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Specialty Contact Lens Guide

I love soft disposable contact lenses.  I have been wearing them with success for over 25 years.  Even more so, I love prescribing soft disposable contact lenses.

Of the estimated 130 million world-wide contact lens wearers, approximately 92% utilize the soft disposable modality.

The advancement of soft lens material technology, market availability and ease of use make soft disposable contact lenses the ideal choice for the vast majority of patients.  There are, however, patients whose anatomical or refractive/vision status will not allow for soft disposable contact lenses as an option.  Fortunately, there are excellent alternative contact lens modalities:

Custom Soft Lenses

There are patients in which prescription limitations will not allow the use of mass-produced disposable contact lenses.  Numerous ophthalmic laboratories exist that can manufacture soft contact lenses, custom created for the patients eye.  The modern materials these laboratories utilize are designed to be durable (allowing for less frequent replacement) without sacrificing oxygen permeability for corneal health.  Virtually any combination of nearsightedness (myopia), farsightedness (hyperopia) or astigmatism can be corrected for.  Custom soft lenses can also be created as a prosthesis; a specially tinted lens that, once applied, conceals scarring of the cornea and iris from trauma or ophthalmic disease.

Rigid Gas Permeable:

There are patients whose anatomical circumstance will not allow for soft lens material to correct vision properly.  If the cornea (the ocular surface ‘window’ that contact lenses are applied to) contour is not smooth, either by underlying medical condition (keratoconus, keratoglobus, Terrien’s marginal degeneration), injury/trauma, or as a result of refractive surgery (RK, PRK, LASIK), vision blur is more distortional.  This distortional blur may not be corrected by either glasses or soft contact lenses.  A rigid lens surface applied to an irregularly shaped cornea can ‘trick’ light entering the eye to be free of distortion.  Rigid lens material technology advancements have made the lenses both safer to use and easier to tolerate.

Scleral Design Rigid Contact lens:

This modality of contact lens design represents both contact lens heritage (the very first contact lenses hundreds of years ago) and the latest technological innovations.  The sclera is the white shell of the eye.  Most soft lens designs overlap to the sclera by a small degree, but rigid gas permeable lenses do not.  High degrees of corneal irregularity will not support the physical presence of a rigid gas permeable contact lens.  A rigid scleral lens is designed to ‘vault’ the cornea completely- only the white sclera has contact with the lens.  Vaulting the cornea allows for distortion-free vision and saves the fragile irregular cornea from the frictional/mechanical stress of the lens presence.

The recent innovations of scleral lenses revolve around their design:  digital imaging via corneal topography and optical coherence tomography allows for customization of the inner lens curve to maximize performance.  The scleral rigid lens design also represents the highest form of contact lens customization.  Investment in the imaging instrumentation above and a commitment to in-office fitting/design time by both the doctor and the patient make this lens modality unique to a select few practices.  In my time designing scleral rigid contact lenses for patients, I have seen the incredible difference it can make for patients with advanced corneal irregularity.

Contact lenses represent a significant share of the vision correction market.  Technological advancements have broadened the available vision correction types and ocular conditions in which contact lenses are successfully prescribed.

Contact us for your next contact lens fit consultation: 786-242-7755