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Medical Forum / General / Vision / July 2006RGP fit (tight vs. loose)
Sorry to keep bugging the group with my RGP's, but things seem fairly slow anyway. My RGP fit, in my non-professional opinion, is on the loose side. When I blink they go up, then slide back down and hang low. If I turn my head to the side, they slide toward the ground. I expressed my concern to my eye doc on the follow-up check after getting the lenses, but he thought I should keep them this way. His rationale, as best I can understand, is that he didn't want to make them too tight because of possible irritation where the edges touch the eye. My vision is great in these lenses, except that I have quite a bit of eye watering at times, which makes vision worse. At some times of the day, I also get fogginess from dryness (fixable with drops). Also, when the lenses ride low, I get effects like light reflecting off the top of the lenses when going under overhead lights. I'm trying to decide if I should wait this out a little longer, or if I should go back and ask _again_ whether these should be tightened up. What do the group experts think are the pros and cons of tight vs. loose fitting RGP lenses? Do you guys agree that there are patients who are better off with low sagging lenses? Is there irritation associated with the lenses sliding around that could be contributing to my watery eye problem? > Sorry to keep bugging the group with my RGP's, but things seem fairly > slow anyway. Not a problem. > My RGP fit, in my non-professional opinion, is on the loose side. When > I blink they go up, then slide back down and hang low. If I turn my [quoted text clipped - 3 lines] > understand, is that he didn't want to make them too tight because of > possible irritation where the edges touch the eye. Sometimes, but not always, a low riding lens is indicative of a tighter fit. There's certainly nothing wrong in wanting a comfortable fit and a stable retinal image. > My vision is great in these lenses, except that I have quite a bit of > eye watering at times, which makes vision worse. At some times of the > day, I also get fogginess from dryness (fixable with drops). Also, > when the lenses ride low, I get effects like light reflecting off the > top of the lenses when going under overhead lights. "WHEN" the lenses ride low, meaning sometimes they don't? Sometimes, too much tearing can cause a lens to ride low. You mentioned dryness, which suggests the mechanism whereby the eye becomes dry, the dryness triggers corneal irritation, which triggers an episode of tearing, which in turn causes the lens to ride low. > I'm trying to decide if I should wait this out a little longer, or if I > should go back and ask _again_ whether these should be tightened up. [quoted text clipped - 3 lines] > associated with the lenses sliding around that could be contributing to > my watery eye problem? Again, it isn't clear that the lenses are too loose. But, there are more options these days, including larger intralimbal lenses that can facilitate centration, and corneascleral lenses, i.e. Macrolenses that always stay centered, no matter what. If you were my patient, I would expect you to come back in this situation. DrG > > Sorry to keep bugging the group with my RGP's ... > [ ... ] > Again, it isn't clear that the lenses are too loose. But, there are > more options these days, including larger intralimbal lenses that can > facilitate centration, and corneascleral lenses, i.e. Macrolenses that > always stay centered, no matter what. If you were my patient, I would > expect you to come back in this situation. If you were my patient, I'd suggest a pair of simple spectacles, and, with a bit of luck, not having to come back for a while. Of course you would not be my patient, as I am not a Dr.. -- Dicky >>> Sorry to keep bugging the group with my RGP's ... > [quoted text clipped - 11 lines] > come back for a while. Of course you would > not be my patient, as I am not a Dr.. No, he wouldn't be your patient because you preach Zenni's and not wasting all that money on doctors at all -- since their sole purpose is to take your money right? Just some cheap experimentation on your own should take care of anything for half the price. Besides contacts are just a vanity item like those name brand frames and stuff. I'm sure glad your here to add balance to the group Dicky. -Quick > > > Sorry to keep bugging the group with my RGP's ... > [quoted text clipped - 9 lines] > with a bit of luck, not having to come back for a while. Of course > you would not be my patient, as I am not a Dr.. Apparently you have some anti-contact agenda. Too bad, since aside from my few complaints, my vision hasn't been this good in 10-15 years. And, incidentally, the whites of my eyes have never been whiter. >> > > Sorry to keep bugging the group with my RGP's ... >> [quoted text clipped - 13 lines] >from my few complaints, my vision hasn't been this good in 10-15 years. >And, incidentally, the whites of my eyes have never been whiter. Dick is just one big agenda. Sorry if I missed this, but what were you wearing before? Glasses? Soft contact lenses?? RGP lenses have a *very* high Dk rating (oxygen transmissibility). The last time I tried a pair--though it didn't work for me--all the redness disappeared from my eyes, too. Incidentally, the ones I tried *were* the intra-limbals mentioned above, and I *have* known a few people who were *quite* happy