Contact Lens Problems
All contact-lens wearers should have an annual follow-up examination. People who wear extended-wear lenses are often seen every three to six months. Remember that extended wear of contact lenses not designed for extended wear increases the risk of a serious eye infection and is not recommended.
These examinations allow the fitter to review the care, wearing, and fit of the lenses. Problems or potential problems may be found at these examinations before they interfere with vision and before the wearer notices them.
Fitting of contact lenses involves a complete eye examination with measurements of the cornea and selection of appropriate lenses.
The fitting is not complete until follow-up evaluations confirm the correct fitting of the contact lenses.
After this, in most states, the fitter must give the contact-lens prescription to the wearer whether or not he or she asks for it.
Some people order their lenses by mail order or through local stores. If this is done, it is essential to make sure that the lenses received are exactly the same (same brand, material, base curve, diameter and thickness) as the lenses that were fit and dispensed.
Recognize that some people will have problems which they think might be solved by ordering new lenses, and the cause may actually be an infection or other serious problem. If lenses are ordered by mail, be sure to have your regular follow-up exams.
Although mail order is used because of an expectation of a lower price, you should check with your fitter. Your fitter will usually meet or beat the price of the mail-order companies.
If lenses are not purchased from the fitter, be sure to have follow-up examinations at the intervals recommended by the fitter.
Wearing correct-fitting lenses, using the correct care regimen, and undergoing periodic follow-up examinations by the fitter should prevent most problems.
Cleanliness is essential. Do not handle contact lenses without first washing your hands. Contact-lens cases must be cleaned every day. They should be discarded and replaced periodically because they may serve as a culture medium for bacteria and fungi. Once a week they should be washed with hot water and allowed to air dry afterward.
Any contact lens wearer must follow the general rules of good hygiene. The wearer must also be motivated and mature enough to follow the instructions for avoidance of problems. For this reason, some fitters will not fit children.
Children must be evaluated on a case-by-case basis.
In young children (younger than 8-9 years of age), contact lenses are usually prescribed for medical reasons only. For example, after congenital cataract surgery, contact lenses offer essentially normal vision without the use of thick glasses. Parents assume the responsibility for the correct care and wearing of the lenses.
Different types of lenses have different care routines. In general, lens care involves rinsing of the lenses upon removal, cleaning the lenses, and storing them in a disinfecting solution. Homemade or non-contact-lens saline or solutions should never be used. Only use the solutions that are recommended.
The lenses should be worn and discarded as directed. If lenses are to be replaced on a scheduled basis (for example, daily, weekly), it is a false economy and dangerous to try to extend the lenses by replacing them less often.
The safest way to wear lenses is to wear them on a daily basis and discard them every day. This avoids the use of solutions and decreases handling. However, it is slightly more expensive, and daily disposable lenses are not available in all prescriptions.
Overnight wear of contact lenses is available for certain prescriptions. Although approved by the U.S. Food and Drug Administration (FDA), this is not believed to be safe by many fitters because of the increased rate of infections with extended wear.
Most complications may be eliminated by meticulous wear and care by the wearer and following instructions meticulously as well as getting follow-up examinations by the fitter.
It is essential to be examined by your ophthalmologist, optometrist, or other fitter at least once a year and more often if extended wear lenses are worn. Every examination should, at a minimum, include a history as to how the lenses are cared for and to find out if there are any problems.
The vision should be checked with the contact lenses, and the lenses should be observed on the eye with the slit lamp. An evaluation of the vision with glasses (after removing the contact lenses) should also be performed.
The examination also includes an examination of the shape of the cornea. No distortion or changes should be present. The cornea, as well as the rest of the eye, should be evaluated and measured, along with an evaluation for the possible presence of any eye diseases, such as glaucoma or cataracts.
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