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Complex Eyes
Errors of vision come in all sorts of guises; from relatively straightforward long or short sightedness and astigmatism to highly complex cases usually seen in Hospital Eye Departments. What they have in common is that Contact Lenses – often specially designed Contact Lenses – can solve the problem.
So if you think - or have been told - that you're too complex, think again! We've been fitting lenses here for 37 years and have only had a handful of patients that we couldn't fit. Complex cases are our unique specialty - we'd get bored without those challenges! And if we really can't find a lens that would work for you we won't charge you....so give us a call - what do you have to lose?
Jump to: Astigmatism | Presbyopia | Keratoconus | Scleral Lenses | Squints or Turns | Therapeutic Lenses
Aneisometropia | Colour blindness | Dyslexia
Astigmatism
This is actually a very common condition, in fact most people have some degree of astigmatism whether they're aware of it or not. Unless the front surface of your eye (the cornea) is perfectly round with equal curvatures like a tennis ball you have astigmatism. For most people with astigmatism the curvature of the cornea more closely resembles an egg than a tennis ball. As a result of this uneven curvature light is focused at two different points on the retina causing blurring or even double vision in more severe cases.
Astigmatism - uncorrected Astigmatism - corrected
If your astigmatism is pretty minor your spectacle optician may not have even mentioned it.
Regular Contact Lenses will correct minor astigmatism. However as the degree of astigmatism becomes greater more complex Contact Lenses are needed to solve the problem. Many opticians don't have the experience or can't devote the time needed to fit the specialised Contact Lenses needed, so will tell patients that they are unsuitable for contacts because of their astigmatism. This is NOT the case. We CAN and regularly DO fit patients with severe astigmatism with Contact Lenses - even with lenses they can sleep in! In fact we are such experts in this field that a soft contact lens, PROCLEAR TORIC made by COOPERVISION and designed by Geoff specifically for astigmatism has FDA approval and is now sold worldwide!
Some patients come to see us knowing they have astigmatism and have been fitted with special Contact Lenses to correct this but still don't enjoy the same level of vision they expect from their glasses. More often than not the reason for this is that the internal focusing lens is irregular in shape. Our TOPOGRAPHER which accurately maps the corneal surface quickly indicates if any or all of the astigmatism is ‘lenticular'. Lenticular astigmatism, contrary to some people's belief, CAN be corrected with contacts but requires more complex lenses than normal astigmatic lens designs.
Click here for a more info about correction of Astigmatism with Contacts.
Getting older and needing reading glasses - PRESBYOPIA
It comes to us all sooner or later!
Sooner or later, even if you have perfect distance vision, you'll find that the small print seems to be smaller than it used to be or your arms just aren't long enough to hold the newspaper. Sadly it's a fact of life, as we get older our eye muscles just don't have the same oomph that they used to and that makes reading the small print....or threading a needle really difficult.
What is NOT a fact of life is that this deterioration means that you're confined to glasses for the rest of your life.
Nothing could be further from the truth! Geoff fitted his first bifocal contact lens in 1966 and he wasn't the first - other top specialists have been fitting them since the 1950s. Today we have many options including the Triton Rigid Bifocal and Trifocal Lens from Australia. We also have multifocals to correct both distance (where needed) and reading. These are available as Flexible Oxygen Permeable Lenses, Soft Lenses and even as Sleep-In Lenses.
An interesting feature of many multifocal lenses is that unlike bifocals or varifocal glasses (where you can only see to read when you look down) you can see close up regardless of what direction you're looking in.
An alternative and very effective method is Mono-Vision. This is when one eye is corrected for distance and one for reading. It may sound strange, but trust us - it's used around world and is very successful for many patients.
If it should happen that none of the standard ‘off the peg' designs available work for you - don't worry, we can custom design something that will be just right for you!
So - if you or your friends have been told that because you're older you're going to have to wear glasses, come and see us and we'll show you how you can get rid of them forever!
There are many multifocals - the above illustrates how one popular design works.
Multifocal vision compared to Monovision - when one eye is used to see distance and the other to see close.
Keratoconus
Keratoconus is a relatively rare degenerative condition which causes structural changes within the cornea (the front of the eye). These changes result in the cornea growing forwards and changing to a more conical shape. (A healthy cornea is more spherical in shape). If you have Keratoconus your vision will be distorted because of the changed shape.
Keratoconus is a serious but treatable condition. If the progression of the change of shape of the cornea is not physically halted it can ultimately lead to the rupture of the cornea resulting in blindness if a corneal graft is not performed and even with a corneal graft eyesight may be severely compromised.
At the Contact Lens Practice we are experts at working with this condition and have been able to achieve vision up to and above that required to read a number plate at 25 yards for many of our patients. In other words some Keratoconus patients come to us legally unable to drive but leave intent on booking driving lessons!
A conical cornea typical of Keratoconus
Glasses are not very effective in correcting Keratoconus as it is impossible to create the necessary curves on a spectacle lens that would cause the light to focus correctly at the back of the eye. It may be possible to improve your vision a little but it will still be distorted and since by definition this condition continually changes frequent changes of spectacle lens will be necessary which of course means more expense.
Rigid Contact Lenses on the other hand exert a positive pressure over the top of the cornea so holding it in the required shape for optimal vision. Rigid Oxygen Permeable lenses are those most frequently used to correct Keratoconus. These used to be relatively normally sized lenses which fitted between the eyelids but, over recent years with computer controlled lathes, we have been able to develop new designs. Whilst still Rigid and Oxygen permeable these fit onto the sclera - the white of the eye, like soft lenses. These not only usually give better vision than smaller KC lenses but vastly improved comfort since the sclera is virtually insensitive.
