Contact Lenses for Hard-to-Fit Eyes: Patient Care By Gordon Wong, OD on February 15, 2017

A woman with a contact lensWhen people visit our La Jolla eye care center, they know they can rely on our team to provide them with the latest in custom vision solutions. When picking out prescription ontact lenses or glasses, we will offer a full rundown of each treatment option and why it may be most ideal for a patient.

Some patients have eye conditions that may make contact lenses challenging to wear. Let's consider what we can do to help patients who experience these issues.

What Makes Eyes "Hard-to-Fit"?

Essentially, eyes that are challenging to fit mean patients experience a number of conditions that make wearing contacts uncomfortable or difficult. Some of those conditions might include:

  • Keratoconus
  • Astigmatism
  • Presbyopia
  • Dry Eye

If any of these conditions are present, that doesn't mean you can't wear contacts. However, it does mean that an eye specialist may have to make special considerations when it comes to picking the right contact lenses for you and your needs.

With that in mind, let's cover each of these issues individually and discuss contact lens options for each.


Keratoconus is a condition in which the cornea become thin. This leads to the eye bulging outward into a oblong or conical shape rather than a round or spherical shape. Think of the difference between a baseball and a football. Keratoconus can lead to progressive nearsightedness and irregular astigmatism as well as more serious vision issues later in life.

Patients with keratoconus who need contacts generally benefit from having gas permeable contacts or hybrid contacts. Scleral contacts may be one option, which are gas permeable contacts that fit over the entire corneal surface. Hybrid contact lenses combine the hardness of a gas permeable lens with the comfort of a soft contact lens.


Astigmatism refers to a case in which the light passing through the eye does not focus on a single point of the retina. This leads to blurry vision and distorted vision.

When treating astigmatism with contact lenses, hybrid contact lenses and toric contact lenses tend to be most ideal. Toric contacts are contact lenses designed specifically for people with astigmatism.


Presbyopia is a type of age-related farsightedness that begins around middle age. The condition results in blurring of vision for nearby objects, making it more difficult to read and see things up close. It's a natural part of the aging process.

To treat presbyopia, it's common to consider bifocal contacts, multifocal contacts, as well as monovision contact treatment. Bifocal and multifocal contacts function like bifocals and trifocal glasses. Monovision contact treatment means wearing a contact for distance vision in one eye while wearing a contact lens for near vision in the other.

Dry Eye

Dry eye syndrome is a condition that occurs when there is not sufficient moisture in your eyes. This leads to irritation, itchiness, red eyes, and discomfort. Strangely, some dry eye attacks may lead to your eyes watering in order to address sensations of discomfort and itchiness.

You can still wear contacts if you have dry eye, though you will likely wind up wearing special soft contacts or gas permeable lenses. The ideal option will be determine by your eye care specialist.

Learn More About Custom Contact Lenses

For more information about contact lenses made specifically for people with unique vision and eye health problems, be sure to contact our team of experienced eye doctors today. The team at our practice looks forward to your visit and discussing these issues in greater detail.

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GW Eye Associates

Our team at GW Eye Associates in La Jolla and Del Mar can provide a wide range of high-quality eye care services. Dr. Gordon G. Wong and Dr. Wildon C. Wong have over 45 years of combined experience and belong to several prestigious organizations, including:

  • American Academy of Ophthalmology
  • American Optometric Association

For more information about our services, contact our office online or call us at (858) 454-4699 today.

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