Charlotte Eye Doctors That Specialize in Hard-To-Fit Contacts (Including Scleral Lenses)!
Updated: Oct 2
If you’re reading this article, odds are your eye doctor said you’re not a candidate for contact lenses. But what exactly does that mean? Are your eyes too hard to fit? Do you require specialty contact lenses that take more time and expertise to get right? Or, are you unable to wear contacts at all due to circumstances you can’t control?
Regardless of your situation, we’re here to set the record straight! Let’s start with the basics.
Are you a candidate for wearing contact lenses?
Honestly, it depends! At Northlake Eye, our doctors have experience fitting people of all ages with contacts.
For kids and teenagers, we find motivation and parental support is a huge factor in their success. For young adults and adults, we’ve identified fear, poor hygiene, dryness, and eye diseases as the greatest obstacles to success. Fortunately for you, we can overcome most of these factors and fit almost anyone with contact lenses.
For example, if your child wants to wear contacts, but is scared to do so, our team can train them on how to safely put them in and take them out of their eyes. On the other hand, if you have dry eyes and a history of discomfort in contact lenses, our doctors can manage your dry eye disease and fit you with lenses designed for maximum comfort.
What are specialty contact lenses?
Hard-to-fit contacts vary in difficulty and essentially anything other than soft, spherical lenses for nearsightedness or farsightedness. For example, if you have presbyopia (i.e. difficulty seeing to read), our doctors would likely fit you in multifocal or monovision contacts. With higher success rates, both of these lens options are easier to fit than scleral, RGP, and hybrid contacts.
On the other hand, if you have keratoconus or dry eye, our doctors would likely recommend a scleral, RGP, or hybrid contact lens. These lenses are much more challenging to fit but are by far the best option for those who corneal irregularities.
Who needs hard-to-fit contact lenses?
While almost anyone can be fit in specialty contacts, they’re mostly reserved for the following:
High prescriptions (nearsighted, farsighted)
Irregular corneas (i.e. injury, post-transplant)
Severe dry eye disease (often from Sjogren's syndrome)
Post refractive surgery (i.e. LASIK, PRK, RK)
Corneal ectasias (i.e. keratoconus, pellucid marginal degeneration)
How much do specialty contact lenses cost?
Honestly, this really depends on the type of contact lens you need.
For example, if you’re evaluated to wear soft contact lenses for astigmatism or presbyopia, the most you’ll pay at our office is $100 (as well as a small fee for insertion and removal training, if you are a first-time wearer).
Conversely, hard specialty lens evaluations vary in price and can cost you anywhere from $280 to $2000.
Keep in mind, both of these examples are BEFORE adjusting for any insurance coverage (see below).
Does insurance cover hard-to-fit contacts?
The short answer is YES!
In fact, many vision and medical insurances will cover your specialty contact lens evaluations and materials. With this in mind, coverage is obviously insurance dependent and is something our eye care team can investigate for you! Click here to see a list of insurances we accept.
Soft toric contact lenses (for astigmatism)
While fairly mainstream, soft contact lenses for astigmatism are not a one size fits all option. When evaluating you to wear these lenses, our doctors taking into consideration your prescription, the unique curvature of your cornea, and daily activities to prescribe you contacts that are custom to your eyes.
Soft multifocal contact lenses and monovision (for presbyopia)
Soft multifocal contact lenses have come a long way over the past 5 - 10 years! Our doctors are trained to evaluate you to wear the newest technology multifocal lenses. If you’re unsure of these lenses or have had trouble adjusting, we’re happy to troubleshoot any issues you’re facing as well as review alternative options.
Speaking of alternate options, monovision contact lens fits are definitely one of them. In fact, monovision is where your dominant eye is corrected to see in the distance and your non-dominant eye is corrected to see up close. If this sounds confusing to you, that’s probably because it is! However, your brain is a powerful organ that is capable of adapting to monovision signals to provide you with functional vision up close and in the distance.
Between multifocal and monovision, our doctors are very successful at fitting and evaluating presbyopic patients with contact lenses that meet their lifestyle.
Rigid gas permeable (RGP) contact lenses
Rigid gas permeable contact lenses, also known as RGPs or GPs, are a type of hard contact lens that does an excellent job allowing oxygen to the front of your eye. They are easy to clean and last significantly longer than soft disposable contact lenses. Also, they vary in size and designs, providing our doctors with a lot of options!
One downside of RGPs is, since they are rigid in shape and sit directly on your cornea, they tend to take longer to get used to than other types of contacts. Overall, RGPs are great for anyone who has strict visual demands or has a corneal disease that doesn’t allow them to wear soft contact lenses.
Hybrid contact lenses
Hybrid contact lenses have a hard center with a soft surrounding. The hard center is designed to provide you with the clarity RGPs provide while the soft surrounding is designed to improve the comfort of these lenses on your eyes (compared to traditional RGPs). Like RGPs, these lenses are great for anyone who has strict visual demands or has a corneal disease that doesn’t allow them to wear soft contact lenses.
At Northlake Eye, we feel scleral contact lenses are in a league of their own! Scleral lenses are large-diameter RGPs that sit on the sclera (white part of your eye) instead of your cornea. In doing so, they’re able to completely vault over top of your cornea and eliminate corneal irregularities from injury, surgery, ectasias, and more! Also, like traditional RGPs, they vary in size and designs, providing our doctors with a lot of options!
Furthermore, scleral contact lenses are becoming more and more popular for patients suffering from advanced dry eye disease. Since these lenses are filled with saline solution before inserting them onto your eye, they provide continuous lubrication to your cornea all day long. As a result, many patients find a decrease in their symptoms and improved overall vision when wearing scleral contact lenses.
Orthokeratology, also known as ortho-k or corneal refractive therapy is the process of using an RGP lens to reshape your cornea to correct myopia. When evaluated to wear ortho-k lenses, our doctors will prescribe you RGP lenses that you sleep in overnight. When you wake up in the morning, this temporary shaping of your cornea allows you to see better, often without the need for glasses or contact lenses. Also, recent studies have found ortho-k helps reduce the development of nearsightedness in children.
It’s important to note that ortho-k does not permanently reshape your cornea like LASIK or PRK. Also, the processes of reshaping your cornea may take a week or two to take full effect. Once treatment is complete, the frequency you wear your lenses will vary. For example, you may have to wear your lenses a few times a week or every night. Since everyone’s eyes are different, this really depends on your response to treatment.
Caring for hard-to-fit contacts
Like soft disposable lenses, hard to fit contacts need to be cleaned every night. We recommend using the following:
Soft contact lenses: Biotrue, Optifree Puremoist, Revitalens, or ClearCare.
Hard and hybrid contact lenses: ClearCare or Boston Simplus.
Lastly, it’s important to replace your contact lenses as directed by your doctor. We recommend the following replacement schedules:
Soft contact lenses: Daily, bi-weekly, or monthly.
Hybrid contact lenses: Every 6 months to 1 year.
RGP and scleral lenses: Every 1-2 years.
Time to try specialty contact lenses?
Now that you’re learned all about hard to fit contact lenses, it’s time to give them a try yourself!