with Macrolenses. The scleral might be shooting a mouse with an elephant gun in your case. I really don't know.... > Sorry if I missed this, but what were you wearing before? Glasses? > Soft contact lenses?? Just glasses before. I tried torics a little but never had any luck getting consistent good vision. > RGP lenses have a very high Dk rating (oxygen transmissibility). The > last time I tried a pair--though it didn't work for me--all the > redness disappeared from my eyes, too. It's pretty amazing really. I had glasses before and chronic slightly red eyes. Maybe it's just the extra tearing induced by the lenses or something? > Incidentally, the ones I tried were the intra-limbals mentioned > above, and I have known a few people who were quite happy with > Macrolenses. > > The scleral might be shooting a mouse with an elephant gun in your > case. I really don't know.... What's the down side of these other types vs. the run of the mill? Just cost? Neil Brooks wrote: >> Incidentally, the ones I tried were the intra-limbals mentioned >> above, and I have known a few people who were quite happy with >> Macrolenses. >> >> The scleral might be shooting a mouse with an elephant gun in your >> case. I really don't know.... Charles replied: >What's the down side of these other types vs. the run of the mill? >Just cost? Here's where I bow out to the docs for real answers. From my limited knowledge, there's not much downside to the intra-limbals: http://www.lensdynamics.com/Irregular%20Corneals/Dyna%20Z%20Intra-Limbal.htm OR: http://tinyurl.com/zqo8e or the MacroLens: http://www.chcontacts.com/macrolens.asp http://www.chcontacts.com/article.asp?title=machist http://www.chcontacts.com/article.asp?title=macconcpt [I don't like their site particularly. Difficult to find ready info, IMO] The "however" is: it's quite possible that there are larger diameters available for the lens you are wearing ... if that turns out to be the issue (rather than fit or design). Again ... above my pay grade ;-) Doc's? If you would?? [scuse me] > > My vision is great in these lenses, except that I have quite a bit > > of eye watering at times, which makes vision worse. At some times [quoted text clipped - 7 lines] > triggers corneal irritation, which triggers an episode of tearing, > which in turn causes the lens to ride low. They almost always move towards low. They move somewhat slowly, so if I blink often, they keep moving back up and the effect isn't as pronounced. Towards the end of the day my eyes seem more dry and the lens are more likely to stick between blinks. I just put them in this morning and looked right away. They are riding a little low, but not as low as after wearing a while. They also stay in place sometimes. On one occasion I noticed a lens sticking a little high, so I get the impression that the lenses move high when I blink, then start moving down. Where they stop seems to depend on how "watery" my eye is at the time. > > I'm trying to decide if I should wait this out a little longer, or > > if I should go back and ask again whether these should be tightened [quoted text clipped - 9 lines] > always stay centered, no matter what. If you were my patient, I would > expect you to come back in this situation. Thanks for the info. I'll probably schedule another visit. I hate being the problem patient. I already moved on from my last eye doc because I started getting a feeling of "eyes rolling" when I walked in for repeated visits. Is RGP a specialized enough area that I ought to seek out an expert if I want to be picky and really nail this? I see so much promise for great vision with these if I could just solve these few little issues. > They almost always move towards low. They move somewhat slowly, so if > I blink often, they keep moving back up and the effect isn't as [quoted text clipped - 7 lines] > down. Where they stop seems to depend on how "watery" my eye is at the > time. One old technique for getting a lens to stay in place is to have it stay tucked up under the upper eyelid. It may be that your upper lid may actually be catching the upper edge of the lens, and then forcing it down when you blink. As well, you may be only partially blinking, which then never allows the upper lid to "capture" the lens and pull it back up. > Thanks for the info. I'll probably schedule another visit. I hate > being the problem patient. I already moved on from my last eye doc [quoted text clipped - 3 lines] > so much promise for great vision with these if I could just solve these > few little issues. Sounds like you should see an expert, although I'm not versed in how you go about finding one. : ) DrG > One old technique for getting a lens to stay in place is to have it > stay tucked up under the upper eyelid. It may be that your upper lid > may actually be catching the upper edge of the lens, and then forcing > it down when you blink. As well, you may be only partially blinking, > which then never allows the upper lid to "capture" the lens and pull > it back up. Hard to say for sure, but it looks to me like my eyelid pulls it up, then it slides back down. When my eye first opens, it's up. > Sounds like you should see an expert, although I'm not versed in how > you go about finding one. : ) > > DrG Where are you located? I travel for business sometimes... > Where are you located? I travel for business sometimes... http://www.copfameye.com DrG What diameter are your lenses? If they aren't sufficiently large, they