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Are There Other Contact Lens Alternatives?

Several eye conditions and diseases can make it hard, even impossible, to wear standard contact lenses. For patients who suffer from these conditions, achieving clear vision can be difficult. That’s where scleral contact lenses and other specialty contact lenses come in.

Below you’ll find information about some of the other contact lenses we offer that are suitable for hard-to-fit eyes. Please contact us if you think any of these options would be suitable for you, or if your current lenses are giving you any trouble.

Our practice serves patients from Old Bridge, East Brunswick, Woodbridge, and Edison, New Jersey and surrounding communities.
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What are Scleral Lenses?

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Types of Astigmatism And How They Can Be Corrected

Astigmatism is a type of refractive error characterized by an irregularly shaped or non-spherical cornea, the outer front surface of the eye. Although this condition may sound concerning, it’s relatively common, affecting approximately 1 in 3 individuals around the world.

Additionally, astigmatism doesn’t affect the health of the eye, but rather how the eye focuses light onto the retina.

A perfectly spherical cornea refracts all the light entering the eye with the same focusing power, so there is one focal point within the eye. An astigmatic eye, on the other hand, has two different refracting powers of light, so there are two focal points within the eye that affects visual clarity.

Most people with astigmatism also have other refractive errors, like myopia (nearsightedness) or hyperopia (farsightedness).

The hallmark symptoms of astigmatism are:

  • Blurred vision (both near and far distances)
  • Difficulty with night vision
  • Irritated eyes
  • Frequent eye strain
  • Headaches

There are 3 types of astigmatism and several ways to correct this refractive problem.

Types of Astigmatism

The 3 main classifications of astigmatism are based on the principal meridian of each eye. Think of the eye’s meridian as a plane or axis of the eye — for example, the horizontal meridian and vertical meridian.

When the horizontal axis is steeper than the vertical, it creates a stronger focusing power in the horizontal meridian. The difference in the focusing powers results in two different focal points on the retina and the blurry vision associated with astigmatism.

1. Myopic Astigmatism

When one or both of the eye’s principal meridians is myopic (focuses light in front of the retina), the result is myopic astigmatism. There are 2 subdivisions of myopic astigmatism:

  • Simple myopic astigmatism: when incoming light creates 2 focal points — one in front of the retina and one in the correct position — directly on the retina.
  • Compound myopic astigmatism: when the 2 focal points are both in front of the retina, and in separate locations.

Examples of this type of astigmatism as they appear on the optometrist’s prescription are plano /-2.00 x 180 or -2.25 / -1.00 x 90.

2. Hyperopic Astigmatism

Hyperopic astigmatism occurs when both or one principal meridian is farsighted (focuses light behind the retina).

This type of astigmatism is also divided into 2 types:

  • Simple hyperopic astigmatism: when one focal point lands correctly and directly on the retina, and another virtual focal point sits beyond the retina.
  • Compound hyperopic astigmatism: when both focal points are 2 separate virtual locations behind the retina.

Examples of this type of astigmatism as they appear on the optometrist’s prescription are +2.00 /-2.00 x 180 or +3.25 / -1.00 x 90.

3. Mixed Astigmatism

Mixed astigmatism is when one principal meridian is farsighted (beyond the retina) and the other is nearsighted (in front of the retina).

Regular vs. Irregular

Another way to classify astigmatism is regular vs. irregular. Regular astigmatism is when the principal meridians are either horizontal or vertical meridians, and irregular astigmatism occurs when the principal meridians are not at the horizontal or vertical angles, such as 135 or 45 degrees.

Examples of this type of astigmatism as they appear on the optometrist’s prescription are: +2.00 /-2.00 x 135 or +3.25 / -1.00 x 45

Ways to Correct Astigmatism

Whether you have myopic, hyperopic or mixed astigmatism, your vision will be blurred. The degree of blurred vision will vary from patient to patient. Your optometrist will recommend the most suitable corrective method for your eyes.

For people with mild to moderate astigmatism, prescription lenses in the form of glasses or standard contact lenses do a fine job of correcting the refractive error.

Another option for correcting astigmatism is through refractive surgery; however, this choice is less popular due to the possible complications of surgery.

For patients with high levels of astigmatism, standard contact lenses usually aren’t an option due to the highly irregularly-shaped cornea. Instead, scleral contact lenses are a safe, comfortable and effective way to correct vision for hard-to-fit eyes.

