and routine for most people, for some, it is much more complex. These people, colloquially referred to as “hard to fit” patients, need more specialized lenses.

Hard to Fit Contact Lenses in Olympia

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.

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Standard contact lenses sit right atop the eyeball and have a standard curve. While everyone’s contact lens will vary due to prescription differences, standard lenses fall within the same general range. It’s when someone requires lenses that fall outside this range that they are considered hard to fit, and the lenses have to be specially made by an optometrist (following an eye exam to be sure that the specifications are precise.) 

Specialty contact lens clinics also have additional devices such as a corneal photographer, which can fully map, in three dimensions, the various ridges and bumps on the cornea, to allow the creation of custom lenses. Additionally, doctors who specialize in hard to fit patients will have more experience helping people with these conditions and therefore be better equipped to help you.

Following the exam, the optometrist will go over your options. Depending on the reason for you being hard to fit, it might lead your optometrist to suggest some options over others.

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.
Lens Options

Find the Best Options for Your Hard to Fit Eyes

If you suffer from any of the previously listed conditions, and want to wear contact lenses, visit our eye care professionals who specialize in contact lenses and can give you a proper examination and recommend options based on your unique needs. Those who specialize in contact lenses and in working with hard to fit patients will also be more aware of newer contact lens developments that might work better for you than previously known options.

They are also, of course, more than able to answer any other questions you may have about contact lenses. 

Common Questions

In short, a good adjustment will typically hold your glasses in place. What this means is the angle of the temple, the part that curves behind the ear, is just right to hold your glasses comfortably. The nose pads are adjusted and angled correctly to compliment the temple adjustment. On occasion, a little more handiwork is needed but generally those two adjustments work for most people.
In this day and age this is the question. We can do one of two things or a combination of the two. Position the glasses and mask differently and or use anti-fog spray. The fogging comes from the exhaling of hot air and if the mask isn't positioned properly it'll be funneled right into the space between your glasses and your eyes. In that area it hasn't had enough time to cool, hence the fog. If we increase the size of that space by positioning our glasses over our mask, and not before it, we'll channel the air differently and allow enough space for the hot air to dissipate. Also we can buy anti-frog sprays and apply them to our lenses for added protection. Do your research, find one that works, and use it in conjunction with proper glasses positioning to reduce fogging.
Hard contact lenses are custom designed to fit specifically on your eye, the fitting process is more precise than with soft lenses, so this results in a more personalized fit with the hard lenses. There are various benefits of hard contact lenses. One benefit is that hard lenses provide sharper vision. Since hard lenses are custom fitted to your eye and maintain their form better than soft lenses, this results in sharper clarity of vision. Another benefit is that hard contact lenses are better for patients who have a high level of astigmatism, irregular corneas, or keratoconus, because hard lenses retain their shape allowing for better vision whereas soft lenses would just take up the shape of the irregular cornea and not correct the vision as well. Other benefits of hard lenses is that this may be a better option for patients suffering with dry eyes because hard lenses are deposit resistant and do not dehydrate. Another benefit is that hard lenses are extremely durable.
Typically when determining whether kids are a good contact lens candidate, it doesn't really have to do so much with age, but more so with their maturity levels. In fact studies have shown that younger kids are actually less prone to contact lens associated problems than teenagers. There can be various types of contact lenses that are great for younger kids. If a child is part of the myopia management program, they typically do well in the hard ortho-keratology lenses or soft daily disposable multifocal lenses. What’s great about the daily disposable contacts is that it allows the child to wear a brand new pair of contacts every morning, so this minimizes the risk of infections and other problems that may be associated with wearing contact lenses. Soft contact lenses are also more comfortable on the eyes. However, each eye is different so it’s important to have a proper contact lens evaluation to see which contact lens is best for the child’s eye.Typically when determining whether kids are a good contact lens candidate, it doesn't really have to do so much with age, but more so with their maturity levels. In fact studies have shown that younger kids are actually less prone to contact lens associated problems than teenagers. There can be various types of contact lenses that are great for younger kids. If a child is part of the myopia management program, they typically do well in the hard ortho-keratology lenses or soft daily disposable multifocal lenses. What’s great about the daily disposable contacts is that it allows the child to wear a brand new pair of contacts every morning, so this minimizes the risk of infections and other problems that may be associated with wearing contact lenses. Soft contact lenses are also more comfortable on the eyes. However, each eye is different so it’s important to have a proper contact lens evaluation to see which contact lens is best for the child’s eye.
These are daily disposable contact lenses. Daily disposable contact lenses are single-use contacts that are discarded after one day’s use. With this design you open up a fresh new pack every day. There are several advantages of daily disposable contact lenses. For example, daily disposable contacts are more convenient because there is no lens cleaning required and they do not need to be stored in a solution or case. So although daily disposables may appear to be more expensive, you are actually saving money on not needing any contact lens solutions/cleaning agents or cases. Also, daily disposable contact lenses are healthier on the eyes since they are less prone to lens deposits accumulating and less of a chance to develop contact lens related eye infections. Daily disposable contacts are also sometimes found to feel more comfortable due to the thinner nature of the lens. Additionally, depending on the brand of contact lenses, they vary in prices and can be less expensive than some biweekly or monthly lenses. So, be sure to have a proper contact lens evaluation with your eye doctor so they can discuss which option is best for you.
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Summary

While the process of getting contact lenses for hard to fit patients is more complex than it is for most people, that doesn’t mean it should be hard for you to find the right contact lenses. Contact us at (360) 491-2121 if you have additional questions, or wish to schedule an evaluation.

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