Contact Lens Examinations

For many people, contact lenses provide greater convenience and more satisfying vision correction than eyeglasses.

Here’s what’s involved in a diagnostic contact lens exam for a patient trying contact lenses on for the first time.

A medical eye examination comes first

Before contact lenses are prescribed, a medical eye examination is performed. During this examination, your doctor determines if your eyes are healthy enough to begin wearing contact lenses. If your eyes are healthy enough, the next step is a diagnostic contact lens examination.

Diagnostic contact lens examination

Prescribing contact lenses involves a consideration of your lifestyle and your preferences regarding contact lenses. For example, you might want to change your eye color with tinted contact lenses. Other patients are more interested in convenient options such as daily disposables or overnight wear. Although most patients choose soft contact lenses, the advantages and disadvantages of rigid gas permeable contact lenses will be discussed.

If you are over age 40 and need bifocals, modern multifocal and bifocal contact lenses are available.

Corneal curvature vs. contact lens curvature

Just as one shoe size doesn’t fit all feet, one contact lens curvature doesn’t fit all corneas. If the curvature of a contact lens is too flat or too steep for your cornea’s shape, you may experience discomfort or even damage to your eye. Measurements will be taken to determine the best contact lens curvature, size and design for your eyes.

Diagnostic contact lenses

In most cases, diagnostic contact lenses will be used to help determine the prescription. Lenses will be placed on your eye and your doctor will use a biomicroscope to evaluate the position and movement of the lenses as you blink and look in different directions. You will also be asked how the lenses feel.

For patient new to contact lenses, good comfort is usually achieved in about 15 minutes. When your diagnostic lenses provide good comfort and clear vision, you will be given instructions on how to care for your lenses and how long to wear them. You will also receive training on how to handle, apply and remove contact lenses.

Follow-up examinations to maintain good eye health

Your contact lens treatment program might involve a number of follow-up examinations so your doctor can confirm the lenses are maintaining good eye health. Often, your doctor will be able to see signs of contact lens-related complications before you are aware of a problem. If abnormal signs are present during your follow-up examinations, your doctor may modify the initial contact lens prescription by trying a different lens or lens material, using a different lens care method, or adjusting your contact lens wearing time.

Your contact lens prescription

After confirming that a particular contact lens provides good comfort and vision, your doctor will then be able to write a final contact lens prescription for you. This prescription will designate the contact lens power, the curvature of the lens, the lens diameter, and the lens name and manufacturer.

Regular contact lens examinations

Regardless of how often or how long you wear your contact lenses, your eyes should be examined on a regular basis to make sure your that you are not developing any contact lens-induced complications.

Kids and Contact Lenses

A common question many parents have about contact lenses and kids is:

When is my child old enough to wear contact lenses?

Physically, your child’s eyes can tolerate contact lenses at a very young age. Some babies are fitted with contact lenses due to eye conditions present at birth. And in a recent study that involved fitting nearsighted children of ages 8-11 with one-day disposable contact lenses, 90% had no trouble applying or removing the contacts without assistance from their parents.

A matter of maturity

So the important question is whether or not your child is mature enough to insert, remove and take care of their contact lenses. How they handle other responsibilities at home will give you a clue. If your child has poor grooming habits and needs frequent reminders to perform everyday chores, they may not be ready for the responsibility of wearing and caring for contact lenses. But if they are conscientious and handle these things well, they may be excellent candidates for contact lens wear, regardless of their age.

Contact lenses for sports

Many kids are active in sports. Contact lenses offer several advantages over glasses for these activities. Contacts don’t fog up, get streaked with perspiration or get knocked off like glasses can. They also provide better peripheral vision than glasses, which is important for nearly every sport.

For sports, soft contact lenses are usually the best choice. They are larger and fit closer to the eye than rigid gas permeable lenses, so there’s virtually no chance they will dislodge or get knocked off during competition.