Why are Scleral Lenses Optimal For Astigmatic Eyes?

Scleral lenses have a larger diameter than standard soft lenses. The large lens vaults over the cornea and sits on the sclera (the white of the eye) with a nourishing reservoir of fluid in between the lens and the cornea.

The customized scleral lens acts as an artificial cornea, creating a new corneal shape that refracts light correctly for clear and comfortable vision all day long.

Scleral lenses are made of high-quality material and maintain a rigid shape, so the lens remains stable, no matter the degree of astigmatism.

What’s more, many optometrists prescribe sclerals to their patients with corneal abnormalities as a therapeutic tool in post-surgery patients.

Scleral contact lenses provide crisper and more stable vision than standard soft lenses, in addition to offering a continuously nourishing and breathable environment for the cornea.

How We Can Help

Our knowledgeable and experienced eye care team is trained to fit all types of patients with scleral lenses. Our goal is to provide each patient with crisp and comfortable vision, no matter their level of astigmatism or corneal abnormality.

Our optometry clinic has the latest diagnostic technology to provide you with the most efficient and accurate eye exam.

To schedule a consultation with Dr. Moshe Roth and Dr. Steffani Tiomno, contact Family Eye Care today.

Our practice serves patients from Old Bridge, East Brunswick, Woodbridge, and Edison, New Jersey and surrounding communities.
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Call Us 844-450-6850
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Keratoconus Myths & Misconceptions

Keratoconus is a serious eye condition that progressively changes the shape of the cornea and causes it to thin and bulge. This eye condition can alter your vision to the point that it interferes with your day-to-day life.

There are many myths and misconceptions around keratoconus and its treatment. Find out the truth about keratoconus before starting any treatment for the condition.

Myth: Keratoconus results in blindness

Truth: While keratoconus changes the shape of the cornea to the extent that vision may deteriorate, it does not cause total blindness. However, keratoconus can cause significant vision loss that could make it difficult to perform regular activities.

Myth: Contact lenses can prevent the progression of keratoconus

Truth: There is a misconception that once a patient starts wearing contact lenses, the progression of keratoconus will stop. This is not true. While contact lenses improve visual clarity, they do not offer a permanent solution for keratoconus. Also, contact lenses that are poorly fitted may worsen the condition.

Myth: Only young people are diagnosed with keratoconus

Truth: While keratoconus usually develops in people under the age of 30, some people are diagnosed in their 40s and 50s.

Now that you know the truth about keratoconus, contact Family Eye Care to discuss the best way to manage the condition.

Our practice serves patients from Old Bridge, East Brunswick, Woodbridge, and Edison, New Jersey and surrounding communities.
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Treatments for Keratoconus

What is Keratoconus?

Keratoconus (KC) is an eye condition in which the cornea weakens and thins over time, causing the development of a cone-like bulge and optical irregularity of the cornea. This condition occurs in approximately 1 in 2,000 individuals.

Keratoconus typically begins to affect people in their late teens or early twenties, and may progress for 10-20 years before slowing or stabilizing. Each eye is affected differently. In the early stages of keratoconus, you might experience mildly blurred vision, difficulty seeing at night, frequent headaches, an increased sensitivity to light, and the need to frequently change your eyeglass prescription.

During later stages of keratoconus, you may experience higher levels of blurry and distorted vision, an increase of nearsightedness or astigmatism, or be unable to wear contact lenses, as they will no longer fit properly, no longer provide clear vision and be uncomfortable.

Keratoconus Treatments

There are a variety of treatment options for keratoconus, including rigid gas permeable (RGP) contact lenses, scleral contact lenses, intracorneal ring segment implants and more. Learn about these options below.

Eyeglasses or Soft Contact Lenses

Wearing prescription lenses improves your vision because the lenses bend rays of light to focus images on the retina inside your eye. The cornea is the clear dome-shaped part of the front of the eye and is responsible for the majority of the focusing power of the eye. However, as keratoconus progresses, the cornea becomes more irregularly shaped and stronger optical lenses are required for clear vision.

Even though eyeglasses and soft contact lenses may help correct refractive errors like nearsightedness and farsightedness, some vision issues associated with keratoconus may still persist due to the irregular corneal shape, such as light sensitivity or discomfort.

