Most patients who need glasses to sharpen their vision can wear contact lenses. You can think of contacts of an alternative way to see well when you are not wearing glasses. The doctors at McChord Optometry can do your eye exam for contacts. Our goal is always to fit patients in healthy contact lenses and to encourage healthy wearing habits. If you are going to wear a prosthetic lens on your eyes, you may as well avoid damaging your eyes in the process. When you see one of our doctors, they will likely inquire about your current contact lens wearing habits to make sure everything is out in the open and you are not putting your eye health at risk.
When worn appropriately, modern contact lenses are really quite safe. The vast majority of the contact lens complications that occur are related to over-wearing (such as wearing lenses all day every day, or sleeping in them on a regular basis) poor hygiene, or failing to replace old lenses in a timely manner.
In addition to the health checks outlined in the “Eyeglass Exams” service type, an eye exam for contacts will provide you with the necessary testing for a contact lens fitting. There is a Washington State law designed to keep you safe that requires all patients to have their eye health checked prior to being fit in contacts. This means it is not legal (or safe) to fit a patient in contact lenses if they don’t get their eye health checked. This regulation is designed to keep patients safe. The state is hoping to make sure any eye that is fit in contacts is healthy enough to wear a prosthetic lens.
If possible, wear your current contact lenses into the appointment – and bring documentation of what they are. This allows your eye doctor to assess how well they perform and to see how they physically fit on the front of your eye. This data will give your optometrist the data they need to optimize your next contact lens prescription for you. Patients who wear lenses in and bring documentation of current powers (or had them prescribed by us previously) will be allowing the doc to focus on fine-tuning their Rx instead of trying to start from scratch. However, if you do not have documentation of your previous powers, we can still fit you in contacts.
The selection of contact lenses available is always changing. It seems every other month brings an exciting new lens to market. The doctors at McChord Optometry will tend to keep you in your habitual contact lens unless a new product has been introduced that may be more comfortable, provide better optics, or better health benefits. However, due to constantly shifting contact lens landscape there may be some discussion of a switch even if you tell us that you really like your current lens. Every contact lens fit (even if the powers don’t change) requires additional testing to see how that lens fits on your eye. Therefore, even if everything ends up the same as last time we prescribed you contacts, there will be a fee for each year’s contact lens evaluation. Follow-up visits and the cost of trial lenses are then provided at no additional cost. Quite often we can send patients home with trial lenses on the day of their initial visit and then have them email or phone in to approve the lenses.
Simple spherical contact lens fittings utilize ‘single vision’ (not toric or multi-focal) lenses on both eyes and are relatively straightforward most of the time, so our fee is just $55 (plus the routine eye exam fee of $85). We try to keep our pricing simple, so if you are a new wearer who needs insertion and removal training, or someone who needs toric, monovision, or multifocal contacts, the ‘premium contact lens fit’ price is $75. Your insurance may or may not cover your contact lens fitting.
Once a patient graduates into bifocal or progressive glasses, contact lens fits do get a bit more complex, but we have lots of patients over age 40 who wear contacts every day. The added complexity has to do with a natural ageing process in the eyes called presbyopia. Presbyopia is in a loss of the ability to focus the eyes up close, making near work such as reading more difficult.
There are three basic strategies we can utilize to keep contact lens wearers seeing well at both distance and near. The simplest way to go is to utilize over-the-counter reading glasses in combination with distance contacts. This strategy gives great distance and near vision in most cases, but there is the downside of needing to wear glasses over your contacts for all your near work. Many patients ask what is the point of wearing contacts if I need contact lenses over top? This is a good question that leads to two possible answers: Monovision or Multifocal contacts. Each of these three strategies has it’s advantages and disadvantages.
Monovision is a setup that involves having one eye (your dominant eye) focused for distance, and your other eye focused for either your computer distance or your reading distance. It sounds like a crazy idea but over 80% of the time patients adapt and do really well with Monovision contacts. It’s not like you need to close one eye to drive and shut the other one to read, your brain typically just sorts out which eye to pay attention to pretty quickly (within a few days). Due to the fact that the eyes are not focused at the same distance, depth perception can be somewhat reduced. This is not a strategy we suggest for dentists or surgeons. This issue could also hamper your ability to catch a softball or thread a needle.
Another potential downside of using monovision contacts is that there are really three distances that most of us work at: distance, intermediate/computer, and near. Yet there are only two eyes and thus we have to pick either good computer vision or good reading vision – and then accept that the other will be a little off. Despite these limitations monovision is a great option for many patients, especially those who need an astigmatism lens in one or both eyes.
Multifocal contacts are a great option for many patients over age 40 who have moved up to bifocals or progressive glasses. As with the other options discussed above, there are advantages and disadvantages to multifocals. They are the high-tech option with each of the lenses having power for distance, intermediate, and near. This technology works best for patients with one diopter or less of astigmatism. Many patients ask how one lens can have multiple powers in it. This technology is basically set up with concentric rings, meaning that different diameters of the lens have different powers in them.
When wearing multifocal contacts, your vision will not be perfect. Our goal is to give good functional vision at all distances, but it won’t be as crisp as when you wear glasses. Often times patients will report that they can see the street signs about as early as the passenger in their car, but that there is a bit of a shadow on all of the letters. When setting patients up in multifocal contacts, we like to discuss the “80% rule”. The 80% rule states that if you are happy with your contacts 80% of the time – or are able to see what you need to see without putting on readers 80% of the time, then that is a successful fit. This rule of thumb is really about setting expectations at the right level. We are really good at fitting these lenses and some patients will report that they are happy more like 90% of the time, which is a phenomenal result. If you expect perfect vision, we should not even try multifocals.
We can typically get our multifocal contact lens patients to see 20/20 or close to it for distance, and 20/25 or so for near (without readers). Due to the fact that each lens has some power for near and distance, some of the light rays are bound to be defocussed no matter where you are looking.
Another key question that comes up frequently is this: “is my child old enough to try contacts?” We typically start fitting our pediatric patients in contacts at age 13, but there are exceptions to that rule of thumb. Thirteen is typically a good initial age because you need to bring a good deal of maturity to the process of inserting, removing, and properly caring for contacts. Not following basic safety or hygiene rules can lead to complications with life-long consequences.
Yet there are some patients who start wearing lenses younger. In fact the young lady in the photo at the top of this article is just nine years old. She is our patient at another practice and asked to try contacts so that she could continue to pursue gymnastics. She was highly motivated and definitely more mature than most nine year olds, so Dr. Mark Cannon fit her in contacts. Since starting to wear contacts she has switched to ballet, which would be nearly impossible to do well with glasses on.
Many patients wonder what testing is done at an eye exam for contacts. At McChord Optometry, your optometrist is likely to perform the following tests at your annual exam. For a more basic discussion of these tests, please do refer to the EyeGlass Exam service description. The following tells how these test are used to help with your contact lens fitting specifically.