Contact Lens Fitting Exam

Standard Contact Lens Exam

All eye exams begin with a comprehensive exam that includes a prescription for glasses. Contact lens exam requires the Optometrist or Ophthalmologist to transpose your prescription to accommodate an optimized and comfortable contact lens experience. Your contact lens prescription considers comfort, vision, and daily tasks. Contact lens eye exams usually require a follow up exam for patients new to contact lenses and patients that are experiencing a change in prescription. Depending on the prescription and contact lens type, contact lens exams may require multiple visits to assure patient needs are met. Some first-time or beginners to contact lenses may need several training sessions.

What’s different about the contact lens prescription that my glasses prescription doesn’t cover?
Your contact lens prescription will include information about the type of lens (soft, hard, scleral, or other specialty lens), and the shape and size best suited for your eye (curvature, diameter parameters of the lens). Your contact lens prescription is optimized for comfort, vision, and daily tasks.
Calculate the right prescription | Lens Power
Even though you know your glasses prescription, your contact lens prescription oftentimes is not the same.
Considerations for the shape of your eye
Not every eye is the same. Depending on the curvature of your eye, your doctor will select the best lens shape for you. If the curvature of the contact lens is too flat or steep for the shape of your eye, you could experience discomfort or damage to your eye.
Considerations for the type of contact lens
  • There are many types of contact lenses: soft, spherical, toric, daily, monthly, rigid contact lenses, scleral lenses. We take into consideration your vision, lifestyle, prescription, and visual symptoms to select the best lens for you.
  • Soft vs Rigid Contact Lenses: Soft contact lenses are typically more comfortable initially and have a regular replacement schedule. Rigid lenses are more durable, can offer more crisp vision and improved oxygen to the eyes, but may initially feel less comfortable.
  • Spherical vs. Toric Lenses: Based on the amount of astigmatism you have, you may need toric lenses to maximize the clarity of your vision through contacts. Patients without astigmatism or with minimal astigmatism may wear spherical lenses and still have clear vision.
  • Replacement Schedule: Daily, Bi-weekly, or Monthly lens replacement are considered based on your lifestyle, how often you want to wear lenses and for what activities you do while wearing lenses.
  • Scleral lenses: These specialty lenses are uniquely designed for patients with corneal disorders such as keratoconus.
Pupil and Iris Measurements
The size of your pupil and iris may also be measured as part of your contact lens eye examination. Pupil and iris measurements factor into the size of your contact lenses. Contact lenses that are of a proper size will fit well and look best on your eyes.
Evaluating Overall Eye Health, are your eyes suitable for contact lens wear?
  • Using the slit lamp we will evaluate the overall health of your cornea. Are you having allergies, are there any active infections? Is the front surface of your eye healthy enough for contact lenses?
  • Tear Film Evaluation: Determining if you have Dry Eye or experience symptoms of dryness. If the lenses are not kept adequately hydrated and moist, they will become uncomfortable and your eyes will feel dry, irritated and itchy. In cases of severe dry eye, contact lens wear is uncomfortable and may not be recommended. This portion of the exam helps us protect your eyes.
  • Visible Signs of Contact Lens Abuse: over time with decades of contact lens wear or overwear, we may begin to see damage to the eye such as Pannus and/or corneal neovascularization, signs that the eye is starved for oxygen. Recommendations: discontinue contact lens wear, do not overwear contact lenses. Do take care of contacts by paying attention to your cleaning regimen and replacing them on time.
  • Corneal Ulcer: This is the contact lens wearer’s worst nightmare. A corneal ulcer is an erosion of the cornea and can be caused by contact lens abuse or infection. Where healthy tissue should be there is a hole. This is painful and can cause symptoms of tearing, discomfort, redness, and pain. This can be caused by contact lens overwear, abuse, or poor hygiene. Active infection could result in loss of vision/eye.

Toric Contact Lens exam

Based on the amount of astigmatism you have, you may need toric lenses to maximize the clarity of your vision through contacts. Toric contact lenses have special markings on them to show if the contact lens is aligning correctly on the eye. If the contact lens is not in alignment, blurry vision may occur and a different contact lens brand or prescription may be needed. This is one reason why glasses and contact lens prescriptions may not be the same. Another reason glasses and contact lens prescriptions may not be the same is that while glasses can be made to very specific degrees of astigmatism (i.e. -2.00 x087), soft contacts come in pre-fabricated amounts of astigmatism (typically -0.75, -1.25, -1.75, -2.25) and offer an axis every 10 degrees (i.e -1.75 x080 or -1.75 x090).

