Hard-to-Fit Contacts
Contact Lens Options for Every Eye
Some patients struggle with contact lenses. Eye shape, medical conditions, or surgery can make lenses harder to wear.
These cases are called “hard-to-fit.” But many options are now available. With a careful exam and fitting, most patients can find safe and comfortable lenses.
Contact Lenses for the Hard-to-Fit Patient
If you are a hard-to-fit patient, contacts are still possible. They require custom contact fittings by an experienced doctor. Your doctor will review your condition and suggest options.
You may need hard-to-fit care if you have:
- Dry eyes
- Astigmatism
- Giant Papillary Conjunctivitis (GPC)
- Keratoconus
- Pellucid Marginal Degeneration
- Past refractive surgery such as LASIK
- Presbyopia (age-related near vision loss)
Corneal scarring
Dry Eyes and Contact Lenses
Dry Eye Syndrome causes burning, redness, gritty feeling, and blurred vision. Contact wear may worsen symptoms. Even people without chronic dry eye sometimes notice irritation with lenses.
Before trying lenses, treat the dryness first. After care, your doctor may suggest dry eye lens fittings with specific products or materials.
Many soft lens brands are designed for dryness. Cleaning solutions may also help comfort. Gas permeable lenses (RGPs) hold some moisture under the lens, which can improve comfort.
Your doctor may also suggest shorter wear times or frequent replacement schedules.
Toric Lenses for Astigmatism
Astigmatism occurs when the cornea has two curves instead of one. This creates blurred or double vision.
Standard contacts often fail in these cases. Astigmatism lens exams often lead to toric or RGP lenses. Toric designs are custom-made to fit your eye.
Soft torics stay in place for most patients. If lens rotation occurs, RGP contacts may be tried. Customization takes longer and may cost more than standard lenses.
Giant Papillary Conjunctivitis (GPC) and Contact Lenses
GPC causes swelling of the inner eyelid. Protein buildup on lenses often makes symptoms worse.
Treatment may include daily disposable lenses or RGPs, which reduce deposits. Doctors may also prescribe drops and pause lens use until recovery.
Gas Permeable (RGP) or GP Lenses
RGP contacts work well for many difficult cases. The firm, oxygen-permeable design reduces infection risk and helps moisture retention.
RGP contact evaluations confirm fit and comfort. These lenses are durable and last longer than soft lenses.
RGPs for Keratoconus
Keratoconus causes thinning and bulging of the cornea into a cone shape. Soft contacts and glasses often fail in these cases.
RGPs are often used in mild to severe cases. They can also slow changes in the cornea. Some patients benefit from scleral lens fittings, which vault over the irregular cornea.
Doctors may perform a keratoconus eye exam or irregular cornea assessments to confirm the best option.
Post-LASIK or Vision Correction Surgery
While LASIK is often successful, some patients notice glare or halos at night.
RGPs can reduce these problems and restore clear sight. Post-surgical lens exams help confirm safe lens options after vision surgery.
Bifocal and Multifocal Contact Lenses for Presbyopia
Presbyopia makes near vision harder after age 40. Many patients use bifocal or multifocal glasses, but contact options exist.
Some choose monovision, where one eye is corrected for distance and the other for near. Others choose multifocals, which use both eyes for distance and near together.
Both approaches require about a week of adjustment. These are common specialty lens assessments for patients with complex needs.
Summary
If you struggle with contacts, don’t assume they won’t work. With custom contact fittings, modern designs allow safe use for patients once considered “hard-to-fit contacts.”
FAQs
Frequently Asked Questions
Why is it so hard for me to put on contact lenses?
Insertion takes practice. With training, most patients adjust within days.
What are hard to fit contact lenses?
They are lenses designed for patients with unique eye conditions or shapes.
What is the 4 to 1 rule for contact lenses?
This rule reminds patients to replace their case every three months for safety.