Customized Contact Lenses (RGP, Scleral, Hybrid)

Rigid gas permeable (RGP) contact lenses and custom-fit scleral contact lenses create a smooth, uniform surface, allowing the light to be clearly focused. A saline solution fills in the space between the rigid lens and the cornea, “masking” the irregular corneal shape. Contact lens fittings may become more challenging as keratoconus becomes more advanced.

Scleral contact lenses in particular help with keratoconus because the lens creates a dome over the irregular cornea and functions as the new refractive surface of the eye. They are preferred by most eye doctors who provide custom-fit contact lenses because of their superior comfort & versatility.

Corneal Cross-Linking (CXL)

This minimally invasive procedure uses Riboflavin eye drops plus UVA light to slow keratoconus progression. Riboflavin eye drops are activated with UVA light to create additional cross-link bonds in the cornea, making it stiffer. CXL does not restore vision that has already been lost and does not eliminate the need for glasses or contact lenses. But it can help limit the progression of keratoconus.

Intracorneal Ring Segments (ICRS)

These specifically designed implants are made of medical plastic that are surgically placed under the surface of the cornea to help improve the corneal shape. The ICRS are implanted into the cornea to flatten the steep part of the cone into a more regular shape. This surgery does not slow keratoconus progression and glasses or contact lenses are usually still needed.

Corneal Transplant Surgery

This surgery replaces part of the cornea with donor tissue to improve corneal shape and/or clarity. The irregular or scarred corneal tissue is replaced with donor tissue from a cornea without keratoconus. Corneal transplant surgery is usually reserved for advanced cases, when the patient can no longer tolerate contact lenses or vision is severely compromised.

If you are concerned you may have keratoconus, reach out to Family Eye Care today. We can help. With expert experience and a deep understanding of keratoconus, we can recommend the treatment option that is best for you in order to maximize your comfort and ensure you have clear, consistent vision.

Our practice serves patients from Old Bridge, East Brunswick, Woodbridge, and Edison, New Jersey and surrounding communities.
Book An Appointment
Call Us 844-450-6850
Learn More About Scleral Lenses
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What are Scleral Lenses?

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Why Health Professionals Refer Patients To Us For Customized Contact Lens Fittings

Family Eye Care is a contact lens practice that continues to develop great relationships with other practitioners around the Old Bridge area. We work with corneal specialists and other physicians to offer a continuum of care for their patients with corneal irregularities by providing advanced custom contact lens fittings, even for the most hard-to-fit patients.

Our training and expertise in the area of scleral and other custom-fit contact lenses is the primary reason that other healthcare professionals refer to our practice.

We’re Here For Your Patients

The health care professionals you choose to refer your patients to matters.

You want your patients to visit a practice where they’re offered world-class eye care, professionalism and empathy. That’s why we do the utmost to ensure a quality experience for all of the patients you refer.

We know that patients want to be heard. We set aside time to discuss and evaluate their needs.

Your patients deserve safe and effective treatment, which is why the treatment we provide is evidence-based and utilizes the most advanced technology — all with utmost professionalism and care.

List of Common Corneal Conditions

We evaluate, diagnose and recommend treatment for all types of corneal conditions, including:

  • Keratoconus/Keratoglobus
  • Post LASIK/RK/PRK Ectasia
  • Post PK/INTACS/DMEK/DALK/DSAEK, etc.
  • Post Corneal Cross Linking
  • Corneal Dystrophies, such as Fuchs’ and Map-dot-fingertip corneal dystrophy
  • Severe Ocular Surface Disease (OSD)
  • Aniridia, ICE Syndromes and Trauma
  • Corneal Scarring

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Why Scleral Contact Lenses?

The many benefits of scleral lenses render them a popular and satisfying choice for patients with corneal irregularities who desire clear and comfortable vision.

Custom-designed scleral lenses help patients with a range of corneal conditions achieve dramatic improvements in visual acuity and comfort. The lenses’ oxygen-permeable and fluid-filled chamber protects the eye while providing the moisture and oxygen it needs to stay healthy. This makes scleral lenses the best choice for promoting corneal healing.

Case Studies

Here are a few examples showing the typical patient presentations and the successful outcomes.

*These patient testimonials are meant to reflect actual testimonials of patients but not necessarily our patients.