Medical Contact Lens Exam (RGP, Scleral, Specialty Lenses)

Patients who have high refractive error (especially astigmatism), or keratoconus, or other corneal diseases or degenerations will benefit from a medical contact lens examination. Because the cornea is an important refractive surface, any corneal irregularities can cause blurred images, ghosting, and uncomfortable glare. After careful evaluation of the cornea, a specialty lens can be fitted to improve visual clarity better than what can typically be seen with glasses alone. Rigid lenses can be made very specifically to fit the curvature of the eye. Scleral lenses are specialty lenses that vault the irregular cornea entirely, offering a smooth refracting surface.

Contact lens types

A variety of different contact lenses are available to accommodate eye conditions as well as patient preferences. Let's explore these contact lenses that serve a unique purpose and help patients achieve maximum visual acuity. It is vital that you consult a vision physician before using these.

  • What is an RGP?
  • RGP (Rigid Gas Permeable) lenses are rigid contact lenses that allow more oxygen to the cornea by letting the tears flowing under the lenses.
    RGP lenses provide very crisp vision, are more comfortable to wear and can be worn longer than most contact lenses.

  • Why are RGP contact lenses recommended?

    RGP contact lenses are recommended for people with mild to moderately dry eye, who can wear RGPs longer than standard lenses.
    Moreover, these contact lenses are made of materials that don't contain water, so liquids and protein from your tears don't adhere to RGP lenses as readily as they do to other lenses.
    Additionally, RGP contact lenses require very little maintenance and, thus, can last for years until a prescription change is needed. Though you can break them, RGP lenses aren't easily torn like soft lenses.


    Standard RGP lenses provide excellent vision correction and work wonders with irregularly shaped eyes. Given that they are easier to handle, they are long-lasting and require very little maintenance.

    RGP Contact Lenses Are Made Of …

    RGP lenses are made from a robust plastic material, with microscopic holes that allow Oxygen to filter through. Most RGP lenses are now made of Silicone, Acrylate, and Fluorine. As such, they retain their shape when you blink, providing sharper vision than soft lenses.



    • Sharp vision
    • Correct most corneal astigmatism
    • Durable
    • Good handling characteristics
    • Easy to maintain


    • Initial wear may not be comfortable
    • Longer adaptation period
    • More susceptible foreign objects intruding the eye, such as dust
    Hybrid (Soft Edges)

    Hybrid contact lenses combine the wearing comfort of soft lenses with the crisp optics of RGP lenses.
    Despite its unique features, only a small percentage of people wear these lenses as they are challenging to fit and cost more to replace than silicone hydrogel and soft lenses.

    Hybrid RGP Contact Lenses Are Made Of…

    Hybrid RGP contact lenses are made of a permeable material, walled by an outer fitting zone made of silicone or regular hydrogel soft lens.



    • Greater initial comfort than standard RGP lenses
    • Shorter adaptation period
    • Perfect for intermittent wear
    • Less susceptible foreign objects intruding the eye
    • Less sensitivity to light than RGP lenses
    • Available in a variety of tinted versions


    • Less durable than RGP lenses
    • May dry out eyes in hot rooms, or dry weather
    • High maintenance
    • Susceptible to more lipid and protein deposits, which reduces your lenses performance overtime
    • May absorb chemicals from the surrounding environment, which can lead to irritations.
    Double Ridge
    Double Ridge RGP Contact Lenses Are Made Of
  • What Is A Scleral Contact Lens?
  • Scleral lenses are large-diameter GP contact lenses that are specially designed to cover your entire corneal surface as well as the sclera.
    Scleral lenses functionally replace the irregular cornea with a perfectly smooth optical surface and help correct poor vision caused by corneal irregularities.

  • Why Are Sclerals Contact Lenses Recommended?

    Scleral contact lenses are recommended to patients with an irregular corneal surface. This includes patients with pellucid marginal degeneration, Keratoconus, post-penetrating keratoplasty, and corneal scarring.
    For some patients, fitting scleral may eliminate or delay the need for corneal transplant surgery. Additionally, scleral lenses are comparatively less drying to other contact lenses and are ideal for patients with ocular surface disease.
    Moreover, scleral lens also facilitate healing as well as long-term corneal health, helping to maintain a hydrated and protected corneal surface.


