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Medical Forum / General / Vision / January 2006Contact lens question
I've been wearing contacts for 15 years or so to correct pretty severe myopia. I know I'm > -10 in each eye, probably more, but I don't have an actual Rx. I'm 45 and should be presbyopic, but I'm still "a few clicks" from needing reading glasses. I'm also a long time T2 diabetic with no evidence of eye problems (I get a dilated eye exam from an optho yearly as well as one from a my regular optometrist). I've been going to this same optometrist for all 15 of those years, and have been very happy with the contacts (and full correction) until the past 2 years. Now I think I'm going nuts. The right contact lens has been bugging me. Last January I got a new pair. The left lens was fine, the right seemed off center and frequently blurry. I got that one swapped out and it was better, but still not really good. This January I got another pair. Same thing. The right lens is just a little off. Slightly blurred and often dry feeling. Yet some days it's fine. I want to ask for a new lens, but the last 3 haven't been good, so what are the chances it's the lens and not "me". My optometrist says there's only one company that makes contacts for my Rx. They used to be clear and now they have a light blue handling tint. I swear, my 3 year old right lens with a slight tear is more comfortable than any of these new ones! Is there a chance that my lens is not the right size and not floating well enough? Some days it really does seem normal, and I can see fine, but most days I'm happiest to get out of the contacts and go back to my 10 year old way out of date Coke bottle bottom glasses. > My optometrist says there's only one company that makes contacts for my > Rx. They used to be clear and now they have a light blue handling tint. I > swear, my 3 year old right lens with a slight tear is more comfortable > than any of these new ones! Most doctors feel "durable" contacts carry undesirable risks (*3* years old???) Many of the 2-week and 1-month lenses are now available (at standard prices) up to -12.00 (Acuvue, lots of others), -15.00 (Focus Monthly), and -16.00 (Precision UV). The Gelflex EWII goes to -20.00. Assuming your CL Rx is -12.00 or less, you might find the comfort pleasantly surprising with an Acuvue2 8.3. Ask for a free trial pair. If your optometrist says 3-year lenses are better, find another doctor. > Is there a chance that my lens is not the right size and not floating well > enough? Most often I attribute your symptoms to a lens that fits "too flat." Flat lenses move too much and often feel "dry," sometimes pop out and may be difficult to insert. -MT, OD >> My optometrist says there's only one company that makes contacts for >> my Rx. They used to be clear and now they have a light blue handling [quoted text clipped - 3 lines] > Most doctors feel "durable" contacts carry undesirable risks (*3* > years old???) I've never had short term lenses. Ever. They've never been offered and I never cared. But I only wore the 3 year old lens one day (and no, my doctor didn't suggest it, I doubt he even knows I still have them). I just wanted to see if I was misremembering the comfort. I wasn't. > Many of the 2-week and 1-month lenses are now available (at standard > prices) up to -12.00 (Acuvue, lots of others), -15.00 (Focus [quoted text clipped - 11 lines] > Flat lenses move too much and often feel "dry," sometimes pop out and > may be difficult to insert. I'll call in the morning and see what can be done. From vague memory, one eye is -15 or so, but my memory ain't what it used to be. I would like to know my actual prescription, but for some reason the few times I've asked for a hard copy, the office staff makes it seem like that's a very unusual request. Maybe they don't want me to go elsewhere for glasses/contacts? > I'll call in the morning and see what can be done. From vague memory, one > eye is -15 or so, but my memory ain't what it used to be. I would like to > know my actual prescription, but for some reason the few times I've asked > for a hard copy, the office staff makes it seem like that's a very unusual > request. Maybe they don't want me to go elsewhere for glasses/contacts? It sounds a little odd. Spectacle prescription release has been required by the Federal Trade Commission for about 30 years, and since 2004 a contact lens consumer law requires them to deliver you a copy of your contact lens prescription at the end of a "reasonable fitting period." Assuming you're in the US. I prescribed "durable" contacts (replaced once or twice a year) for many years after disposables became available. There may be some situations where they are still appropriate but it's getting pretty rare. The primary reason is that keratitis and corneal ulcers are far less common when lenses are replaced once a month or more. A year's worth of "one-month" lenses might cost around $150, so the economics no longer favors "one year" lenses. A single pair might look cheaper, until you add in the average cost of lost/torn replacements and emergency office visits. Some people avoided disposables because they "are made for overnight wear." That doesn't mean you have to sleep in them; it means they're safer. Others avoid disposables