Post Corneal Graft

Patients with keratoconus or corneal transplants can see clearly by wearing scleral contact lenses; they are the safest and best way to correct vision for irregular astigmatism. Following a corneal transplant, the cornea should not come in contact with a contact lens. This makes scleral lenses the optimal solution, as they vault over the cornea without touching it directly.

John came to our practice seeking a solution for his keratoconus, which affected both of his eyes. He had recently undergone a corneal transplant and had a corneal graft for his keratoconus.

In order to improve John’s visual acuity, we did the following:

We took a topography reading of 11,000 points on each cornea and then designed the lens to individually match all 11,000 points of the patient’s corneas. Because he had a corneal transplant, it was crucial that the lens not touch any part of the graft to ensure maximum comfort.

OCT images were used to measure the clearance in microns, between the back surface of the scleral lens and the front surface of the cornea. This maintains a healthy graft while wearing the contact lenses.

As a result, John was able to achieve 20/25 vision in both eyes. He now has clear, comfortable vision all day and is very pleased with his scleral lenses.

Post LASIK Complications

While LASIK surgery has a high success rate, some patients come out of the surgery with imperfect vision.

Debbi’s primary concern was the reduced visual acuity following refractive laser surgery.

Unfortunately, her post-LASIK resulted in sub-optimal vision. Her LASIK surgeon recommended an enhancement procedure to improve her vision, which led her to undergo subsequent LASIK surgeries. Unfortunately, these attempts left her with extremely poor vision in each eye, and Debbi was desperate to find a solution to her vision problems.

Debbi arrived at our practice after hearing that we specialize in helping people achieve clear vision following poor LASIK results. A comprehensive eye exam found that Debbi’s eyes had a very high prescription and irregular astigmatism following her surgery.

Her best option was to wear scleral lenses as they would correct her astigmatism and farsightedness and were perfectly safe for her corneas, which after multiple surgeries, were scarred.

Since getting fitted for her custom-designed scleral lenses, Debbi is thrilled with how sharp and comfortable her vision has become.

Post-Radial Keratotomy Surgery Complications

Many patients underwent radial keratotomy (RK) surgery to correct myopia and astigmatism during the early days of refractive surgery. Such patients sometimes experienced some refractive error in the form of nearsightedness, farsightedness, or irregular astigmatism. Those with irregular astigmatism experience blurred, distorted vision that cannot be corrected with glasses. These are among the more serious and frequently occurring complications following corneal refractive surgery.

Matthew, a 52-year-old teacher, underwent bilateral RK surgery in 1995. Though the initial results were positive, within two years his vision deteriorated. He developed corneal ectasia, and complained of blurred vision, discomfort and red eyes when wearing contact lenses.

The slit-lamp examination revealed damaged corneas that had severe staining along the incision lines and around the cornea at the limbus. This was a result of the fit of the GP lenses he was wearing at the time. These lenses were touching the anterior elevations of the cornea and did not allow for enough tear exchange.

Fitting a scleral lens was the best option to treat Matthew’s damaged corneas, alleviate discomfort and improve his vision.

At the one-year visit the patient had improved visual acuity and quality. The fitting of a well-designed semi-scleral GP contact lens filled with a saline solution created a healthy environment behind the lens, which in turn allowed the cornea and limbus to heal. The scleral lenses also helped protect the RK incisions from further abrasions caused by blinking.

As this case demonstrates, patients who developed irregular corneal surfaces following refractive surgery can benefit from a customized scleral contact lens designed to improve their wearing comfort and vision.

Who We Work With

We work with many practitioners including:

  • Family doctors
  • Local hospitals
  • Optometrists
  • Ophthalmologists
  • Corneal specialists

Feel free to contact us for more information or with any inquiries. We look forward to providing your referred patients with world-class eye care.

Our practice serves patients from Old Bridge, East Brunswick, Woodbridge, and Edison, New Jersey and surrounding communities.
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Are Your Contact Lenses Uncomfortable?

Most people are familiar with the traditional soft lenses which provide clear vision for those with nearsightedness (myopia), farsightedness (hyperopia), or astigmatism. In certain cases, particularly for those with corneal irregularities or astigmatism, Gas Permeable (GP), Rigid Gas Permeable (RGP) or Scleral Lenses are recommended.

