Contact Lenses

A contact lens is a thin plastic or glass lens that is fitted over the cornea of the eye to correct vision problems such as myopia, hyperopia or astigmatism.

There are two general types of contact lenses--soft and rigid gas permeable hard lenses. They both have unique benefits and some may even come with a colored tint, ultraviolet protection or as bifocals.

Soft lenses

Soft lenses are made of a soft plastic and are more comfortable than hard lenses because they hold more water. Many soft contact lenses also provide UV protection. They are usually disposable and can be thrown away after a short period of use, generally every two to four weeks or daily, depending on the type of lens prescribed. Being able to have a fresh pair of lenses means less chance of infection, less cleaning, and more comfort, especially for people whose eyes naturally produce more protein that clouds lenses.

While most people choose soft contact lenses because of their benefits, there are also some disadvantages. Soft lenses easily absorb pollutants like lotion or soap from your hands, which can irritate your eyes. They are also more fragile than hard lenses and can rip or tear easily.

The most recent types of soft contact lenses to hit the market include daily disposables and silicone extended wear disposables.

Soft contacts need to be properly disinfected whenever they are worn by soaking them in a disinfecting or multi-purpose solution overnight.

Daily disposables

These contacts are only worn once and then thrown away. The benefits of daily disposables include never having to clean your contact lenses, convenient replacement schedule, and reduction of dry eye and irritation related to contact solutions. If you are an allergy sufferer, these are the contacts for you.

Silicone extended wear disposables

These are made with a new material that can be worn for up to 30 nights and days. The new silicone material also prevents deposit build up and reduces dry eye irritation.

Rigid gas permeable hard lenses

Rigid gas permeable lenses, or hard contact lenses, are more rigid than soft lenses and therefore more durable. Unlike older versions of hard lenses, rigid gas permeable lenses are made with silicone polymers, allowing oxygen to circulate to the cornea of the eye. Compared to soft contact lenses, hard contacts maintain their shape better and offer clearer vision for some types of corrections. They are also extremely durable and easy to take care of. However, if you are considering this type of hard contact lens, you should know that:

• There is a 10-15 times greater risk of developing corneal ulcers, a serious infection, which may damage your vision if not treated.
• Sleeping in any contacts may decrease the flow of oxygen to the cornea and lead to a serious eye infection which can damage your vision.
• Undesirable reshaping of the cornea may occur.
• The amount of time needed to adjust to hard contacts is often repeated after not wearing them for as little as a day. Therefore, in order to achieve maximum comfort, you have to wear the contact lenses every day.

Bifocal contacts

Bifocal contact lenses are designed to give good vision to people who have a presbyopia. These lenses work much like bifocal eyeglasses, having two powers on one lens: one to correct distant vision and another to correct near vision. Bifocal contacts come as both soft and rigid gas permeable lenses.

Toric contact lenses

Toric lenses are special lenses for people with astigmatism. They are made from the same material as other contact lenses and come in soft or rigid gas permeable forms. Like bifocal lenses, toric lenses have two powers, one for the astigmatism and another for myopia or hyperopia if either of these conditions is also present.

Colored contacts

Colored tints can be added to certain contact lenses that make them easier to see when handling, enhance or change eye color, and improve contrast for outdoor sports, like golf and softball. Contact lenses with novelty effects are available, but should still be handled and cared for like prescription lenses.

How do I know which type of contact lens is right for me?

The type of vision correction needed, your lifestyle, and expense will all play a role in your eye care specialist's recommendations for the type of contact lenses that you should wear.

Who should not wear contacts?

Contacts are generally not prescribed for people who:

• Do not produce enough tears
• Are constantly exposed to fumes
• Have a history of viral infection of the cornea
• Are under age 9

Where do I go to get contacts? Can I order them through the mail?

Contacts can be purchased from a variety of places including your eye doctor, a store specializing in optical wear, through mail order, or over the Internet. There is no one ideal place to purchase contacts--it is a matter of individual preferences or need. Before you begin to shop around for contact lenses, be aware that you first must have your contact prescription.

When shopping for contacts, cheaper does not always mean better. Some other things to keep in mind when pricing contacts include:

• Convenience: Is customer service readily available to assist you if need be? Does the company have policies with regard to lenses damaged during shipping?
• Insurance coverage: Be sure to contact your insurance company about coverage of contact lenses. Many plans do not cover specialty lenses, such as colored lenses.
• Availability: Are your lenses in stock? Are you willing to wait longer if necessary for your lenses to arrive?

Regardless of where you get your contacts, it is important to regularly get eye exams so that any changes in your prescription can be noted and that the overall health of your eyes can be maintained.