because they're "more fragile." Some of them are, but many of them aren't. And even so, you have replacements readily available and you're less often "forced to wear" damaged lenses. It's a delicate situation. If you call your doc and tell him some Joe from the internet recommended you try a "steeper-fitting disposable" it's very likely he'll find several objections. IMO, you have the right to expect comfortable lenses, meaning you don't feel them most of the time. There are some people who can't get there, but you can't decide that based on one or two attempts. -MT I also wished contacts were comfortable for me but of several brands ive tried, all of them cause the same symptoms you describe. I will try focus day and night but theres no way im sleeping in them, ill use them as regular contacts, perhaps napping in them but no longer than nap and remove them every night before I sleep. It takes less than 1 min to remove them and im not THAT lazy I cant even take em out before hitting the pillow! This is unusual you can function without reading glasses over your contacts at 45! I am only 23 and although I can read without reading glasses, its blurred like shown below: http://img305.imageshack.us/img305/6809/newspaper27vx.jpg The blur looks like that. When I had an eye exam they tested me at 20/50 near point with my glasses on. The lady did hold the chart pretty close, like 10 inches. I dont have 4 diopters of accomodative amplitude. Perhaps your eyes are drier now that you are 45? have you tried refresh eyedrops or something? I can see why you hate glasses, being a very high myope they minify significently and are thick and heavy. >> I'll call in the morning and see what can be done. From vague >> memory, one eye is -15 or so, but my memory ain't what it used to [quoted text clipped - 8 lines] > copy of your contact lens prescription at the end of a "reasonable > fitting period." Assuming you're in the US. Yup, US. I called today. My doctor's out of the office until Friday, but the receptionist said she'd have my glasses and contact Rx in my file for me to pick up with my new glasses, whenever they get here. Just out of curiosity, I asked what my glasses one was and it's -12 right and -13 left. I know there's some astigmatism, but I didn't write that down. > I prescribed "durable" contacts (replaced once or twice a year) for > many years after disposables became available. There may be some [quoted text clipped - 5 lines] > until you add in the average cost of lost/torn replacements and > emergency office visits. Well, the doctor always says my lenses look very clean, even after a year. Since we've had some problems before with new contacts being "not quite right" and having to be replaced (high power/more problems, he says), I never thought having a new lens every week/month would be a good thing. I've never lost one and the only tear is in that really old lens (and I don't remember it being torn when I stashed it away, could be age). I don't wear them overnight because I did that for a while and got some blood vessels growing into my cornea (? vague memory). In general, they've been so comfortable that I forget they're there. I'm starting to think my eye's just getting dry. I sleep on my left side - maybe I crack that eyelid in my sleep? > I've been wearing contacts for 15 years or so to correct pretty severe > myopia. I know I'm > -10 in each eye, probably more, but I don't have an [quoted text clipped - 24 lines] > days I'm happiest to get out of the contacts and go back to my 10 year old > way out of date Coke bottle bottom glasses. Since you purchased a new lens one year later and it felt the same, my first thoughts would be that your eye has a problem. If I were your optometrist I'd check for GPC (irritation underneath your eyelids) and dry eye (very common in females a little older than you are!). As Mike Tyner said, you really should be wearing dispoable lenses. We're living in 2006 not 1979! If your optometrist hasn't even suggested them to you he's not doing a good job in my opinion. I'd go a step further and recommend the newer silicone hydrogel material (it's still a soft contact lens) for much higher oxygen transmission. Two brands that go to -12.00 (at least here in Autralia) are: Purevision (Bausch & Lomb) and Acuvue Advance (Johnson & Johnson). Much, much better for your eyes. However if it turns out that you have GPC then I wouldn't recommend the Purevision after all (that's another story). Dom > Since you purchased a new lens one year later and it felt the same, my > first thoughts would be that your eye has a problem. If I were your [quoted text clipped - 11 lines] > However if it turns out that you have GPC then I wouldn't recommend > the Purevision after all (that's another story). Thanks for the info. I replied to Mike upthread, but I'm starting to think dry eye. Don't ya just love getting old? Thats why you could try getting eyedrops. I may have to do the same thing in order to keep contacts comfortable. However being "only" a -4.5 my glasses arent thick and dont minify very much unlike your -12s. If your thinking of lasik, it wouldnt be a good route to go. If any, you should look into IOLs instead. Of course just sticking to glasses is saftest. |
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