Some people experience discomfort when wearing gas permeable lenses. For those patients, scleral lenses may be a more successful alternative.

What Are Gas Permeable Contact Lenses?

Modern-day hard contact lenses often provide sharper vision than eyeglasses or soft contact lenses. Gas permeable lenses are made of hard plastic materials and are called ‘permeable’ because they transmit oxygen to the cornea, thus keeping it healthy. GP lenses are ideal for individuals with astigmatism that may have been told that they cannot wear soft contact lenses.

The rigid nature of the lens holds its shape on the eye, which allows for more clear and stable vision correction. Though it takes a little bit of time to get used to wearing GP contacts, the clarity of vision and durability that these lenses provide make it worthwhile. Gas permeable lenses are uniquely fitted to each patient and take about a week to manufacture.

What are Scleral Contact Lenses?

Custom designed scleral lenses help patients with sensitive eyes or corneal irregularities achieve dramatic improvements in visual acuity and comfort. Scleral lenses vault over the cornea and rest on the sclera instead. This creates a new optical surface and prevents discomfort by minimizing irritation to the cornea. Moreover, the reservoir of pure saline solution between the back surface of the lens and the front of the cornea ensures that the eye is always in a liquid environment – making it optimal for health and comfort. This unique design makes scleral lenses the ideal lens for comfort, sharp vision and healthy eyes.

We recommend scleral lenses for the-hard-to-fit eyes, those with keratoconus, or astigmatism, or for people with a medium-high astigmatism that other contacts can’t comfortably correct. Scleral lenses are also perfect for anyone wanting to wear comfortable lenses while keeping eyes hydrated all day.

Below are the advantages and disadvantages of wearing GP lenses. This information can better assist you in making a better decision with regards to whether to choose one over the other.

What are the Advantages and Disadvantages of Wearing Gas Permeable Lenses?

Advantages of Gas Permeable Contact Lenses

Gas permeable contact lenses have a number of distinct advantages over typical soft contact lenses. In many instances of various eye conditions, a GP contact is required as soft contacts will not be comfortable or deliver the vision correction required. Here are some advantages.

Health & Hygiene

close eye with scleral lenseBecause these lenses are oxygen permeable, they provide the wearer with better comfort and a healthy cornea. Their ability to transmit oxygen reduces eye problems, such as dry eyes, which is caused by diminished oxygen transmission to the cornea – common among most soft lens’ brands or hard (non-GP) lenses.

GP lenses are made from a firm plastic material and retain their shape when you blink. This tends to provide sharper vision than pliable soft lenses and are extremely durable; unlike soft contact lenses, they don’t tear easily. They are easy to clean and disinfect, and when properly cared for, a pair can last a year or more.

Gas permeable lenses are made of materials that do not contain water and thus don’t absorb water from your eyes. Moreover, they harbor fewer protein and lipid deposits from your tear film than other contact lenses do, which renders these lenses a more hygienic and healthier alternative for your eyes.

Enhanced Comfort With Scleral Lenses

GP lenses have a smaller diameter than soft contacts, meaning that they cover less of the surface of your eye. While this may take some time to get used to initially, ultimately, many wearers may find that these lenses become comfortable over time.

Improved Visual Clarity

Due to their rigid material, GP lenses have a smooth surface and maintain their shape, moving along with the eye to hold their place. This provides sharp and stable vision. Furthermore, because they do not dehydrate, they don’t cause reduced vision, which is usually the case with traditional contact lenses. GP lenses can be worn on all eyes, but are particularly fitting for those with astigmatism or bifocal needs.

Cost of Gas Permeable Lenses

GP lenses are durable and long-lasting. Though costs are initially higher than traditional contact lenses, in the long term they are more cost-effective, and unlike disposable lenses, they don’t require ongoing replacement.

So why doesn’t everyone wear gas permeable lenses? Primarily because soft lenses are instantly comfortable, whereas GP lenses require an adaptation period before they reach the same level of comfort.

Disadvantages of Gas Permeable Contact Lenses

Sometimes, whether due to sensitivity, corneal irregularities, or various eye conditions, a gas permeable contact lens isn’t the ideal solution and scleral lenses may be required or preferred.