There are two general types of contact lenses: soft and rigid gas permeable hard. Both have unique benefits and some may even come with a colored tint, as bifocals, or as trifocals.

Soft lenses are usually disposable and can be thrown away after a short period of use (generally every two to four weeks) or daily, depending on the prescription. Being able to have a fresh pair of lenses means less chance of infection, less cleaning, and more comfort, especially for people whose eyes naturally produce more protein that clouds lenses. Soft lenses are made of a soft plastic and are very comfortable because they hold more water than rigid gas permeable lenses. Many of the new materials provide ultraviolet (UV) protection. While most people choose soft lenses because of their benefits, there are also some disadvantages. Soft lenses easily absorb pollutants that can irritate your eyes, like lotion or soap from your hands. They are also more fragile than hard lenses and can rip or tear while cleaning.

The latest revolutions in soft contact lens technology are daily disposables and silicone extended wear disposables. Daily disposables are contacts that are only worn one time and then thrown out. The benefits of daily disposables include never having to clean your contact lenses, convenient replacement schedule, and reduction of dry eye and irritation problems related to preserved solutions. These lenses are excellent for allergy sufferers.

The silicone extended wear disposables are made with a new material and can be worn for up to 30 nights and days. The new lenses provide the highest level of oxygen transmissibility (up to six times greater than ordinary lenses). The new silicone material also allows the lens to avoid deposit buildup and reduce dry eye irritation.

Rigid gas permeable (RGP) lenses are more rigid than soft lenses and therefore more durable for an active user. This type of hard contact lens is made with silicone polymers, allowing oxygen to circulate to the cornea of the eye. Older versions of hard lenses could not. RGPs maintain their shape better and offer clearer vision with some types of corrections. They are also extremely durable and easy to take care of. Deposits from tears and outside irritants are not as easily absorbed.

If you are considering a RGP lens, you should know that:

• There is a 10-15 times greater risk of developing corneal ulcers, which may damage your vision.
• Sleeping in extended wear contacts may decrease the flow of oxygen to the cornea.
• Undesirable reshaping of the cornea may occur.

To achieve maximum comfort with RGP lenses, you have to wear them everyday.

Colored tints can be added to certain lenses to make them easier to see when handling, enhance or change eye color, and improve contrast for outdoor sports like golf and softball. Contact lenses with novelty effects are available, but should still be handled and cared for like prescription lenses.

The type of vision correction you need, your lifestyle, and the expense will all play roles in your eye care specialist's recommendations for the type of contact lenses that you should wear.

Contact lens care

Always wash your hands with warm water and soap before handling your contacts or before touching your eyes. Any residue from lotions, soaps, or chemicals may adhere to the lens, causing pain, irritation, or blurred vision. Dry your hands with a clean towel.

• Wear your contacts as prescribed. Your eye care specialist will recommend a wearing schedule specific to the type of lens you have selected. Only wear your contact lenses for the time recommended.
• Remember that it will take about 10-12 days for your eyes to adjust to either type of contact lens. Not wearing your prescribed contacts will not cause eye disease, but it can cause discomfort, including eyestrain, headaches, or possibly even injury brought on by the lack of safe vision. If wearing prescriptive contact lenses is uncomfortable for you, ask your doctor about trying another brand or other alternatives, like switching from contact lenses to eyeglasses or exploring corrective surgery.
• Clean and store your contact lenses as prescribed. Different types of lenses require special care and certain types of products. Always use the eye care products recommended by your health care provider. Some eye products or drops are not safe for contact lens wearers.
• Contact lenses need to be properly disinfected after every use. They should be stored in a disinfecting solution overnight- not in saline solution.
• Sleeping in any contact lens is not recommended. The incidence of serious eye infections is greatly increased when sleeping in them- even for one night.
• Always store your contact lenses in a clean case in fresh solution, as recommended by your doctor.
• Clean your contact lens case after each use with either sterile solution or boiling water.
• Always use commercial sterile saline solutions for rinsing your contacts or to dissolve enzyme tables. Never use plain water on your contacts, and never put your contacts in your mouth to "rinse" them. Microorganisms can live in even distilled water and can cause infection or damage sight.
• Clean your contact lens by rubbing it gently with your index finger in the palm of your hand. The newest "no rub" solutions allow you to rinse your lenses only.
• If you develop an eye infection (signs include redness, burning, or excessive tearing), remove your contacts and discontinue use until you talk with your eye care specialist. Wearing a contaminated pair of contact lenses will invite the infection to remain. After resuming contact lens use, closely follow your doctor's instructions to help prevent future eye infections.
• Wearing contact lenses may cause your eyes to become more sensitive to sunlight. Wear sunglasses with total UV protection and/or a wide brim hat when in the sunlight.
• Never wear another person's contacts, especially if they have been worn before. Using them may be a hazard if they are a different prescription and can also spread any bacteria, infection, or particles from their eyes to yours.
• To keep your eyes lubricated, use a rewetting solution or plain saline solution.
• Do not sleep with your contacts in unless you have been prescribed an "Extended wear" material. While the eyes are closed, tears cannot carry healthy amounts of oxygen to the eye. Your contacts will become dry and "stuck" to your eyes if you sleep with them in. If you accidentally do fall asleep with your contacts in, be sure to put eye drops in your eyes and wait a few minutes before trying to remove your contacts.
• Visit your eye care specialist at least once a year. At an annual visit, your eye care specialist will check your contact lens prescription and your overall eye health. Discuss your family medical history with your eye care specialist to prevent vision problems or eye diseases. Your eye care specialist will want to know about your family's history of diabetes, glaucoma, cataracts, or macular degeneration. Most diseases that cause vision loss, like glaucoma and diabetes, can be treated or their progression slowed with the proper diagnosis and management.
• Visit your eye care specialist immediately if you have any degree of sudden vision loss, blurred vision, light flashes, eye pain, infection, swelling, unusual redness, or irritation.