Another new concept is ‘hybrid' lenses which have a Rigid Oxygen permeable centre attached to a soft peripheral ‘skirt'. These lenses are therefore superbly comfortable and offer excellent visual acuity - they are also available for all the less complex vision errors and can correct astigmatism and be made as varifocals! For more information follow this link.
Hybrid Lenses from SynergEyes - soft skirt with rigid centre
If neither of these produce the best results we may recommend a "piggy back" system - a soft lens with a rigid lens on top. If the base soft lens is made from an oxygen permeable enough material this may often be left in overnight so that the wearer only has to apply and remove one pair of lenses most nights.
There is one other alternative which is a Scleral Lens or Haptic. First fitted in the 1880's and made from glass these fit over the whole of the eye and have always been very comfortable to wear but caused severe problems because they restricted oxygen flow to the cornea. They have now graduated to being made in highly oxygen permeable plastics. See www.sclerals.com/what.html for more information about these lenses.
Scleral Lenses
Recently specialist soft hydrogel and silicone hydrogel lenses have been developed that are proving both very effective in correcting the distorted vision of a KC sufferer AND giving supreme comfort.
We fit Kerasoft range including the latest Kerasoft IC lens
If for some reason Contacts fail a relatively new treatment is being pioneered in some specialist centres called COLLAGEN CROSS LINKING - see Collagen Cross Linking Info . This is a chemical treatment which ‘hardens up' the collagen fibres which make up the cornea so restraining their conical progression. Once treated Contact Lenses still remain the only viable method of visual correction.
Click here to see some patient testimonials
For even more about KERATOCONUS see wikipedia or the keratoconus group website.
Squints or Turns
Squints usually first appear in early childhood. They are caused by a slight imperfection of one or more of the 6 ocular muscles that control the movement of each eye. Even the slightest variation in the length of one of these muscles can cause one eye to fail to coordinate with the other, so that your eyes appear to be looking in different directions. Usually the "rogue" eye will be turned in or out, but sometimes it can be up or down.
Most squints can be treated by exercises (orthoptics) or by wearing suitable glasses or Contact Lenses. If you have a squint you may have been told that you are unsuitable for Contact Lenses. This is NOT always the case, but you do need to see a specialist Contact Lens Practitioner as most Opticians don't have the skill to fit these lenses - in fact many Opticians refer these patients to The Contact Lens Practice as they know that Geoff and his team will be able to help. Even if your glasses incorporate special lenses (prisms) Contact Lenses can sometimes be made to have the same effect.
In a small number of cases exercises or corrective lenses may not be enough, necessitating a small operation to alter the muscle lengths.
Very occasionally, because of the presence of a squint, one eye may not learn to see to its full ability and has permanent poor vision which cannot be corrected with optically - this is often called a 'lazy eye'.
For further information take a look at this website.
Aneisometropia
Aneisometropia actually describes the vision when one eye has a very different prescription error to the other - usually when one eye is long and the other short sighted (for details of errors of vision see here).
Uncorrected Long Sighted Eye Uncorrected Short sighted eye
If you look through a friends glasses if they are short sighted their spectacle lenses will make the whole world look smaller.
If you look through those of someone who is long-sighted everything will look bigger.
When a person suffers with Aneisometropia this creates a big problem for the poor old brain because it has great difficulty putting the two pictures together to see just one of everything --- at the least this means that vision through glasses is not just uncomfortable but usually means that the sufferer simply sees DOUBLE!
Luckily there is one very simple way of solving the problem of Aneisometropia - Contact Lenses.
One of the biggest advantages of Contact Lenses is that, because they float right on the front of the cornea, they don't enlarge or reduce the size of everything but focus a natural sized picture on the retina at the back of the eye.
As a result, by fitting Contact Lenses anyone with Aneisometropia will enjoy normal comfortable binocular vision, which would be impossible with glasses!
Therapeutic Lenses - Hospital cases fitted
Since their beginning in the 1880s Contact Lenses have been used not only to correct errors of vision but have also been used extensively to treat medical eye problems. This is known as Therapeutic use.
Most Eye Hospitals have a Contact Lens Department and millions of people today owe their sight to the use of Contact Lenses to correct, contain or even cure a whole range of pathological eye conditions. Patients fitted with Therapeutic Lenses range from those only a few months old to elderly patients with chronic "dry eye syndrome".
Many people with exceptionally high or complex prescriptions can't meet driving test standards with glasses but can do so with Contact Lenses.
Generally patients who need Contacts for therapeutic reasons are seen at hospital eye clinics and are eligible to have them fitted under the Health Service. However because the waiting lists there can often be very long some turn to us for advice and a solution to their problem.
Most opticians don't have the experience or the training necessary to deal with these cases, but thanks to his specialisation Geoff does and can provide many of the tailored solutions normally only found in Eye Hospitals. If a case is too complex for us to deal with we can refer you to appropriate specialists in the NHS or privately as required.
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Disfigured eye caused by Trauma |
Eye corrected with Cosmetic Soft Lens |
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Disfigured eye without Contact Lenses |
Disfigured eye with Contact Lenses |
Just two examples how we can cosmetically improve a severely disfigured eye.