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Contact Lenses: Which Kind is Right for You?

Can I wear contacts?

Whether you're nearsighted (you can't read the road signs) or farsighted (you can't read the paper), contact lenses can make your life easier. Even people who have astigmatism (an imperfection in the eye's surface that distorts your vision) or who need bifocals or reading glasses often can trade in their specs for contacts. The little plastic disks move with your eyes, so there's none of the distortion you get when looking through glasses, and your entire field of vision is sharp and unobstructed. Here are your options:

Non-Disposable Soft Lenses

Almost everyone chooses some kind of soft contacts nowadays because they usually feel comfortable right away. Soft lenses are made of flexible water-absorbing plastic that molds to fit your eyeball. "Non-disposable" soft lenses ($60 to $175 per set) must be rubbed with cleaning fluid every time you take them out, disinfected in a multipurpose solution overnight, and treated with an enzyme solution once a week to remove protein deposits. "Daily-wear" versions have to be taken out every night; "extended-wear" can be worn for days at a time. Both kinds are supposed to last about a year, but they can wear down after a few hundred cleanings and you may rip or lose one before their time is up.

Disposable Soft Lenses

Most people opt for disposables ($6 to $12 per set, or $150 to $300 per year). The most common kind last two weeks if you take them out and store them in a cleaning solution every night, or one week if you keep them in all the time. Disposables are a little flimsier than non-disposable lenses and may be harder to get in and out of your eyes, but they don't ever need to be treated with enzymes, since you don't use them long enough for proteins to build up on them.

Daily Disposables

If you're happy with your glasses but want to be able to wear contacts once in a while, consider "dailies" ($35 to $50 for 45 pairs). They're the ultimate in convenience: You wear them for one day only and then throw them away, so there's no need to clean or store them. As with all disposables, they require no break-in period; they should be comfortable immediately.

Bifocal and Reading Lenses

Bifocal contact lenses are made so that the part that corrects for reading is located on the outer edge or weighted to sink to the bottom (so you see through it when you look down -- just as you do with bifocal glasses). These lenses are more expensive ($200 to $350 per year) and pretty hard to get used to. Another option for those who wear bifocals or reading glasses is "monovision." You wear a lens for reading in one eye and a distance-corrected lens or no lens (depending on your needs) in the other eye. After a period of adjustment, your brain learns to give preference to the eye receiving the clearest image at the time.

Rigid Gas-Permeable Lenses

If you have severe astigmatism or can't see well with soft contacts, try gas-permeable lenses, which are made of a stiffer plastic that lets oxygen through but doesn't absorb as much water. They're not the torture devices they used to be, and 5 to 10 percent of contact wearers actually prefer them. Getting used to them may take a little longer, but they're cheaper ($70 to $90 per set) and more durable (they should last about two years). Extended-wear, bifocal, and reading versions are also available.

Non-corrective Decorative Lenses

Decorative contact lenses that can change your eye color or display your favorite sports team logo are a big hit these days. However, the Food and Drug Administration warns that they can pose a serious health risk if they aren't fitted by an eye care professional. Poorly fitting lenses can cause corneal ulcers that can lead to infection, scarring, and even blindness. In October, 2002, the FDA began seizing imported decorative lenses and advised consumers to stop wearing lenses that hadn't been prescribed and fitted by a professional. In late 2005, the FDA classified all contact lenses -- including purely decorative ones -- as devices, subject to regulation. Previously, non-corrective, decorative lenses were classified as cosmetics.

References

C. Stephen Foster, MD. Contact Lenses. Massachusetts Eye & Ear Infirmary Immunology Service, 1998.

How to Protect Yourself: Eyeglasses and Contact Lenses. Florida Attorney General's Office.

FDA Warns Consumers Against Using Decorative Contact Lenses Obtained Without a Prescription or Professional Fitting. FDA News. P02-43. October 21, 2002.

Food and Drug Administration. FDA Public Health Notification: Fungal Keratitis Infections Related to Contact Lens Use. May 2006.

Food and Drug Administration. Guidance for Industry, FDA Staff, Eye Care Professionals, and Consumers. Decorative, Non-corrective Contact Lenses. November 24, 2006.

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