Requires an adaptation period

To achieve maximum comfort with GP lenses, you need to wear them regularly. If not worn for a week, you’ll require a few days to adapt and get comfortable wearing them again. This distinguishes them from soft contact lenses, which, even if not worn for a long period of time, are comfortable upon insertion.

Unstable on the eye

GP lenses are smaller in size than soft lenses, which means that they are sometimes prone to shifting or popping out. If stability is essential, scleral lenses are a better bet.

Dust and debris

Happy Girl Fingers Near Eyes 1280x853Because gas permeable lenses move on the eye with every blink, there is a higher risk of dust and debris getting lodged under the lenses. This can lead to discomfort and potential corneal abrasion.

If you’ve tried gas permeable lenses and have experienced any of the above, or if you’re seeking a more comfortable alternative to wear all day, it’s worth looking into scleral lenses.

Visit us to find out how scleral lenses can be a better option for you. At the Family Eye Care, our eye doctors specialize in fitting custom contact lenses, including sclerals, which provide excellent, effective vision correction for many hard-to-fit eye conditions, such as keratoconus and irregular corneas. We also recommend scleral lenses for astigmatism, when other types of contacts don’t work well.

We fit sclerals for patients from the Old Bridge area, as well as East Brunswick,Woodbridge, Edison and throughout New Jersey.

What are the Benefits of Wearing Scleral Lenses?

Scleral lenses provide the very best level of comfort, visual acuity and stability.

Stable Vision

With scleral lenses, you’ll experience consistently clear vision. Their large diameter ensures that they stay centered and stable on your eye. Their size also prevents scleral lenses from popping out easily, even if you play sports or lead a very active lifestyle.

Long-Lasting Lenses

Constructed from high quality, durable materials, these gas permeable lenses typically last for the long haul. Therefore, while the initial cost of scleral lenses may be higher than standard contacts, you’ll benefit from the maximum value for your money.

Safe and Easy-to-Use

The large size and rigid material make scleral lenses much easier to insert and remove from your eyes. These features also reduce the risk of accidentally injuring your cornea while you handle your lenses.

Comfort for Dry Eyes

While the scleral lenses vault over your cornea, they contain a pocket filled with moisturizing tears. This wet, lubricating cushion offers a very comfortable wearing experience, as well as healthier eyes. In addition, because sclerals don’t touch your corneal surface, rubbing is [minimized] and your risk of corneal abrasions is drastically diminished.

Wide Visual Field

The wide optic zone provides wearers with a wider, more precise peripheral vision. They also reduce sensitivity to glare and light.

Cost-effective

Scleral lenses are custom-fit to each eye. Though the fees for fitting sclerals and the cost of the lenses are higher than standard lenses, their life span and benefits make the cost worthwhile.

Though coverage rates and restrictions vary among providers, if considered a medical necessary, most insurance companies will reimburse the cost of scleral lenses. Consult with our eye care team at the Family Eye Care to discuss your specific payment options and cost of scleral lenses.

Are Scleral Lenses Better Than Gas Permeable Lenses?

In terms of comfort, visual clarity and stability, scleral lenses are superior to gas permeable lenses. In cases of corneal irregularity or severe sensitivity, scleral lenses are often the only viable option. However, they are more costly than GP lenses as well.

The question of which contact lens is best for you should ultimately be decided in conversation with us. Trained in fitting specialty contact lenses of various types, from the simple near-sighted first-time wearer to the complex astigmatic, bifocal or distorted cornea patient, Dr. Moshe Roth and Dr. Steffani Tiomno will consult with you about your best options.

Our practice serves patients from Old Bridge, East Brunswick, Woodbridge, and Edison, New Jersey and surrounding communities.
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Call Us 844-450-6850

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Choosing an Optometrist vs. an Ophthalmologist for Contact Lenses

If you need new contact lenses or are thinking of trying them out for the first time, who do you turn to? An optometrist or an ophthalmologist? To know with whom to set up an appointment, it’s important to understand the differences in eye care professionals.

The Difference Between Ophthalmologists and Optometrists

What is an Ophthalmologist?

An ophthalmologist is a medical doctor (MD) who examines eyes and performs vision-related surgical procedures. Ophthalmologists generally complete 4 years of college, 4-5 years of medical school, one year of internship, and at least three years of residency in ophthalmology. Their advanced medical training provides them with the expertise to diagnose eye diseases, offer treatments, conduct scientific research on vision disorders, and prescribe medication.

