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Medical Forum / General / Vision / February 2008Question about my contact lenses
Two days ago I went to the optometrist to get new contact lenses. I have not worn contacts in a while but I left off with the Acuvue Oasys, which were very bothersome. I don't think they were fitted to my eye properly. So I made a point to my eye doctor that perhaps my eyes just needed to be fit properly. He agreed and gave me 4 pair of contacts to try. Pair 1: When I put these in, I had the feeling like I had put them in a bit wrong. They were mildly annoying, PROBABLY BECAUSE THEY WERE THE WRONG DIMENSIONS, but my doc chopped this up to "sometimes ya gotta get used to the lenses and it might take a few days". Now, I am no genius, but everyone who I have talked to who is happy with their lenses has said "Yeah, I can't even feel them or tell they're there!" or something close to that. Not once have I encountered someone who said, "My contacts really bothered me for a week and now I love them." I couldn't fall asleep in these for about 30 minutes, ended up putting in some eye drops and then went to bed. The right one fell out when I was asleep. Big surprise. Unfortunately I am not sure the specifications of this lense as I put them in at the doctor's place and didn't keep the thing they come in. The day after, I put in pair Pair 2. Pair 2 is Acuvue 2 (my rX is -2 diopters btw) and these were uncomfortable from the start. VERY. And right after I put them in I had a meeting to go to go, and it was very painful and I took them out as soon as I got home. Now, here I am, thinking that I must have goofed up when I put these in or something, but I look closely at the 3 different kinds of lenses I have, and NOTICE THEY ARE ALL DIFFERENT DIMENSIONS. My doctor has given me 4 lenses WITH DIFFERENT CURVATURES to evaluate and see which one is more comfortable. HMMM, LET ME SEE, PROBABLY IT WILL BE THE ONE THAT FITS BEST, seeing as they are all silicone hydrogel lenses suited for continuous wear. The Acuvue 2's have a BC of 8.3, and a DIA of 14.0 The CIBA visions, which I have JUST put in, and find quite comfortable, although not PERFECT, have a BC of 8.6 and a DIA of 14.2 The CIBA night and day's (the one's suited for 30 day wear...although I would never have them in for more than a weak) have a BC of 8.4 and a DIA of 13.8 So, I guess my question is: Did my optometrist goof up big here, or do these lenses really come in such different dimensions that the "personal preference" he was talking about is actually just the sizes that the lenses come in (which I find hard to believe...as they would try to fit as many types of people as possible)? Also, do you guys think I should try Bausch and Lomb Purevision? I have read nothing but great reviews about them. Thank you very much for your responses! > Two days ago I went to the optometrist to get new contact lenses. I > have not worn contacts in a while but I left off with the Acuvue [quoted text clipped - 53 lines] > > Thank you very much for your responses! I just checked my old Acuvue Oasys lenses, they had a BC of 8.4 and a DIA of 14.0, SHOCKINGLY SIMILAR to the Acuvue 2's I just tried that were very uncomfortable. I think I am getting to the root of my contact lense problem. Also, it has occured to me that perhaps my doctor gave me all these different dimensions so that he could find out which type of dimensions fit my eye properly...although this seems unlikely seeming as how they mapped my eye and he spent a few minutes shining a light in my eye and using another machine to determine the shape of my eye. In 25 years of fitting contacts, I've never found any "measurements" that would guarantee a comfortable fit with soft lenses. I've seen plenty of SHOCKINGLY SIMILAR lenses where one pair felt fine and the other felt terrible. "Dimensions" are a guideline but they aren't a very reliable predictor of comfort. It isn't entirely trial and error but I can't look at the fit in a microscope and guarantee that the lenses will be comfortable. Even when they "fit" and feel fine in the office they may feel "dry" and become unwearable by the end of the day. Some people aren't comfortable with ANY soft lens. Given all that, why would you NOT want to try several lenses? -MT, OD > I just checked my old Acuvue Oasys lenses, they had a BC of 8.4 and a > DIA of 14.0, SHOCKINGLY SIMILAR to the Acuvue 2's I just tried that [quoted text clipped - 6 lines] > as how they mapped my eye and he spent a few minutes shining a light > in my eye and using another machine to determine the shape of my eye. > In 25 years of fitting contacts, I've never found any "measurements" that > would guarantee a comfortable fit with soft lenses. > > I've seen plenty of SHOCKINGLY SIMILAR lenses where one pair felt fine and > the other felt terrible. "Dimensions" are a guideline but they aren't a very > reliable predictor of comfort. Moreover, different individual lenses of the exact same prescription+batch can fit very differently -- some good, most bad, and that after a LOT of trial & error attempts.  