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Contact lenses: What to know before you buy

Specialized contact lenses

Both soft and gas permeable contact lenses have become more versatile in recent years, so more people are able to wear contacts for vision problems once correctable only with glasses. Specialized contact lenses also play a role in treating some eye conditions other than impaired vision.

  • Contact lenses to correct presbyopia. Presbyopia is the gradual loss of close-up vision. Contact lens options to correct presbyopia include bifocal lenses, monovision and modified monovision. Bifocal contact lenses feature two prescriptions on one lens: one to correct distance vision and the other to correct near vision. Bifocal contact lenses are available in daily wear soft and gas permeable materials.

    Monovision involves using a contact lens with your reading prescription in one eye and a contact lens with the distance prescription in the other eye. Modified monovision entails wearing a bifocal or multifocal contact lens in one eye and a single-vision lens in the other eye. For instance, you may have a lens for distance correction in your dominant eye and a bifocal lens in the other eye. Both eyes can be used for distance viewing, but only one eye for reading. Monovision requires some getting used to, and not everyone will find this type of vision correction comfortable.

  • Scleral contact lenses. Scleral contact lenses are made of gas permeable materials. They're larger than standard gas permeable or soft contact lenses, and are designed to rest on the less sensitive white part of your eye (sclera), not your cornea. Scleral contact lenses provide space for a protective layer of saline between the lens and your eye. This allows for better comfort and better vision for people who can't wear glasses or regular contact lenses due to corneal inflammation or very irregular corneas or ocular surface problems — such as might occur with severe astigmatism, keratoconus, corneal inflammation, Stevens-Johnson syndrome or after corneal surgery.

Avoiding eye infections

Wearing contact lenses increases your risk of corneal infection. Some of the added risk is unavoidable: All types of contact lenses reduce the amount of oxygen that reaches your cornea — the clear tissue that lies over the pupil and iris — and less oxygen can promote infection.

This reduction in corneal oxygen makes proper cleaning and disinfection all the more important. Here are some tips:

  • Wash, rinse and dry your hands thoroughly before handling your contacts.
  • Use multipurpose contact lens solutions with caution. While combination cleaning-disinfectant-storage solutions are convenient, two brands have been withdrawn from the market in recent years because they've been linked to serious eye infections. Do not use any solutions that have become discolored; this might mean that the product is out of date or contaminated. Gently rubbing the lenses during cleaning enhances the cleaning performance of the solutions.
  • Choose daily wear contacts, and take them out before you go to sleep. Infections are more common with extended wear contacts, worn continuously, than with daily wear contacts.
  • Follow your eye-care professional's instructions for taking care of your lenses. Use only sterile products that are commercially prepared specifically for contact lens care, and make sure you use lens-care products formulated for the type of lenses you wear.
  • Replace your contact lenses as recommended. If one or both lenses bother you before you're due to replace them, get them checked or try a new set — if you have a supply.
  • Replace your contact lens case every three to six months. Discard the solution in the contact lens case each time the lenses are disinfected. Don't "top off" old solution that's already in the case.
  • Wear contact lenses only to correct your vision. Costume contact lenses aren't regulated by the Food and Drug Administration and may cause serious eye injury or even blindness.

Getting the right fit

If you decide you want contact lenses, have a thorough eye examination and fitting by an experienced professional. Follow-up exams are important to monitor any changes to your vision and to update your prescription. If you're a regular contact lens wearer, see your doctor annually for an eye exam and a contact lens evaluation — more often if you have any problems.

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Aug. 22, 2008

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