Contact Lenses

mubs

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You can either handle it or you can't. I tried them in 1989 and almost went blind - corneal scarring because of hypersensitive corneas. I had to go to a specialist who said I could continue using them if I wanted to go blind. On the other hand, there are others in the family who have been wearing them for 25+ years with no problems. If I had a choice, I'd love to wear them and have the freedom of not having to wear these damn glasses I've worn for 35 years.
 

timwhit

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I have been wearing them for about 10 years now.

Get 2 week disposable lenses. Try not to wear them longer than 12 hours a day (although I regularly wear mine longer than this). Take them out at night. Other than that you should be fine.

Still waiting until I can afford surgery to have them fixed for good.
 

Mercutio

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Contacts are disgusting. Putting things in your eye is disgusting.
I know someone who lost an eye because he wore a set of contaminated disposable contacts
Contacts are bad.

Glasses frame and draw attention to your eyes. They make you look distinguished and intelligent.
 

i

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This is just going to be a meandering mass of suggestions and commentary. I apologize in advance.

Don't go for corrective eye surgery. The surgical eyes website used to be a good source to read about the countless examples the laser correction industry doesn't want you to see. Now the site has gone commercial and insists on all sorts of registration garbage.

Contact lenses are ok, but I will start with one piece of unusual advice: don't wear them while gaming. If you're an average human, your blink rate will drop when you're keeping track of fast-paced action. I have some minor corneal damage that was self-inflicted because of this. I played 3D-shooters for hours and hours, day after day for several years, almost always while wearing my contacts. Not so smart.

My original lenses were basic soft contact lenses. They would normally last about 1 year, maybe one and a half years.

I've recently started wearing daily-disposable soft lenses. They're a nice luxury, but harder to work with. They're thinner than the older soft lenses I had. This means they're harder to keep the right shape while inserting, and harder to get out (but not frightenly so or anything). A newcomer to contact lenses could find them frustrating.

The benefits include that I don't have to carefully clean them at the end of the day -- they just go in the trash. That's unlike my old ones, that required a committment to clean every day and take good care of. The other nice thing is that if I lose a pair now, it's not a big deal. I can also keep a couple of spare pairs at work in a drawer.

Here's my 3 point plan:

1. Don't consider hard lenses. They're not even a consideration these days for 99.999% of the population.
2. If your optometrist says your a good candidate for contacts, start with regular soft contact lenses for a year. It can be a drag to look after them, but they're so much easier to put in and take out than daily-disposables. It'll be a good introduction to the world of contact lenses. Plus, they're usually the cheapest option.
3. If you're hooked, switch to daily-disposables. I can't recommend weekly or 2-week disposable lenses because you still have to clean them each day. Where's the advantage? You can have lenses that last a year that you have to clean each day, or you can have contact lenses that you have to keep replacing every week ... and still clean every day. That's just more work.

Other random advice:

Don't wear contact lenses while sleeping, even if the pair you have claims it's ok. The 12 hour maximum suggestion is a good one. I used to be able to manage that without any problems. Nowadays I feel better with just 8 hours. My eyes start to complain if I go much beyond that these days.

On average, the older you get the harder it is to wear contact lenses. I'm 30. I've been wearing contact lenses off and on since I was 18. I don't think I have more than 5 more years before I just won't be able to wear contacts at all anymore. Your eyes tend become less and less accomodating to contact lenses as you age.

Don't you dare consider smoking if you're a contact lens wearer. Likewise, avoid prolonged exposure to second-hand smoke. Make sure you're getting lots of sleep. Eat well and just take care of yourself in general. All of that will affect how your eyes cope with contact lenses.

Whatever type you wind up with, pay attention to how your eyes are faring, and keep the contact lenses clean. It'll take a few days for your eyes to get used to having contact lenses around. But stop wearing them immediately if you sense or see a problem. Find yourself an optometrist you trust. See if you can get recommendations from people you know. Upscale optometrists are probably better. Avoid those one-hour mall-type places.

And finally, some of the content is a bit out of date, but read this.
 

sechs

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I'm personally a little touchy about putting bits of plastic on the only part of my brain that sticks out.
 

i

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I could argue that the rest of my body is simply an exposed extension of my brain, as much as I could argue that my brain and the rest of my body is simply an extension of my immune system in its relentless drive to feed upon more would-be parasites.