Controlling nearsightedness

If your young son or daughter is nearsighted, rigid gas permeable contacts may be the best choice. In some cases, rigid contact lenses may slow the progression of myopia in children. (Soft contact lenses don’t offer this potential benefit.) Also, rigid lenses are more durable and often provide better vision than soft contacts.

Building self-esteem with contact lenses

Contact lenses can do wonders for some children’s self-esteem. Many kids don’t like the way they look in glasses and become overly self-conscious about their appearance because of them. Wearing contact lenses can often elevate how they feel about themselves and improve their self confidence. Sometimes, even their school performance and participation in social activities improves after they switch to contact lenses.

Glasses are still required

If your child chooses to wear contact lenses, they still need an up-to-date pair of eyeglasses. Many kids need the option of part-time contact lens wear to maintain proper eye health.

Don’t push contacts on your kids

Motivation is often the most important factor in determining whether your son or daughter will be a successful contact lens wearer. If you wear contact lenses yourself and love them, that still doesn’t mean they are the right choice for your child. Some children like wearing glasses and have no desire wear contact lenses.

We can usually tell at your child’s diagnostic contact lens examination if they really want to wear contact lenses. If it appears that they would rather stay in glasses, we will certainly respect their decision – and you should, too.

Sometimes it’s just a matter of timing. Often, a child may feel they don’t want contacts, but a year or two later, they do. There’s always time to make that decision.

When your child is ready to try contacts

When you and your child agree it’s time for contacts, call our office to schedule an examination. We welcome the opportunity to help kids of all ages enjoy wearing contact lenses.


Rigid gas permeable lenses are a type of hard contact lens that allows oxygen to pass through the lens to the eye. Though not as common as soft contact lenses, rigid lenses offer a number of advantages over soft lenses.

Advantages of rigid gas permeable contact lenses

  • usually more durable than soft contact lenses.
  • may provide clearer vision than soft contact lenses.
  • usually easier to keep clean than soft contact lenses.
  • can be less expensive than soft lenses in the long run.
  • may slow the progression of nearsightedness in some children.
  • used to perform orthokeratology, where contact lenses are worn during sleep to reshape the cornea and improve vision.

Disadvantages of rigid gas permeable contact lenses

So why doesn’t everyone wear rigid contact lenses? Potential disadvantages of rigid lenses (compared to soft lenses) include:

  • Need for adaptation. Unlike wearing soft lenses (which are usually comfortable right from the start), you may need few weeks before you can wear rigid lenses comfortably all day. Initially, you may be able to wear the lenses only a few hours daily until your eyelids adapt to them. For most patients, a brief adaptation period is followed by comfortable all-day contact lens wear.
  • Inability to wear part-time. To fully adapt to rigid lenses and to stay comfortable wearing them, you have to wear them almost every day. If you stop wearing them for several days, you will be more aware of the lenses on your eyes and you’ll have to re-adapt to wearing rigid lenses.
  • Increased possibility of dislodging. Because they are usually smaller than soft lenses, rigid lenses can dislodge from your eyes during contact sports or if you rub your eyes aggressively.
  • Vulnerability to sand and dust. Rigid lenses don’t conform to the shape of your eye like soft lenses do, so it’s possible sand or dust can get under your lenses at the beach or on a windy day. (You can minimize this risk by wearing wrap-style sunglasses outdoors.)”


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Keratoconus is a disease of the eye that causes structural damage to the cornea and varying degrees of visual impairment.

Abnormal Corneal Signs

  • Steepening of the corneal shape
  • Thinning of the corneal apex
  • Irregular astigmatism
  • Breaks in the posterior cornea

Abnormal Vision Symptoms

  • Decreased vision
  • Distorted vision
  • Glare
  • Halos around lights
  • Monocular diplopia
  • Ghost images
  • Multiple attempts in obtaining good visual acuity with eyeglasses
  • Vision not correctable with eyeglasses

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