Contact lens compatibility: Am I suitable?

“Am I suitable for contact lenses?”

If you put a fiver in a pot every time someone asked this question, it would allow someone to have a very nice holiday to the Bahamas!

The question, however, is not so clear-cut, there are many considerations when someone first presents themselves for a contact lens consultation. Not only whether they are suitable for contact lenses per say but which type, which material, which disinfecting system, which modality. The list goes on and not forgetting which price range.

From a prescription point of view, it’s a shame that some spectacle wearers or previous lapsed contact lens wearers, presume contact lenses are not suitable for them relating to information that is now out of date. Contact lens materials particularly have improved tremendously over the last few years and computer-aided software has meant that prescriptions and designs that had previously been impossible are now in regular use, including lenses for high astigmatism, multifocal designs for those of us needing reading glasses, and let’s not forget complex custom-made designs. It is worth noting however that unlike us, not all opticians have access to all lens designs as some have a limited range of contact lens suppliers.

Consequently, your prescription is no boundary to wearing contact lenses, however, there are other considerations…

Age and dexterity?

All age ranges wear contact lenses, from young children (sometimes just for sport) to the elderly, as long as the eyes are healthy and lens handling is possible. Parents can be involved and taught to safely apply and remove contact lenses for very young if this is deemed necessary.

Responsible and compliant?

This is not always a given; contact lens wear however small, does carry an increased risk of infection, so a responsible approach is required.

Requirements and motives?

Most new wearers have regular prescriptions with healthy eyes and the process of fitting contact lenses is straightforward. However, occasionally a new wearer’s requests and expectations need to be managed with care. For example, someone attending that has had a history of recurrent eye infections with already poor vision is at high risk of further complications and therefore would be fitted with far more caution, if at all.

Occupation/hobbies/driver?

Of course, there are many varied scenarios. Contact lens wear and which type is to be considered carefully and advice is given accordingly. Occasionally, one type of lens is advised for regular wear and an alternative design for sport.

General health/medication/eyedrops?

Some health conditions such as diabetes also need to be addressed so that the risks are minimised. Any other general health concerns discussed in addition to their likely impact on the contact lens wear. Some medications can have an effect on your vision and on the tear film which can lead to dry eyes and associated complications.

Allergies or skin complaints?

Allergic responses can cause some issues as can skin complaints such as eczema, contact lenses can still be fitted in most cases but extra care with hygiene, use of lubricants, daily disposable designs where available and wearing times managed.

Ocular health/family history of eye problems/previous contact lens wear

Along with all the above, a full history is essential so good management of contact lens wear is maintained and risks evaluated.

At the assessment, a special microscope called a slit lamp is used to examine the front of the eye where a contact lens sits to check the surface is healthy and there are no contraindications. Fluorescein (a painless orange dye) is often instilled to check tear quality and quantity. Measurements are taken and sometimes a detailed map of the front surface using an instrument called a topographer to rule out any issues regarding the curvature of the eye.

Once all the aforementioned areas have been considered and discussed, contact lens options can be recommended with the relevant pros and cons of each approach. The contact lens trial would then follow on from this and lenses placed on the eye so fitting can continue. A new wearer’s initial response to a lens being placed on the eye is usually favourable but again needs to be factored into suitability.

Regular aftercare for a contact lens wearer is paramount to success as is compliance with any instructions given regarding safe wear and handling. A full eye examination usually every two years is still necessary.