But it's late, so I won't.

As for contact lenses, I used to be reluctant about them also. I mean you're intentionally sticking something in your eye!

Then you learn that soft contact lenses are like transparent, soft, soggy sponges. The daily-disposable lenses I have currently, for example, are only 31% solid. The other 69% of the space they take up is initially a sterile water solution, but after being in place for a while, it's replaced with the natural moisture that's present on your eye. So they actually rely on the presence of moisture to sort of inflate or puff-up to take the right shape. And that means they have to stay moist. With any soft contact lens you don't want them to dry out. You'll ruin them if you let that happen. If they start to dry out while in place, they'll begin causing irritation.

Anyway, with that moisture you also get some level oxygenation. And oxygen transfer is an important consideration to avoid cornea problems -- one of the problems that can turn gruesome. That link I mentioned at the end of my last post should have some background on that.

Only 31% solid. Keep them clean and that's pretty benign.

There are new materials supposedly in the works that will allow for even higher moisture content (and thus more oxygen permeability). A quick check turned up soft contact lenses available today that range anywhere from 24% to 69% water.

It would be difficult to do of course (although it happens to me sometimes for a brief wonderful moment if I have excessive tears) but imagine a contact lens made of 100% water. Would you have a problem wearing that? No? Ok, so how about one that's 69% water?

If you approach it maturely, learn about the choices, read about the risks, play it smart and pay attention to how your eyes look and feel normally, don't ignore any problems or changes to how your eyes feel or look, find an optometrist you trust, and take care of the contacts and your eyes, you have an excellent chance at being just fine. Some people can't accept the small risk. To those people I say, "at least it's not intentionally allowing someone to slice the front of your eye open and then have someone blast a laser into parts of it."

Just kidding. To those people I say that I understand. Really. Everyone approaches decisions like this differently.

But I'll take the risks from contacts, thanks. It's been 12 years and the only real problem I ran into was a self-inflicted side-affect from a game addiction. That's just an average story from an average life. Not a story of gruesome catastrophe. Be smart and chances are that you won't have to deal with anything like that either.
 

jtr1962

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I had considered contacts a while back but decided against it because of the expense and having to take them in and out each day. I rarely remember to do anything on a daily basis except eat so with me it's likely the contacts would stay in for several days. Also, outside of when I watch TV I don't need to see with perfect clarity. My close-up vision is actually better than normal. 99% of what I do is within the range of my vision before it starts going blurry. Distance vision is 20/200 but I can cycle just fine. I couldn't wear glasses anyway when cycling because they woud fog up and/or fall off. Therefore, TV watching is the only time I use any vision correction. I suppose I would have to wear my glasses if I drove but I don't anticipate ever needing to drive.

I had considered laser surgery briefly. Putting aside any chance of complications, there was one big drawback for me. The improved distance vision would have come at the expense of my near vision. I would probably have to use magnifiers when I do any close-up work. This would be a poor tradeoff for me. I'd rather have things blurry the 1% of the time I use my distance vision.
 

Fushigi

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If considering LASIK or another form of eye surgery, I would take the site linked above by i with a grain of salt. Seems to be run by a few people who did indeed have problems with the surgery; I don't question their experiences. However, LASIK-type eye surgery improves every year. There are now reports of a new way to do it that eliminates the need for the initial incision.

Most of what I glanced over on their site is pretty dated. For any horror story you might read, research to see if that kind of thing is still a problem and what the actual error rates are. There is risk in all forms of surgery, but the procedures constantly improve.

My wife had LASIK in Jan 2002. Went from practically blind w/out glasses to 20/20 overnight. As is typical, her eyes were dry for a while afterwards so she used wetting drops. The need for that dimished over time and by the time about 6 months had elapsed so was using the drops just slightly more often than me. She used a doctor that actually teaches other doctors how to do it. He had done literally thousands of procedures already.

I still test 20/20 even at the 'advanced' age of 39. I'm the only one in my family over 25 who doesn't need vision correction, which is surprising considering how much time I spend staring at CRTs.
 

mubs

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i, thanks for the explanation of dryness / corneal problems. I think that's exactly what happened to me. Now I remember, the opto told me to use artificial tears when I first started having problems, but things just kept getting worse. I couldn't wait to get home and pluck those nasty contacts out of my eyes. Things got serious a little later.