SignatureCheers, Bev ================================================================ I didn't break it! It was doing that before I broke it... er... > > In 25 years of fitting contacts, I've never found any "measurements" that > > would guarantee a comfortable fit with soft lenses. [quoted text clipped - 11 lines] > ================================================================ > I didn't break it! It was doing that before I broke it... er... Hmm, that is very odd. So prescribing people contacts is a guessing game? And even if you find a pair you like...it could just be an anomaly? Who knew! Thanks for your responses. I guess I will keep experimenting. >> > In 25 years of fitting contacts, I've never found any "measurements" that >> > would guarantee a comfortable fit with soft lenses. [quoted text clipped - 6 lines] >> prescription+batch can fit very differently -- some good, most bad, and >> that after a LOT of trial & error attempts. > > Hmm, that is very odd. So prescribing people contacts is a guessing > game? Sometimes. > And even if you find a pair you like...it could just be an anomaly? My problem is due to the wrong kind of astigmatism -- most people don't have anywhere near as much trouble as I do. Just lucky, I guess :-( > Who knew! > > Thanks for your responses. I guess I will keep experimenting. SignatureCheers, Bev ====================================================== Guns kill people like spoons make Rosie O'Donnell fat. In article <8b62a88c-2f02-4bfa-88c2-9207818fff11@41g2000hsc.googlegroups.com>, > > > In 25 years of fitting contacts, I've never found any "measurements" that > > > would guarantee a comfortable fit with soft lenses. [quoted text clipped - 4 lines] > > > very > > > reliable predictor of comfort. > Hmm, that is very odd. So prescribing people contacts is a guessing > game? Sometimes I compare shoe sizes with corrective lenses. Everybody has a shoe size, but not only is it not very accurate, but everybody's feet are shaped differently. In fact, for many people, one foot is a different size from the other. To find out whether a shoe fits, you really need to try it on. Even if it is the right size, it may not fit your foot well, and you may need to try a larger or smaller size in that particular shoe. SignatureDan Abel Petaluma, California USA dabel@sonic.net > Moreover, different individual lenses of the exact same prescription+batch > can fit very differently -- some good, most bad, and that after a LOT of > trial & error attempts. Yeah, but if everybody had that experience, nobody would wear contacts. The manufacturers are pretty consistent. At the margins, of fit or optics, you get trouble. The OP has tried AVO, AV283, and probably Ciba Air Optix. If he can't be comfortable in those, then he's tough to fit. Now he's probably wearing CAO in the standard 8.6/14.2. Ciba also customizes CAO disposables into 14 different base curves and three diameters and I'd try about three of them. Perhaps flax oil 4g/d p.o. but I'd start thinking about gas perm contacts and finding someone who fits a lot of contacts. Good news is, apparently he CAN see with them. Bad news is, he wants to SLEEP in them. -MT >Two days ago I went to the optometrist to get new contact lenses. I >have not worn contacts in a while but I left off with the Acuvue >Oasys, which were very bothersome. I don't think they were fitted to >my eye properly. Up until recently, Oasys came in a single size - 8.4 BC, 14.0mm diameter. They now also come in 8.8 BC (the higher the BC, the flatter the lens). Base curve is not a precise thing with soft lenses. You can tolerate a pretty big range. For example, I was initially given 8.7 BC Acuvue Advance, since my eyes are a bit flat, but I can still wear 8.4 BC Oasys (though I'll be trying the 8.8 when I next go back for an exam). Most lenses come in only two sizes - a low-end base curve, and a high-end base curve, with the same