First aid

For chemical exposure in the eyes:

• Remove your contact lenses immediately. Keeping them in your eyes may hold the chemical against the cornea, causing unnecessary damage and pain.
• If you suspect chemicals have entered the eye, begin flushing them immediately with cool water and continue to do so for approximately 15 minutes.
• Seek immediate medical attention by dialing 9-1-1 or going to the nearest emergency room. You will need to know the name of the chemical, or if possible, take its container with you to the emergency room.

For an object in the eyes:

• If you have an object in your eye, do not irritate your eye by rubbing it. You may try to remove the particle if it is not embedded in the eye.
• Do not try to remove an object that is embedded in the eye: seek emergency medical attention by dialing 9-1-1, or go to the nearest emergency room or to your eye care specialist.
• First wash your hands thoroughly with soap and water. This will prevent further contamination or infection.
• Try flushing the eye. Using your finger and thumb, gently pull the upper eyelid down over the top of the lower eyelid. This should cause tearing and flush the object out. You may need to repeat this procedure several times.
• If tearing does not work, you may try flushing the particle out using cool water for as long as necessary. This can be done in a sink, with an outside hose, or a glass of water that is contaminant-free.
• If you can see the object, you may try to remove it with a washcloth. Gently lift the upper or lower eyelid, and use a clean, wet washcloth to wipe the object away. If this does not work, seek immediate medical attention.

How to give yourself eye drops or ointment

• Wash your hands with soap and warm water. Dry them with a clean towel.
• Use a mirror.
• Look up to the ceiling with both eyes.
• Pull the lower lid of your eye down with one hand. Hold the eye drops bottle in your other hand. (Rest part of your hand on your forehead if necessary to keep it steady.)
• Place a drop inside your lower lid. The tip of the bottle should not touch your eye.
• Close your eyes for a minute after putting in the drop.
• If you are prescribed both eye drops and eye ointment, use the eye drops first.
• If you have more than one eye medicine to put in your eyes, wait about 5 minutes after the first medicine before putting in the second medicine.

Congratulations!

You have received your new contact lenses designed specifically for your visual correction. The following information is to help you achieve success as a soft contact lens wearer. You must care for and handle the lenses properly for the best vision, comfort and safe wear. Very little time is required to adapt to the feel of the lens on the eye. However, you may experience the following to some degree.

Normal Response to New Contact Lens Wear

Eyes may itch or feel funny, vision may seem fuzzier than with glasses, awareness may occur with one lens more than the other, vision may be better in one eye more than the other and eyes may tear.

Abnormal Response to New Contact Lens Wear

Pain or redness, foggy or cloudy vision and decreased vision that does not clear up. If at any time you experience an abnormal response to contact lens wear, discontinue wearing the lenses and call the contact lens department at the Cole Eye Institute 216.444.5885.

Your Care System

Multipurpose Solution with enzyme cleaner
Additional Cleaning Solution
Re-wetting Drops

Your Wearing Schedule

Day	Maximum Wearing Time
1–2	4 hours
3–4	8 hours
5–6	6 hours
7–8	10 hours
9–10	12 hours

Follow-Up Evaluation

Wear your lenses for a minimum of 4 hours prior to the scheduled examination time. If mild to moderate problems occur with lens wear, it is helpful to see you with lenses on after several hours of wear in order to assist in the diagnosis of the problem.

