Contact Lens Fitting

Contact lenses are a popular alternative to spectacles for correcting short-sightedness, long-sightedness and astigmatism. Properly prescribed contact lenses provide excellent vision and comfort. In some cases contact lenses provide better vision than spectacles, while their advantages for athletes and other people with active lifestyles are obvious. Contact lenses can also provide a better cosmetic effect, and can often be tinted to change the colour of the wearer's eyes.

Although contact lenses have many advantages, they do have some disadvantages. They must be individually prescribed to ensure that they fit the eyes correctly, as well as focusing light properly. Poorly fitting lenses can lead to severe eye problems including infections. Because contact lenses are placed in direct contact with the eyes they must be cleaned and disinfected regularly, and contact lens wearers need more frequent eye examinations in order to prevent any problems developing.

Our optometrists are highly trained in contact lens fitting, and advancements in contact lens research is atop of the Optomeyes research agenda - so you can be rest assured that you will be getting the best possible advice to allow you to take full advantage of the benefits of being a contact lens wearer.

For more information on contact lenses, see our Contact Lens advice in the Product section.

The costs associated with contact lenses can be broken down into three main categories: consultation fees, lens costs and maintenance costs.

Consultation fees

Consultation fees are the fees charged by eye care professionals for their services. Some of these fees are covered by Medicare, while others are not.

Medicare

Medicare provides benefits for initial eye examinations for all Australians, although there are some limitations. A full benefit is payable for an eye examination by an optometrist every two years, or more frequently if there a clinical justification for the examination. If a person consults a second optometrist within two years of their previous examination, a reduced benefit is paid unless the person has been referred by the previous optometrist.

Medicare also pays benefits for consultations relating to prescribing contact lenses,however not all Australians are eligible for these benefits. In order for benefits to be paid, a patient must meet one of nine criteria, based on their clinical condition. These criteria are intended to ensure that Medicare will pay benefits for people who require contact lenses in order to achieve satisfactory vision, rather than for people who simply want contact lenses for sports or cosmetic reasons. The nine criteria are set out below.

Note: the actual wording of the conditions applying to each item are more detailed than this summary. If you have any doubt about your eligibility, your optometrist will be able to advise you on the exact requirements, and the costs involved in obtaining contact lenses.

Non-Medicare

People who are not eligible for Medicare contact lens benefits will have to pay private consultation fees. These vary, and people contemplating contact lenses should discuss them with their optometrist.

Lens costs

The cost of a pair of contact lenses can vary enormously, depending on the type of lenses.The range of prices for a pair of soft spherical lenses is around $150 to $400. Soft toric lenses and rigid lenses cost more, due to the more complex manufacturing techniques involved in producing them. Other factors affecting the price of contact lenses include tinting and other options.

Although frequent replacement lenses are less expensive than conventional lenses, they need to be replaced more often. As a result, the annual cost of wearing contact lenses is similar for both frequent replacement and conventional lenses.

The price of contact lenses often also includes a warranty on the lenses, allowing them to be exchanged within a set period if necessary. This is useful if it is necessary to alter the lens design to improve the lens fit and performance. Some warranties also allow lenses to be returned for a refund if the patient finds they cannot wear the lenses.

Maintenance costs

All contact lenses, apart from those which are intended to be discarded after one use,need to be cleaned and disinfected. There are therefore ongoing costs involved in lens wear, as cleaning and disinfection solutions will need to be purchased.

There are two main types of contact lenses: soft and rigid. Soft

Soft contact lenses are the most commonly prescribed type of contact lenses. Around 90% of all the contact lenses prescribed are soft lenses.  Soft contact lenses are made from soft, flexible plastics, known as hydrogels, which contain water. The water allows oxygen to pass through the lens to the eye. This is important, as the cornea (the clear front surface of the eye) obtains its oxygen supply directly from the air.

Most soft contact lens wearers find that they adapt to the lenses quickly and they are comfortable straight away (unlike rigid lenses, which require some adaptation). This makes soft lenses suitable for people who do not want to wear their lenses every day, such as a footballer or netballer who only wears their lenses when they are playing. Soft lenses are particularly suitable for sports, as they are difficult to accidentally dislodge.

Soft lenses are suitable for correcting most refractive errors. Special "toric" lenses can be used to correct astigmatism. Soft lenses can be tinted to enhance or change the colour of the eyes.

Rigid
Rigid lenses are made from plastics that are less flexible than those used for soft lenses. While the earliest materials used to make these lenses did not allow any oxygen to pass through the lens, the materials used today are permeable to oxygen, which is why these lenses are most commonly referred to as "rigid gas permeable" or "RGP" lenses. Some of the newer materials allow almost as much oxygen to reach the eye as if no lens was being worn.

 Rigid lenses provide better vision than soft lenses, as the optics can be better controlled, and are suitable for a wider range of refractive errors. In some conditions in which the front surface of the eye becomes distorted, such as keratoconus, rigid lenses are the only way of satisfactorily correcting vision.

Rigid lenses require some adaptation on the part of the wearer. Typically they are less comfortable than soft lenses for the first week or two of wear, but after that they do not cause any discomfort. Adapting to rigid lenses is a bit like breaking in a new pair of shoes - initially they may be a little uncomfortable, but soon you can wear them all day without even noticing you have them on.

Rigid lenses are more durable than soft lenses, so they do not need to be replaced as often

Prescribing contact lenses is a complicated process. Contact lenses must not only correct refractive errors, but must also fit without causing any injury to the surface of the eye. They must move on the surface of the eye and allow the lids to ride over them with each blink, without being uncomfortable. They must also not provoke any reaction from the eye or the immune system. Professional care and advice is essential.

Prescription

There are many steps involved in arriving at a prescription for contact lenses. After assessing the health of the eyes and measuring any refractive error that is present, the optometrist will discuss the various types of contact lenses with the patient, as well as the patient's visual needs, lifestyle and other factors that may influence the decision on what type of lenses to prescribe. Some additional measurements will need to be taken, including measuring the curvature of the front surface of the eye.

A trial lens will then be placed on the eye, so that the optometrist can assess the fit of the lens. Several trial lenses may need to be used to arrive at the best possible fit. When this has been determined, a preliminary prescription can be made, and a pair of lenses ordered.

These preliminary lenses are then placed on the eyes, and the patient is instructed on how to put the lenses in and out of their eyes, as well as how to clean and maintain the lenses. The optometrist will usually reassess the lenses after they have been worn for a week or two, in order to make sure that the lenses are fitting and performing properly, and that the patient is not having any difficulties. It is sometimes necessary to alter the lens prescription at this point to solve any problems which may have arisen.

After-care

Contact lens wearers need to have regular eye examinations. Since a contact lens sits directly on the eye, it increases the risk of complications such as eye infections. Regular eye examinations allow any problems to be detected and corrected early, before they have had time to cause permanent damage. While serious complications of contact lens wear are rare, they can cause severe damage to the eyes and even blindness, so regular eye examinations are a good insurance policy.