Contacts

Understanding Contact Lenses
The concept of fitting a lens directly onto the surface of the eye is an old one, but only in recent years have lenses been developed that permit the cornea, the clear surface of the eye, to carry out biologic functions in a near normal way. Although many people believe they could never tolerate anything touching so sensitive a part of their bodies, most people can tolerate contact lenses rather well. Contact lenses are lighter and more comfortable for the face than spectacles, they allow one's natural appearance to be revealed rather than hidden behind spectacles, they do not distort images as strong prescriptive lenses might, they permit greater field of clear vision than spectacles, they do not fog as spectacles might, and they are competitively priced with fashion spectacles. There are a number of social and medical factors that help eye specialists determine who might benefit from contact lenses and who might be wiser to avoid them.

High Refractive Errors
Patients who have large refractive errors, either myopic or hypermetropic, might benefit from a contact lens. Spectacle correction of large refractive errors will noticeably change the apparent size of an image. If a patient's two eyes have very dissimilar spectacle prescriptions, this phenomenon would cause the patient considerable confusion and discomfort. Contact lenses distort an image only 1/5 to 1/10 as much as spectacles and essentially eliminate this problem. Contact lenses also provide a much wider field of view than spectacles because all light coming into the pupil would be focused. With thick spectacles, the edges cause particularly annoying distortions not found with contact lenses. Additionally, bifocal contact lenses are available that allow the wearer to have their vision corrected to see both near and far without the annoying and confusing images that can occur with the use of bifocal spectacles.

Keratoconus
Keratoconus refers to a cornea that is actually pointy and highly astigmatic. It is nearly impossible to correct this condition satisfactorily with spectacles, although in the early stages, it can be corrected fairly well with contact lenses. Keratoconus can progress to the point where even contact lenses may become insufficient and in these patients, corneal transplantation may be the only option.

Sports, Work and Contact Lenses
Contact lenses worn during hobbies, sports and work often provide clear vision without the need for spectacles. But it must be reinforced that they provide no protection against injuries, projectiles or chemicals, and they can even worsen a problem by trapping foreign bodies or noxious substances against the eye. It cannot be stressed enough that patients enjoying any activity where protective eyewear is required should wear that protection, especially if using contact lenses.

Cosmetic Lenses
Cosmetic contact lenses are available for people with deformations of their iris (the colored part of the eye), pupil (the hole in the iris through which light enters) or cornea. These lenses can mask unsightly scars and improve a patient's self image. However, it is unwise to wear cosmetic lenses simply to change one's eye color or for some dramatic effect, because the risks to the eye from contact lens wear far outweigh the benefits in these cases.

Who Might Reconsider Contact Lenses
Some patients would do better to reconsider purchasing contact lenses. These lenses require meticulous hygiene to prevent ocular infections or allergies. In addition, patients with dry eye, chronic conditions requiring eye medication, or pre-existing eyelid disease (e.g., styes) would do well to avoid these lenses, at least until their other conditions are treated. Smokers or those frequenting smokey areas are at increased risk of contact lens-related problems because contact lenses can trap airborne toxins and present them to the eye, making the eye susceptible to infection and inflammation. It is the responsibility of the eye doctor to evaluate each patient individually to determine whether the patient is a candidate for contact lenses, and, if necessary (on rare occasions) recommend not prescribing them if the risks outweigh the benefits.