Handling Your Soft Contact Lens

Wash Hands

Before handling your lenses, always wash and rinse your hands thoroughly. A mild non-cosmetic soap should be used. Soaps containing lotions, oils or perfumes may leave a film on the hands, which may be transferred to the lenses and cause eye irritation. Dry your hands with a lint-free towel. Fingernails should be short and smooth to avoid damaging the lenses or scratching your eye.

Rinse Lenses

Always start with the lens for the right eye to avoid mixing up the lenses. Remove the right lens from the storage container, place it in the palm of the hand, and rinse with rinsing solution before putting on the lens. If your lens was cleaned the night before and stored in solution, you may just remove from storage solution and insert.

Inspect Lenses

Place the lens on your forefinger and inspect it for foreign particles, tears, or other damage before placing the lens on your eye.

Inverted Lenses

While inspecting the lens, check to make sure the lens is not inside out.

• Method 1: If the lens is in the correct position, the edges will appear almost straight up or turn in. When inverted, the edges will flare out.
• Method 2: Pinch the lens together and if it folds together with the edges curled in, it is not inverted. If the lens flips out and sticks to your fingers when pinched, it is inside out.

Inserting Your Contact Lens

• Method 1: Lens should be placed on the tip of your pointer finger of the hand, which will be used to insert the lens. Make sure your finger is dry as the contact lens will come off a dry finger easier than a wet finger.
  Hold the upper lashes/lid with the hand not holding the lens. Secure the lower lid with the middle finger of the hand holding the lens. Slowly bring the lens toward your eye while looking “through” the lens and finger. Gently place the lens squarely on the cornea.
  Do not blink until the lens is in place. Release the lids slowly, lower lid first then upper lid. Blink a few times. If the lens tends to stick to the finger instead of the cornea, lift the lens from the finger, wipe excess water off of the fingertip, replace the lens on the fingertip and proceed with insertion. Repeat the procedure for the left lens.
• Method 2: Hold the upper lashes/lid with the hand not holding the lens. Hold the lower lid with the middle finger of the preferred hand and look up. Place the lens on the lower white part of your eye. Look down to center the lens on the eye and slowly release the lower lid. Blink a few times to ensure that the lens is centered, free of trapped air, and comfortable. Follow the same procedure for the left eye.

Clean Case

After removing your lenses from the case, rinse your case well with contact lens solution or saline and allow the case to air dry. The storage case should be cleaned every week with liquid detergent and warm water. Replace your case every 3 months. A dirty contact lens case can contaminate your contact lenses with bacteria/ germs, which can be transferred to your eye.

Removing, Storing, and Cleaning Your Lens

Removal

Wash and dry hands thoroughly. Pull down the lower lid with the middle finger of your preferred hand. With the tip of your index finger of the preferred hand, lightly touch the bottom edge of the lens. While looking up, slide the lens down onto the white part of your eye. Then gently pinch the lens off the white part of your eye using your thumb and index finger.

Removal Tips For Toric Lens Wearers

To decrease the chance of tearing a lens, use re-wetting drops prior to removal and gently rotate the lens on your eye and pinch it off. The following day, rotate the lens in the opposite direction and then pinch off the lens. This avoids pinching the lens in the same area at every removal.

If A Lens Sticks Together

Place the lens in the palm of your hand and soak it thoroughly with solution. Gently roll the lens with your index finger in the palm of your hand in a back and forth motion. If gently rubbing does not separate the lens edges, soak it in solution until it resumes normal shape. Adding a drop of lubricant to the eye prior to lens removal will hydrate the lens and prevent it from stick-ing together.

Soft Contact Lens Care

Three steps to proper contact lens care must be followed every time the lenses are removed from your eye.

• Cleaning: After removing the lens, place a few drops of cleaner in the palm of your hand and in the bowl of the lens. Gentle but firmly rub the lens for 20-30 seconds between your palm and the index finger of the opposite hand. Rub in a plus-sign or straight line motion. Take care to avoid contact between your fingernails and the lens. Rinse the lens with rinsing solution and place the lens in the storage case. Repeat with left lens. Cleaning lenses removes mucus and oils that may have collected during the day.
• Rinsing: Place the lens in the opposite palm. Cup your hand and fill the palm with a pool of rinsing solution until the lens is immersed. Rub the lens using the same motion in the cleaning step. Turn the lens over and repeat until all cleaner is removed. Soaking and Disinfection: After cleaning and rinsing your lenses, place them in the storage case. Make sure the lens is completely covered with storage solution. Change solution daily. The lenses must be stored a minimum of 4-6 hours before being worn. Storing the lenses in the multipurpose solution removes protein build-up and disinfects the lenses.