diameter. >Pair 1: When I put these in, I had the feeling like I had put them in >a bit wrong. They were mildly annoying, PROBABLY BECAUSE THEY WERE THE >WRONG DIMENSIONS, but my doc chopped this up to "sometimes ya gotta You didn't say what they were, and I can only guess they are Oasys. If that's the case, there are two sizes, and it's unlikely that you were given the wrong one. Either it works for you, or it doesn't. >The day after, I put in pair Pair 2. > >Pair 2 is Acuvue 2 (my rX is -2 diopters btw) and these were >uncomfortable from the start. VERY. And right after I put them in I >My doctor has given me 4 lenses WITH DIFFERENT CURVATURES to evaluate >and see which one is more comfortable. HMMM, LET ME SEE, PROBABLY IT >WILL BE THE ONE THAT FITS BEST, seeing as they are all silicone >hydrogel lenses suited for continuous wear. Acuvue 2 are not silocone hydrogel lenses, and are not suitable for continuous wear. >The CIBA visions, which I have JUST put in, and find quite >comfortable, although not PERFECT, have a BC of 8.6 and a DIA of 14.2 >The CIBA night and day's (the one's suited for 30 day wear...although >I would never have them in for more than a weak) have a BC of 8.4 and >a DIA of 13.8 8.4 to 8.6 BC is a very small range. The diameters are standard for the lens in question. I don't know what the first CIBA lens you're talking about is, and I'm guessing the second is Focus Night & Day. I find the latter intolerably uncomfortable, and Oasys extremely comfortable. It all depends on your eyes. >So, I guess my question is: >Did my optometrist goof up big here, or do these lenses really come in >such different dimensions that the "personal preference" he was >talking about is actually just the sizes that the lenses come in >(which I find hard to believe...as they would try to fit as many >types of people as possible)? He did not goof up. The main problem here is that you seem to have educated yourself insufficiently about contact lenses. Enough so you feel justified in lambasting your optometrist, but not enough to know the reality of fitting soft lenses (i.e. you pick the existing sizes that are close to your eyes' measurements). You also don't seem to be considering the differences in material at all. Acuvue Advance and Oasys are made from very soft silicone hydrogel with rounded edges, while Focus Night & Day is made from a stiffer silocone hydrogel with unrounded sharp edges. I find the former two very comfortable, and the latter intolerable. >Also, do you guys think I should try Bausch and Lomb Purevision? I >have read nothing but great reviews about them. They are optically quite good. PureVision are much better for night vision than Night & Day (ironically), as the latter have a small optical zone, and unless you have tiny pupils, won't correct your whole visual field in the dark (when your pupils reach their maximum size). The materials feel much the same to me - the PureVision is a tiny bit more comfortable than N&D, but still intolerable to me. Signature- Mike Ignore the Python in me to send e-mail. I just wanted to chime in and exclaim how thrilled I have been with the optics on the Purevision contact lenses. I started with the multifocal, and after diagnosing myself as not quite full fledged presbyopic yet, I insisted my OD put me in the single vision Purevision torics (which have worked out great). The technology of these lenses is great, and the vision outstanding. They have the optics I was hoping for in soft contacts. Crisp and clear, they give me 20/20 vision, I can see for half a mile in the distance, and wear them for 16+ hours (or even sleep in them) with no major drying issues. I am thrilled. I really do buy into Bausch & Lomb's "wavefront inspired" technology--these are great optics for soft lenses in any light source--night or day or artificial. However my goal was always the best optics possible, short of moving into RGP's, and I have to admit that the Purevision lenses, with their thicker silicone hydrogel construction, may not be comfortable for sensitive wearers (particularly the toric version). I have gotten use to them in a day or two, and though I am more "aware" of them in my eye than thinner soft contacts (ProClear for instance), I would not call them uncomfortable, and I consider it a small price to pay for such phenomenal optics in a soft contact lens. But those looking for instantaneous "can't even feel it" comfort, Purevision may not be the answer.
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