Surgery keeps improving, but is still a crapshoot. My b-i-l is a physician. A bunch of his physician friends went to this famous guy who was a pioneer in the area, and had excellent results. After extensive investigations and discussions, my b-i-l had surgery, and had significant difficulties. He had another couple of surgeries to correct the first one. All the other guys stopped wearing glasses, but by b-i-l still has to wear them now.

I could stop using contacts when they gave me problems, but surgery is a one-way street. I'd personally be very, very hesitant to go down that route.
 

sechs

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i said:
I could argue that the rest of my body is simply an exposed extension of my brain

I suppose you could, except that you'd be wrong.

You eyes grow directly from your brain. There are also a group of cranial nerves -- all of which are internal -- that grow directly from your brain. So, unless you're doing some serious slicing and dicing, that's the only part of your brain that sticks out.

Also consider that your eyes aren't much more than balls of goo with light-sensitive cells on one side. You really *should* consider very carefully anying going on with them.
 

ddrueding

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Went to Costco and had a contact lens exam/training for $80. In a week I go back for a follow-up and to fill my perscription. The first time I put them in I had them in for 8 hours before I remembered they were there. Very cool. Got a pair of Maui Jim Ti Sunglasses, the most comfortable I've ever worn, to go with them. Awesome.
 

Adcadet

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I grew up with an optometrist, and am busily entering the medical field. I wear contacts. But I must disagree - some people do both. I have allergies that affect my eyes, and the winters here in Minnesota can really dry my eyes out. So I range from 50/50 to 90/10 (in favor of contacts) depending on the season and other stuff (harder to use a microscope with glasses back in histology and pathology, and if I'm in the OR with contacts I should wear safety glasses...actually I shouldn't wear contacts at all in most ORs).

Also a big fan of nice sunglasses. I prefer polarized brown lenses for most outdoor wear. Great on the water and when there's snow out.
 

Adcadet

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Some argue that the small risk of laser surgery is much smaller than the annual risk of eye infections. I'm sure if you look at the Disability-Adjusted Life Years of most eye surgeries vs. infectious risk of contacts for 10 or more years, surgery would win out.

But then there are others I've heard of who rely on near perfect vision (with or without correction) that they won't risk surgery. They're usually ophthalmologists or other surgical subspecialists. Or vision snobs. Like me.
 

sechs

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Having worked in chemistry and biology labs, as well is in industrial facilities, having glasses is a great way to always have your eyes protected....
 

Adcadet

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sechs said:
Having worked in chemistry and biology labs, as well is in industrial facilities, having glasses is a great way to always have your eyes protected....

True, but I'm pretty sure my safety glasses provide better coverage than small pair of glasses - IF I wear them, of course.
 

sechs

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It depends, of course, upon your particular glasses and what you're trying to protect against... but I've only ever *needed* "safety" glasses when working with chemicals which would cause eye problems (lacrimators, for example) outside of a hood, or when in a plant with high levels of particulates.
 

Adcadet

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I only need barrier protection (doesn't matter if they can stop a bullet). But my regular glasses are the smaller-frame style, and so don't provide good side protection or much protection over the top looking down if I'm, say, intubating somebody. In surgery I also need a pair that I can cinch against my head comfortably, since my (double) gloved hands are considered sterile and my glasses are not, and nurses get annoyed when asked to push up glasses on a med students face (most will just tape them to your forehead with the biggest, ugliest piece of tape they can find).
 

sechs

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Appropriate frames are made... and you generally don't look like a complete moron outside of work. In your situation it may be easier to use safety glasses... I have used several models which fit confortably over prescription glasses.
 

i

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If anyone's interested, there's a nice story on CNN.com that includes some graphic photos of LASIK surgery. Apparently it's LASIK's 10 year anniversary (presumably of the procedure as performed here in the USA -- who knows how long it's been performed elsewhere). Graphic photos are included! In one photograph it looks like someone is having a pen stuck into his eye, and in the other, they've got the guy's eyelid clamped down and what looks like the tine of a fork is being jabbed into his sliced-open eyeball. Great stuff.

:puke-r:
 

cquinn

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I finally took the time for an eye appt for both contacts and glasses
this summer, after having worn the same pair of broken frames
for almost a year.

I found that my glasses prescription was almost exactly the same,
but my contact prescription was radically different for one eye.
The Eye doc had me wearing contacts for a couple of days to
try them out after not having worn any for a while, and my
sight was so blurry I had to take one out to drive home.