Additional Information

Re-wetting Drops

Drops can be used as desired while you are wearing the lenses to hydrate the lenses and reduce dryness and “foggy” vision.

Hydration

Soft lenses must always be in hydrated (wet) form. If the lens is dropped and allowed to dehydrate (dry), it will not be ruined. It will become brittle and could break easily when handled. Place the lens back into the storage case with solution for a minimum of 4-6 hours to allow the lens to disinfect and return to a soft, flexible state. Inspect for defects before wearing. If the lens is uncomfortable call our department.

Water

Never use water, including distilled or mineral water, with soft contact lenses for any purpose. Fresh water or tap water contains impurities which could cause eye infections.

Part-Time Wear

Lenses should be cleaned and placed in fresh disinfecting solution every week and should also be disinfected 24 hours prior to lens wear. Lenses can be stored in some solutions for 30 days safely, but should be disinfected before wearing.

Pain, Discomfort, Redness, Blurring of Vision

If pain, discomfort, or redness occurs, remove lenses, clean, rinse, inspect and put back on the eye. If blurring occurs, this may be due to drying of the lenses and should clear up after blinking several times while moving the eyes back and forth. Instilling re-wetting drops will also help. Check to be sure the lenses are in the proper eyes. You may also try soaking the contact lenses in your storage solution for 30 minutes and replace on eye. If symptoms persist, remove lenses and call our department for an appointment.

Eye Drops

Eye drops, other than re-wetting drops, must not be used when lenses are being worn. Dis-cuss use of other drops with your doctor.

Spectacles

Have a current pair of glasses to wear when taking a break from contact lens wear. Glasses are needed if you have an eye infection or tear a lens.

Sports Wear

Soft lenses may be worn for sporting and athletic activities since these lenses rarely dislodge from the eye.

Swimming

Soft lenses should not be worn for swimming or other water sports unless watertight goggles are worn. Soft lenses may become contaminated with microorganisms or chlorine and can cause an eye infection. Lenses can also adhere to the eye after swimming. Do not remove the lenses if they appear tight on the eye. Instead use several re-wetting drops or saline to loosen the lens. If the lenses do not move freely after 30 minutes, call the Cole Eye Institute contact lens department for assistance. It’s important to clean and disinfect the lenses upon removal.

Cosmetics

Cosmetics, creams and oils for the hands and face should be used only after the lenses have been inserted. When trapped under the lens, cosmetics can cause discomfort. Ideally it is best to use hair spray prior to inserting contact lenses. However, if you use hair spray with lenses in, close your eyes, spray, and then walk out of the “cloud” of spray before opening eyes because hair spray can coat the lenses.

Contact Lenses and Sleep

Do not sleep with your lenses on the eye. If you forget, check upon waking to see if the lenses move freely on the eye. If the lenses move on the eye, remove the lenses for at least sever-al hours. If the lenses do not move, wait 5-10 minutes for your eyes to rewet by tears or place re-wetting drops in the eye. Once the lenses move freely, remove from eyes.

Extended Wear

Do not wear your contact lenses as extended wear (overnight) unless approved by your doctor. Extended wear lenses can be successful only with good care, careful cleaning, proper disinfection and frequent exams.

Every morning ask yourself 3 questions:

1. Do my eyes look good?
2. Do my eyes feel good?
3. Am I seeing clearly?

If the answer to any of these questions is no, contact your doctor for an examination.

Pain, red eyes and blurry vision should not be habitual with extended wear lenses. In the morning, use re-wetting drops to rinse your eyes free of debris and to improve lens comfort. The lenses may dehydrate during sleep. Use extended wear lenses for no more than 1 week without removal. Upon removal, the lenses should be cleaned or thrown away if they are disposable. Lenses should not be worn for one night after one week of continuous wear to provide the eyes with a full night’s “rest.”

For Women Only

Some women’s eyes become uncomfortable with contact lens wear during menstrual periods, pregnancy, menopause or while taking oral contraceptives. Fluid retention produced by hormonal changes in the body may cause the cornea to swell and change shape, resulting in an ill-fitting lens. For these reasons, if a woman goes on or off birth control pills or becomes pregnant, she should advise her optometrist.

Eye Exams

Contact lenses are a prescription device and must be monitored on a regular basis. Annual eye exams are necessary to monitor eye health and condition of contact lenses. Improper use and inadequate care of contact lenses can cause irritation, infections, and corneal injury.

Make an appointment now. Or call 216/444.2020 or 800.223.2273 Ext. 4-2020 to schedule an appointment with a Cole Eye Institute ophthalmologist.