Are Contact Lenses Right for You?

Does wearing a face mask have your glasses fogging up ALL. DAY. LONG? Switching to contact lenses makes that pesky problem a thing of the past. (Plus, contact lenses are completely safe to wear during the coronavirus pandemic.)

And contacts offer other advantages, too. They are available for people of all ages — optometrists can fit contacts for kids around 10 years of age or younger.

Optometrist Wes Immler, OD, discusses the versatility of contacts, plus types and features available.

Contacts versus glasses: How to choose

“An advantage of contacts is that they sit right on the eye and move with it,” says Dr. Immler. For that reason, contacts are a great choice for people who lead active lifestyles.

For example:

• Movers and shakers no longer have glasses shifting or falling off their faces.
• Athletes don’t need to worry about flying objects hitting their glasses and causing an eye injury.
• Swimmers can see in the pool with regular goggles.

“Another benefit of contacts over glasses is that you won’t lose track of them or damage them by sitting or stepping on them,” says Dr. Immler. “Eye care specialists are happy to adjust glasses, but not needing that service can be a timesaver.”

Which are better, hard contacts or soft contacts?

When first developed, contact lenses were only available as hard lenses. Today’s hard lenses, called gas permeable, are much improved. They can be worn for up to a year without needing to be replaced as long as they are properly cared for.

“Typically, the people who choose hard lenses have eye conditions that don’t allow them to wear a soft lens,” says Dr. Immler. “They might have an irregularly shaped eye or a condition called keratoconus, which causes thinning of the cornea.”

The vast majority of Dr. Immler’s patients (around 90 to 95%) choose soft lenses. Soft contact lenses are typically thinner, lighter and more comfortable than hard lenses. Lens manufacturers now use a silicone hydrogel material that allows more oxygen to reach the eye. Soft contact lenses come in three varieties:

• Monthly disposables: Remove the lenses and store them in a disinfectant solution overnight. Repeat for 30 days then discard.
• Bi-weekly disposables: Same as monthly but throw them away after two weeks.
• Daily disposables: Pop in a fresh pair of lenses each day.

“Everything is heading toward daily disposable soft contact lenses — 40 to 50% of the people I see are wearing daily disposables, and that number is growing every year,” says Dr. Immler. “The advantage of a fresh pair daily is the reduced likelihood of dryness and allergies, damage and infection.”

Tips to lower contact lens-associated risks

“Anytime you put something on or near your eye, you’re introducing risk,” says Dr. Immler. “The biggest risk is infection.”

Dr. Immler says infection risks are lowest with daily disposable lenses because you use a fresh pair every day. For other lens types, follow good hygiene practices:

• Soak the lenses in a disinfectant solution overnight. Replace the solution completely each day (don’t top off). Never use water.
• Replace your case every three to six months.
• Don’t try to extend the life of the lenses or use them longer than intended.
• Don’t sleep in the lenses unless they’re specifically designed for nighttime use — sleeping in lenses considerably increases your risk of eye infection.
• Use rewetting drops if you have dry eyes.
• Wash your hands before touching your eyes or handling your contacts.

Types of contact lenses

Contact lens manufacturers make lenses to meet virtually every need. When choosing contact lenses, you may hear these terms:

Spherical lenses

Most people wear spherical lenses. These standard lenses correct farsightedness or nearsightedness.

Toric lenses

Toric lenses are weighted, so they rotate to match your specific eye shape. Optometrists often prescribe them for people with astigmatism (when the eye’s surface or shape isn’t perfectly round).

Multifocal lenses

Multifocal (sometimes called bifocal) lenses allow you to see both far away and close up. Glasses accomplish this by using the top of the lens for distance and the bottom for close up. But contact lenses use concentric rings — one for distance, one for close up — alternated throughout the lens. Multifocal lenses now come in a toric option as well.

“Multifocal lenses work quite well after a week or two of your brain adjusting,” says Dr. Immler. “The advantage is you don’t need to use glasses, but there is some trial and error involved to balance distance and close-up vision. Multifocals usually don’t give perfect vision, but it gets close enough that the benefit of not needing glasses outweighs the imperfection.”

Monovision lenses

Another strategy for meeting both distance and close up needs is monovision lenses. Your eye doctor may recommend a scenario where you put a distance lens in one eye and a near vision lens in the other eye. The brain makes the necessary adjustments so you can see fairly well at all distances.

Hybrid lenses

Hybrid lenses offer the comfort of a soft lens with the vision of a hard lens. The part that touches the eye is soft, while the part over the cornea is hard. Hybrid lenses aren’t widely used but can be a good option for people with a particular prescription or astigmatism.

Scleral lenses

Scleral lenses are sometimes medically necessary if you had eye surgery or have an eye condition such as keratoconus. “This is a unique type of lens used only for certain eye conditions,” says Dr. Immler. “It’s larger than the typical lens and is a rigid lens that vaults over the entire cornea onto the white of the eye.”

Orthokeratology lenses

An orthokeratology lens is approved for nighttime sleeping. The lens acts as a retainer — while you sleep, the lens gradually reshapes or molds the surface of the eye. When you wake up, your vision is clear. Throughout the day, the eye slowly returns to its normal shape.

Prosthetic lenses

In the event of an eye injury, prosthetic lenses can match a damaged eye to a healthy eye. “There are a few providers in every state that offer this type of specialty lens,” says Dr. Immler. “In great detail, an artist paints an eye on a lens. The image includes the pupil, cornea and even vessels. The artistry is so impressive, it’s hard to tell it’s a prosthetic.”

Contact lens features

People who want to change their eye color can choose colored lenses. These are made by adding pigment to the lens to change the appearance of the iris.

Many manufacturers offer coatings to:

• Keep the lenses moist and comfortable.
• Create less friction between the eyelid and surface of the eye.
• Ensure oxygen can pass through the lens.
• Offer protection from the sun’s damaging UV rays.

Only buy contact lenses from a professional eye care provider

“Contact lenses are medical devices, so it is illegal to sell them without a doctor’s prescription,” says Dr. Immler. “If you’re tempted to purchase special effects lenses such as cat eyes for a Halloween costume, you can be putting your eye health at risk.”

Dr. Immler says it’s dangerous to buy contacts over the counter. If not fitted properly, contacts can starve the eye of oxygen and lead to infection. They can also cause an open sore on the eye surface and result in scarring that permanently damages vision.

“When you purchase contacts, your optometrist will match your eye’s shape and curvature to the lens,” says Dr. Immler. “This allows tears to get under the lens to provide the eye nutrients and oxygen.”

Your optometrist will also train you on how to apply and care for your lenses.

Signs you need to see your eye professional about your contact lenses

Remove your lenses and reach out to your eye doctor for an evaluation if you have:

• Redness.
• Pain.
• Decreased or blurry vision.
• Light sensitivity.

“Your eye care professional can prevent scarring or vision loss by addressing concerns early on,” says Dr. Immler.