    Regular scleral lenses provide the highest amount of clearance between the back surface of the lens and your cornea. The lenses usually range from 18mm to 24mm.

    Scleral Contact Lenses Are Made Of …

    Scleral lenses are made with rigid gas permeable lens materials. So, even if they cover your entire cornea, a healthy amount of oxygen is able to reach the front surface of your eye – which makes the lenses all the more comfortable.



    • Clear the corneal surface
    • Offer stable visual acuity
    • Easily customizable


    • Most difficult contact lenses to fit
    • increased difficulty with application and removal of lenses
    • Expensive

    Scleral lenses are made with rigid gas permeable lens materials. So, even if they cover your entire cornea, a healthy amount of Oxygen is able to reach the front surface of your eye – making the lenses all the more comfortable. Mini-scleral contact lenses are usually of a diameter between 15 to 17.9mm and rest on the front part of your sclera.

    Mini Scleral Contact Lenses Are Made Of

    Mini Scleral lenses are made with the same rigid gas permeable lens materials as regular scleral lenses. These lenses are inserted with special non-preserved fluid underneath them, which helps trap moisture in all day.



    • Corneal irregularities like Keratoconus are easier to manage
    • Contacts are easier to apply
    • Less expensive
    • Require very little maintenance and fewer care products


    • Less capacity to hold fluid in corneal curvature
    • Time-consuming fitting
    • Persistent peripheral bubbles
    • Tear stagnation
  • What Are Disposable Contact Lenses?

    Disposable contact lenses are lenses that are worn continuously for short periods. Disposable lenses not only offer better hygiene as well as shortening the period for protein deposits to build upon the surface of the eye.

  • What Are Disposable Contact Lenses Made Of?

    Disposable contact lenses made from silicone hydrogel materials.

  • What Are The Different Types Of Contact Lenses?

    There is a wide range of disposable contact lenses: dailies, weekly lenses, bi-weekly lenses, and monthly lenses.


    Daily disposable contacts are only worn for a day. They are discarded as natural deposits from your eyes build upon their surface, and cannot be reused.


    Disposable contact lenses are packaged in a sterile solution, so if your contact lens isn't beyond its expiry date, they are safe to wear even without rinsing them in an additional solution.


    Daily disposable contact lenses are typically thin and fragile and have high water content compared to other types of disposable lenses. They have a thickness ranging between 0.056mm and 0.205mm.


    Daily disposables don't do much to help people with eye sensitivity issues. Given that these lenses are very thin, they cannot hold in moisture and dry up quickly.


    Biweekly contact lenses are disposable contacts with a scheduled replacement every two weeks. As such, they offer a balance between low maintenance contact lenses and wearing comfort.


    Hydrogen Peroxide contact lens solutions are designed to clean, disinfect, rinse and store contact lenses and are especially compatible with biweekly contact lenses as they provide comfort to your everyday wearing.


    Biweekly lenses have a central thickness that ranges between 0.061mm and 0.243mm.


    Given that biweekly lenses are an in-between to daily and monthly lenses, they have medium ranging compatibility with sensitive eyes.


    Monthly lenses are disposable lenses that wearers need to change after every month.


    Monthly contact lenses need to be disinfected regularly to ensure safe wearing. Using a protein removal solution will not only clean the protein discharge on the surface of your eye but will also make them more comfortable to wear.


    Monthly contact lenses are thicker than disposable lenses, which makes them more durable and long-lasting as well as more resistant to drying out. Biweekly lenses have a central thickness that ranges between 0.061mm and 0.243mm.


    Monthly contact lenses are incredibly compatible with sensitive eyes. Given that they are thicker to standard contact lenses, they can hold in moisture, which helps offset eye irritation.

Contact Lens Exam Conclusion

After taking careful measurements and determining the health of your eyes, your doctor will select and choose a pair of trial lenses that would work best with your eyes. A trial lens is included with every contact lens exam with us. After placing the lenses on, the doctor exams the fit, movement and tearing in your eye. The doctor’s goal is to confirm good vision, fit, and comfort. If the lenses do not appear to be a good fit, the lens or prescription can be adjusted and another lens fitted. Once the lenses are fit, you can keep the trial pair and your contact lens prescription will be finalized and ordered. It is common to schedule a follow-up appointment to check that your updated or new contact lenses are comfortable, fitting properly, and providing good vision.

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