The Focus On Contacts

by Samantha K. McPherson, OD, FAAO // July - August - September 2021

Contact lenses have a fascinating history. Leonardo da Vinci had the rudimentary idea of a contact lens way back in the 1500s. He recognized that his vision changed when looking through water, and thus he created a glass lens with a funnel so that water could be poured into it … but this bulky option never caught on. It wasn’t until the early 1880s that a contact lens could actually be worn on the surface of the eye.

The original contact lens was made of glass and covered the entire eye surface. Very heavy, it was not practical for long-term wear. Most importantly, the eye receives its oxygen supply from the air, so by covering the whole surface, the original essentially suffocated the eyes and caused extreme discomfort after a short period of wear. Advancements in the manufacturing of plastic materials in the 1930s enabled production of lightweight and unbreakable contact lenses. Glass versions quickly fell out of favor and plastic ones became the norm. Mass-produced soft contact lenses as we know them weren’t developed until the 1960s. The popularity of contact lenses took off in 1987 when the first disposable version was introduced.

It is estimated that 45 million people in the U.S. currently wear contact lenses – and it is easy to see why. With just a little practice, it takes minimal time to feel confident about putting them on your eyes and removing them. They feel comfortable from the moment they touch your eyes, and improved vision is immediately noticeable. The ease of wearing them now makes the original contact lenses seem prehistoric. The ultimate in convenience is provided by daily disposable contact lenses, which were introduced in 1996 and are now the fastest growing segment of the market. After wearing your lenses for the day, you simply remove and toss them into the trash. No special storage cases needed, no dealing with cumbersome cleaning and disinfecting routines, and the comfort of a brand-new pair of contacts can be appreciated every day.

If you currently wear glasses for vision correction, take a minute or two to imagine a day without them. Sure glasses provide dependable, clear vision and can even be fun fashion statements. But do they hinder your ability to move the way you want when you are participating in sports or exercise? Do you wish your glasses had windshield wipers to deal with the constant fogging that has become a way of life with recent mask-wearing? Do you sometimes feel your glasses make you appear older than you are? Have you ever taken your glasses off to not only leave them somewhere like a restaurant, store, or airplane? Have your glasses unexpectedly broken, leaving you stranded with poor vision? If you answered “yes” to any of these questions, you may want to consider contact lenses.

Contact lenses’ quality of vision is typically superior as compared to glasses. If your prescription is high, your vision can appear distorted when wearing glasses due to aberrations in the thicker part of the

lenses. If you are very nearsighted, you can experience “barrel distortion,” which causes the edges of objects to appear curved outwards. Objects can also appear smaller than their true size when viewing them through lenses that correct nearsightedness. If you are very farsighted, you may experience “pincushion distortion,” which causes objects to appear pinched inward toward the center. Objects can also appear magnified than their true size when viewing them through lenses that correct farsightedness. You have undoubtedly seen how giant a person’s eye looks behind a magnifying lens! When wearing glasses, your peripheral vision can be restricted due to the frame, size, and type of lenses, or the nature of your refractive error. Contact lenses have no visible border, and because they move with your eye, your peripheral vision remains intact, regardless of where you are looking. Scratches and smudges on glasses lenses also cause blurred vision and increased glare and haloes at night. These issues disappear when you wear contact lenses.

Popularity and interest in contact lenses have skyrocketed among children. Their ease and proven safety record has convinced an increasing number of parents that contact lenses are the right choice for their children. In a clinical study, 80% of parents agree that contact lenses made their children feel more confident. For kids not excited about wearing glasses, contact lenses can help improve self-esteem. For athletes, they can help improve performance by enhancing peripheral vision and eliminating the worry of glasses falling off, breaking, or bouncing around. Parents are also often surprised at how affordable contact lenses can be. If your child is demonstrating responsibility at school and at home, and is eager to try contact lenses, the time just might be right!

Nearsightedness, or myopia, is a global epidemic with significant visual, social, and economic implications. It is not your imagination if you feel that more children are wearing glasses than 20 years ago. Several companies are racing to develop innovative products that treat or prevent myopia. One such new product is a contact lens called MiSight 1 Day. Unlike any other contact lens, it not only corrects vision, but it can also slow down the progression of nearsightedness. In the clinical study, the children who wore the MiSight lens had, on average, only about half of the increase in nearsightedness seen in those who wore conventional soft contact lenses over a three-year period. This is an extraordinary finding that will change the way con-

tact lenses are prescribed for children and will certainly bring about the development of more exciting lenses in the future. The MiSight lens is a convenient daily disposable contact lens and is indicated for children aged 8-12 years of age at the initiation of treatment. It is currently the only contact lens with FDA approval to slow myopia progression. If you believe that this lens may be appropriate for your child, seek out an eye doctor who has received the certification and training required to fit this unique lens.

Contact lenses are not just for kids or young adults. If you are in your 40s and beyond and are looking for an alternative to your bifocal or progressive glasses, you also have options. Many who find themselves in need of reading glasses are unaware that they may be great candidates for contact lenses. As a matter of fact, multifocal and monovision contact lenses are allowing many people to say goodbye to their readers, bifocals, or progressive glasses, and this population segment is fueling the market for contact lens growth. Multifocal and monovision contact lenses are available in daily, monthly, and bi-weekly wearing modalities. Find an eye doctor who has experience and enjoys fitting these types of lenses and you may be very pleasantly surprised that you too can be free from your glasses.

I believe that the most amazing type of contact lenses are niche ones that correct vision in those who cannot successfully wear glasses as a result of significantly high prescriptions or corneal irregularity secondary to trauma, disease, or surgery. People suffering from advanced dry eye know that their vision is often terrible due to the visual fluctuation and chronic blur that cannot be corrected with glasses. 90% of contact lens wearers use soft contact lenses. However, special contact lenses, known as scleral lenses, can be absolutely life-changing for those who are afflicted by corneal disease, such as dry eye or keratoconus. These lenses are made of a rigid plastic, and when fit properly, can be worn comfortably all day, every day. They are filled with saline prior to insertion, so they essentially bathe the cornea in moisture while on the eye. Not only does the saline provide much needed moisture for a very dry eye, but the lenses also improve vision by masking the irregularities of a cornea that has developed an irregular shape due to disease or surgery. Not all eye doctors fit these types of lenses, so do your research if you think that you or a loved one could benefit from a scleral lens.

Vision correction is the most common reason why people choose to wear contact lenses, but they offer so much more than that. They are truly extraordinary small pieces of plastic that offer emotional and health benefits and can now even slow down the progression of myopia. Don’t hesitate to ask your eye doctor if you think that you would like to give contact lenses a try.

Samantha K. McPherson, OD, FAAO

Founder of Dry Eye Center of NC, a subspecialty clinic of McPherson Family Eye Care.