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HEALTHY EYES: TYPES OF CONTACT LENS
The technical difference between spectacles and contact lenses, said the director of the glaucoma and contact lens services at St. Vincent’s Hospital and Medical Center of New York, G. Peter Halberg, M.D., who was president of the Contact Lens Association of Ophthalmologists, is that “Glasses alter the rays to accommodate the defect before they reach the eye. The contact lenses unite the rays inside the eye where they are supposed to unite by actually putting a new surface on the corner. They are a prosthesis floating on a layer of tears.”
However, Dr. Halberg added: “The difference between perfection and disaster is a hairline. On a long term basis, an ill-fitting contact lens can deform the eye.”
To find the specialist who won’t cross that hairline, Morton D. Sarver, O.D., professor of optometry at the University of California School of Optometry at Berkeley and chief of the contact lens service there, said, “The concerned consumer must seek the services of a fitter who is familiar with and has access to all the different lenses available. Consult with people who have been well fitted, get a recommendation from a professional society, call an university with an optometrical or ophthalmological department. The question is similar to asking how to find the best surgeon to perform an appendectomy.”
Of the basic types of lenses – hard, soft, gas-permeable, silicon – differences among them primarily are in the ways they allow the eye to obtain the nutrients that keep it healthy. As mentioned, because the surface of the cornea does not contain blood vessels, it is dependent upon the flow of tears to obtain oxygen and release carbon dioxide. That is a problem with the element silicone. It is hydrophobic, or “water-hating.” Such a characteristic has made it impossible, until now, to get the lenses to ride comfortably on a thin film of tears instead of clinging to the eye.
The soft lens is hydrophilic, or “water-loving;” it absorbs water, so it keeps the eye bathed in fluid. Oxygen reaches the cornea in two ways; by direct passage through the lens and from the tear fluid under the lens. The soft lens fits flush against the cornea, assuming whatever shape it has. Such a lens is inappropriate for a person with an irregular cornea, though newer lenses have been developed to overcome this limitation.
More comfortable than hard lenses, soft lenses require little adjustment. They can be worn for a full twenty-four hours just a few days after first acquiring them. Athletes prefer soft lenses because they are less likely than hard lenses to pop out of the eye and are better at keeping out dust and soot. But they cost more initially and during routine care they are more likely to tear and become clouded. A clouded lens, which happens about every two years, must be replaced. Permanent lens clouding and serious eye infection can occur from poor daily cleaning (done with a chemical solution or by boiling).
If they are permitted to dry out, soft lenses become hard, but the softness can be restored by placing them in a special salt water solution. Keep in mind that they absorb not only water, but other solutions as well. Do not use eye drops while wearing them. Also don’t clean them with the regular solutions used in the care of hard contact lenses. Don’t place them in any liquid except the solutions your doctor will instruct you to use. Soft lenses should be removed before swimming or when you are in the presence of irritating vapors.
The person with a significant degree of astigmatism or small degree of farsightedness will not get the required correction from soft contact lenses. The decision concerning suitability must be made individually for each potential wearer.
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