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Hard-to-Fit Contacts

Contact Lenses for the Hard to Fit Patient

It is not uncommon for patients to have difficulty wearing contact lenses for a number of reasons. Due to the individual eye shape, certain conditions or impairments or the aftermath of surgery, some patients are considered to be “hard to fit” as contact lens wearers.

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For hard-to-fit patients that want to wear contact lenses, there are options available that can provide comfortable and effective contact lens wear. You may be considered a hard-to-fit contact lens candidate if you have one of the following conditions:

Dry Eyes

Dry Eye Syndrome causes your eyes to feel dry, gritty, burning, red, and irritated. Dry Eye Syndrome can also cause blurred vision. Often these symptoms can sometimes worsen by the use of contacts. In fact, many people who do not normally suffer from chronic dry eyes, will experience some of these symptoms as a result of contact lens wear. Patients with mild dry eye we can usually improve comfort and vision from a combination of changing lens materials, lens solutions, wear time, and replacement schedule. Severe dry eye patients may benefit from Scleral RGP lenses.

High Astigmatism

Astigmatism is a condition that causes blurred vision because rather than being round, the front of the eye (the cornea) has two curves instead of one. Think of comparing the shape of a ball to the shape of an egg.

Some people have such high amounts of astigmatism that the major brands of contact lenses do not make lenses in their prescription. Fortunately there are both custom soft and RGP options for these patients that would like to wear contacts.

Giant Papillary Conjunctivitis (GPC)

GPC is a type of conjunctivitis in which the inner surface of the eyelid becomes swollen. The condition can be caused or worsened by a buildup of protein deposits on contact lenses. We may either recommend daily disposable lenses or RGP lenses (which are not water based) and therefore have less of a tendency for protein buildup. We may also prescribe medicated eye drops and require you to stop the use of contact lenses until the symptoms improve.


Keratoconus is a condition in which the cornea thins and bulges forward into a cone shape. Traditional contact lenses may cause discomfort in these patients and the vision often times still blurry. RGP or Scleral RGP lenses are often used for treatment of mild, moderate, and some severe cases. Rigid gas permeable lenses may help to slow down the cone shape from worsening in some cases. Further, RGPs are able to assist in vision correction for keratoconus which is often not possible with soft contacts or even eyeglasses.

Steven-Johnson Syndrome

Steven-Johnson Syndrome is a condition that can lead to permanent changes to the front of the eyes that can lead to severe dryness, scarring, and impaired vision. Scleral RGP lenses help holding tears or artificial tears, helping keep the cornea from drying out while improving vision.

Post-LASIK or Vision Correction (Refractive) Surgery

While LASIK surgery has a very high success rate, there are vision complications and symptoms that sometimes remain. Night vision after LASIK, in particular, can sometimes give you side effects such as glare or halos around lights. RGPs are often effective in helping with these side effects and restoring clear vision.

Bifocal and Multifocal Contact Lenses for Presbyopia

Presbyopia is a common condition in those people usually over 40 years old in which the eyes’ ability to focus on close objects is impaired. Many people keep a pair of bifocal or multifocal glasses on hand for times when they have to read menus, newspapers, books, and other objects that require near vision. For those that prefer contact lenses over eyeglasses, bifocal, multifocal or monovision contact lenses are an option.Read about Ortho-K to see if you may be a good candidate for these gentle overnight cornea re-shaping contact lenses.

Read about Ortho-K to see if you may be a good candidate for these gentle overnight cornea re-shaping contact lenses.