I don't know if his diagnosis was off, or if it was because the
temporary contacts are too generic for the state of my eyesight,;
but I eventually decided on glasses because I could get better
focus from lenses than contacts. Which makes a big difference
when driving, reading, and working on the computer.

I did compromise with myself by getting "frameless" glasses;
which apparently work well enough that only one person has
outright complimented me on having new glasses so far.
 

Adcadet

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cquinn said:
I finally took the time for an eye appt for both contacts and glasses
this summer, after having worn the same pair of broken frames
for almost a year.

I found that my glasses prescription was almost exactly the same,
but my contact prescription was radically different for one eye.
The Eye doc had me wearing contacts for a couple of days to
try them out after not having worn any for a while, and my
sight was so blurry I had to take one out to drive home.

I don't know if his diagnosis was off, or if it was because the
temporary contacts are too generic for the state of my eyesight,;
but I eventually decided on glasses because I could get better
focus from lenses than contacts. Which makes a big difference
when driving, reading, and working on the computer.

I did compromise with myself by getting "frameless" glasses;
which apparently work well enough that only one person has
outright complimented me on having new glasses so far.

Unless you have some significant astigmatism, your visual acuity should be about the same between contacts and glasses once your brain aclaimates (takes me a few minutes for me). If not, I would suspect some other problem - wrong prescription, a lens inside-out, two lenses in one eye, lense fell out, etc.
 

e_dawg

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Just a note that I was researching contacts recently because I wanted to upgrade from the Acuvue 2 contacts that I have been using on and off for the past couple years.

From what I have read and heard, two contact lenses are considered best of breed:

1. Acuvue Oasys (Vistakon/J&J)
2. Focus Night and Day (Ciba Vision)

Why? To add to what i already wrote several months back, let's begin with what to look for in contact lenses:

1. Oxygen permeability/transmissibility (Dk/t)
2. Stiffness (modulus)
3. Surface treatment

Compared to hard (Rigid Gas Permeable, or RGP) lenses, traditional soft contacts are very poor at oxygen transmissibility. In order to improve oxygen transmissibility, manufacturers used more water. But the problem with using water, as i alluded to earlier, is that the higher the water content, the more pliable the lens. Some lenses are so floppy that it's difficult to insert into ones' eyes.

In order to address this oxygen / stiffness tradeoff, newer materials were developed: silicone hydrogels. They provide the best of both worlds: oxygen transmissibility and stiffness (through lower water content). The two lenses noted above (Focus Night & Day and Acuvue Oasys) are made from silicone hydrogels, as is PureVision (Bausch & Lomb) and Acuvue Advance (Vistakon).

Comparing Acuvue 2 to the next gen Acuvue Oasys, we find the following:

Code:
             Acuvue 2      Acuvue Oasys     Focus N&D
Dk              22             105             140
Modulus         40              65             238

On paper (using oxygen permeability and stiffness), it looks like the Focus N&D is the clear winner. However, let's not forget about surface treatment. In order to retain a tear film so that your eyes don't get dried out, manufacturers used to add hydrophilic coatings to essentially hold a film of tears between the lens and the eyeball. These days, mfrs treat the surface to become permanently hydrophilic -- not just some coating that can wear off over time.

Although Vistakon is very secretive about the details surrounding its surface treatment, we find that it is not a surface treatment, but rather, an internal hydrophilic wetting agent. This approach has considerable cost savings over the surface treatment route.

Source: Jones and Dumbleton, Silicone Hydrogels, Out. Auug 20, 2004.
 

timwhit

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I think my new contacts are Acuvue Oasys. I don't know that I like how they feel as much as any other lens I have used in the past. I will have to check on this when I get home.
 

e_dawg

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I should also mention that there are other silicone hydrogel contacts by Ciba Vision and Vistakon that you may have heard of:

Acuvue Advance (Vistakon)
O2 Optix (Ciba Vision)
PureVision (Bausch & Lomb)

From what I've read, Acuvue Oasys is simply a new and improved version of Acuvue Advance -- as in, Oasys is better than Advance in almost every area, and there is no reason to choose Advance.

As for O2 Optix vs Focus Night & Day, there may be a case to choose O2 Optix over Focus Night & Day even though Night & Day has higher oxygen transmissibility and is approved by the FDA for up to 30 days of continuous wear.