will give blur on blinking and side glances. Use a 10 or 10.5mm lens and this will get rid of the edge awareness of your vision. Also, the general rule is fitting large and flat (loose) but sometimes it can help to tighten the lens up a bit. There will be no ocular discomfort from going a little tighter, the edges are polished and will not cut into your eye. dr grant > What diameter are your lenses? If they aren't sufficiently large, they > will give blur on blinking and side glances. Use a 10 or 10.5mm lens > and this will get rid of the edge awareness of your vision. I don't know. I don't know if it's universally this way, but no doc I've been too has ever volunteered my prescription. I always have to ask. I haven't yet asked for my full contact Rx, although I do know the power numbers. Anyway, I did ask my doc about going larger and he though it was a bad idea because they were hanging low, and thus the bottom edge of the contact would be into the white area of the eye. When I first got them I felt like I saw the edges in all different directions. For whatever reason, I now only notice the top edge when they are sagging. > Also, the general rule is fitting large and flat (loose) but sometimes > it can help to tighten the lens up a bit. There will be no ocular > discomfort from going a little tighter, the edges are polished and > will not cut into your eye. What I was told was that tight lenses cause long term "wear" at the top and bottom edges. Sounds like you don't necessarily agree? > What I was told was that tight lenses cause long term "wear" at the top > and bottom edges. Sounds like you don't necessarily agree? A lens that is too steep/tight can "lock" on the cornea and cause lens adhesion which aint good. There are various fitting strategies that can work equally well- I try to get an upper lid fit (sup edge tucked under the lid) for best comfort for most patients. frank > Sorry to keep bugging the group with my RGP's, but things seem fairly > slow anyway. [quoted text clipped - 22 lines] > > -- You have some options there. 1. If you want to stick with RGP contacts, try a different size and base curve. A scaral lens would stay put but its so huge its scary to put in your eye! 2. Go back to glasses. This might not be easy if your pescription is high with lots of astigmastim due to spectacle minification and disortion 3. If you are totally fed up with RGP contacts and really hate glasses, theres laser surgury. Its not without risks and trade-offs. You will NOT see anywhere as well as you do with RGPs and probably not even as well with glasses. But itll greatly improve your uncorrected vision and should give you vision good enough to function. Great if you arent too picky about perfect vision and just want to ditch those irritating contacts/glasses. Charles, Fair warning: Ace woke up in a meadow some years ago ... after a tremendous binge on hallucinogenic mushrooms ... and now seems to think he's an optometrist. Be afraid. Be very afraid. > Charles, > [quoted text clipped - 5 lines] > > Be very afraid. LOL silly doctor Brooks! I wish I were one, but I am not a doctor. >> Charles, >> [quoted text clipped - 7 lines] > >LOL silly doctor Brooks! I wish I were one, but I am not a doctor. Ace, you need to go and do something useful in society. We know you're a bit odd.. probably got Aspergers like half those on usenet but still there must be something you can do. Quit sitting at home and surfing the internet. > Charles, > [quoted text clipped - 5 lines] > > Be very afraid. Don't worry, I read ace's posts for amusement purposes only. > > Sorry to keep bugging the group with my RGP's, but things seem fairly > > slow anyway. [quoted text clipped - 38 lines] > picky about perfect vision and just want to ditch those irritating > contacts/glasses. I gave you a great reply to your RGP problem. knowing you, youll probably just stick to your uncomfortable RGPs and deal with it best as you can. At least it gives you 20/15 vision. You mentioned in another post how picky you were about your vision so I now know that glasses and lasik is out. You wouldnt be happy with 20/40 even though almost everyone would, as long as the quality is reasonable. > I gave you a great reply to your RGP problem. You meant "great" as in volume, right? > You wouldnt be happy with 20/40 even though > almost everyone would, Sorry, 20/40 is not acceptable to me if I can do better. A doc told me that same thing. I found another. > as long as the quality is reasonable. Please explain the difference between 20/40 good quality and 20/40 bad quality? -Quick > > You have some options there. > > [quoted text clipped - 13 lines] > > I gave you a great reply to your RGP problem. Great reply? Please. If you were really trying to help, then thanks, but I'm not an idiot. I can tell you've learned some vocabulary words on the net, but I can do Google searches too. Your first point was the only one that even tried to answer the actual question, but I've already explained why my doc doesn't want to go bigger, or go steeper. Telling me to get glasses or lasik really doesn't help much. > knowing you, youll > probably just stick to your uncomfortable RGPs and deal with it best > as you can. Knowing me? Hmm.... >> > You have some options there. >> > [quoted text clipped - 26 lines] > >Knowing me? Hmm.... Change of address is indicated at this point. Looks like you've picked up a stalker.... |
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