Specifically, while O2 Optix's Dk is lower than Focus Night & Day, it is still around 110 barrers (Acuvue Oasys is 105). But, its surface has lower friction than Focus Night & Day, which is known for having slightly higher friction than its peers.

Haven't heard much about PureVision, so won't comment on it.
 

e_dawg

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Code:
             Acuvue 2      Acuvue Oasys     Focus N&D
Dk              22             105             140
Modulus         40              65             238

Just to clarify something: the above chart uses Dk, which is the oxygen permeability of the silicone hydrogel compound in barrers. However, the effective oxygen transmissibility is affected not only by the oxygen permeability of the compount, but by the thickness of the lens as well. Mathematically, it is Dk divided by t. So, while Focus N&D's lotrafilcon A compound has 40% higher oxygen permeability than Oasys' senofilcon A compound, one must remember that Oasys is only 0.07 mm thick, while N&D is 0.08 mm thick.

Dk/t is therefore 150 for Oasys and 175 for N&D, which is a lot less difference than if you went just by Dk.
 

Howell

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e_dawg, you must have been excruciatingly bored to do all of this research. :p What is it like $10 for a set and then you can just try them? You can even get samples for free.

I just got some of the Oasys lenses about a week ago. These replaced some Ciba lenses of technology circa five years ago. I can really tell a difference. I was pleased with the old Ciba lenses but I'm downright happy with the Oasys. I think I could probably go camping and finally leave the glasses at home. So far I have slept in them for two straight nights and only needed rewetting the evening of the third day.
 

e_dawg

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Howell said:
e_dawg, you must have been excruciatingly bored to do all of this research. :p What is it like $10 for a set and then you can just try them? You can even get samples for free.

It's more the time and inconvenience of having to go to my optical store to order/purchase them. And they don't always have single pairs that you can buy. Sometimes you have to order 2 boxes of 12 lenses minimum if they don't have singles in your size and power, which is $80 US for the Oasys.
 

Howell

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e_dawg said:
Howell said:
e_dawg, you must have been excruciatingly bored to do all of this research. :p What is it like $10 for a set and then you can just try them? You can even get samples for free.

It's more the time and inconvenience of having to go to my optical store to order/purchase them. And they don't always have single pairs that you can buy. Sometimes you have to order 2 boxes of 12 lenses minimum if they don't have singles in your size and power, which is $80 US for the Oasys.

Bah, call them up; build a relationship. If they have any business sense they will get a trial pair and mail them to you. My store will order what I want and turn around and mail the boxes to me. I have never had to pay for a trial pair (usually this happens when I change perscriptions).

I was travelling once when my lense tore. I think I was in Phili. I went to a random store and they just gave me a replacement.

Size? What, do you have eyes the size of saucers? peas?j/k My Oasys were $64US.
 

timwhit

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I checked and I have the Oasys. I don't think I like them. I bought 4 boxes of them too.

They bother me more than any of the previous brands I have used.

Got any recommendations on what to switch to next time?
 

timwhit

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I know this is an old thread, but it was the only mention of Lasik I found on the whole site.

I had the procedure done yesterday. So, far everything is going well. It took about 10 minutes total. It was a little nerve wracking while it was happening, but it was over relatively quickly. I went back this morning and I am already seeing 20/20 in my left eye and 20/25 in my right. Hopefully, the right will hit 20/20 in the next couple days. Either way I am happy so far with the result.
 

Fushigi

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My wife had LASIK in Jan 2002. ... As is typical, her eyes were dry for a while afterwards so she used wetting drops. The need for that dimished over time and by the time about 6 months had elapsed so was using the drops just slightly more often than me. ...

I still test 20/20 even at the 'advanced' age of 39.
My wife still gets the occasional dry eyes but not often enough to be an issue.

I haven't had my eyes tested lately. I'm pretty sure my near-/far-sightedness is basically unchanged but my color perception isn't what it used to be. In moderate light certain shades of green & gray are hard to distinguish as is navy blue v. black. NP in sunlight but incandescent (my closet) can be an issue. Also, on occasion my eyes take longer than I'd prefer to refocus from something close like a book I'm reading to something farther away like the TV across the room. It's no longer instant.

A coworker had LASIK this past January. He had some complications but all said & done he's now sans glasses/contacts and is much happier.
 
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