Though ophthalmologists can fit patients with eyeglasses and contact lenses, they often refer their patients to an optometrist on their team to correct any refractive errors, such as myopia (nearsightedness), hyperopia (farsightedness), astigmatism, or presbyopia (farsightedness related to aging). Optometrists are usually the ones to screen patients for LASIK and work alongside LASIK surgeons to coordinate the surgery.

What is an Optometrist?

optometrist caucasian od bigAn optometrist is a healthcare professional who has earned the Doctor of Optometry (OD) degree. Optometrists have to complete a four-year college degree program in the sciences coupled with four years of post-graduate professional training in optometry school.

Optometrists examine eyes for vision and health problems, diagnose and treat certain eye diseases and conditions, and prescribe and fit patients with glasses or contacts for common refractive errors. Certain optometrists provide alternative services, such as vision therapy, low vision care, dry eye treatment and myopia control. Optometrists can also provide pre- and post-surgery care, such as LASIK, PRK, corneal transplant, among others.

Optometrists in the United States are licensed to prescribe medications for certain eye conditions and diseases, though the scope of medical care that they can provide varies from state to state.

Why Choose an Optometrist?

If your eyes are healthy and don’t require specialized surgical treatment, visiting an optometrist is the obvious choice. Moreover, beyond performing routine eye exams, optometrists can detect, diagnose and manage eye diseases that require medical and non-medical treatment.

These treatments include, but are not limited to:

Dry Eye Treatment, Vision Therapy, Low Vision Management, Myopia Control, Specialty Contact Lens Fitting, Management and/or treatment of various corneal conditions and irregularities.

Think of your optometrist as a primary care physician for your eyes. When in need of a routine eye check-up, or if you’re dealing with an eye condition or notice your vision changing, it’s time to visit the optometrist.

If you’re interested in fitting specialty or traditional contact lenses to aid with specific eye conditions or misshapen corneas, Dr. Moshe Roth and Dr. Steffani Tiomno at the Family Eye Care can help.

Fitting Contact Lenses

Girl Putting in Contact 1280×853Whether you’re a first-time lens wearer or you’ve recently had a prescription change, it’s essential to ensure a proper fit. When lenses are not properly fitted, it can prove to be uncomfortable and can lead to vision problems, infections, or scarring. That’s where we come in.

To ensure a proper contact lens fitting, Dr. Moshe Roth and Dr. Steffani Tiomno will perform a comprehensive eye exam to check your level of refractive error and will also check for any conditions that could interfere with wearing contact lenses. The shape of your eye and personal lifestyle are also important factors in determining the right lens for you. If you spend a significant amount of time outdoors or lead an active lifestyle, that may require a different lens type. Following a proper assessment, the doctor will ensure the best fit for your eyes and overall vision health.

Moreover, your optometrist will show you how to insert and remove lenses, and generally, how to properly care for them. Additional follow-up appointments may be needed in order to monitor and assess the fitting and overall comfort level.

Specialized in fitting traditional and specialty contact lenses, Dr. Moshe Roth and Dr. Steffani Tiomno find the proper fit for all patients, from the simple near-sighted first-time wearer to the complex astigmatic, bifocal or diseased cornea patient. Visit us at the Family Eye Care for a contact lens fitting.

Our practice serves patients from Old Bridge, East Brunswick, Woodbridge, and Edison, New Jersey and surrounding communities.
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Call Us 844-450-6850

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When Gas Permeable Lenses Fail, Scleral Lenses Can Help

When it comes to contact lenses, most people are familiar with soft lenses to help give them a clear vision for nearsightedness (myopia), farsightedness (hyperopia), or astigmatism. In some cases, Gas Permeable (GP) or Rigid Gas Permeable (RGP) lenses are recommended. In other cases, they’re less efficient for long-lasting wear.

When this happens, scleral lenses can be a better option. At The Family Eye Care Scleral Lens and Keratoconus Center, we help patients throughout New Jersey.

Knowing the advantages and disadvantages is important and can make a big difference in comfortable – and superior – vision.

Close-up of woman's hazel eyeWhat Are Gas Permeable Contact Lenses?

Gas permeable contacts are lenses which are made from hard plastic materials. They’re called ‘permeable’ because they allow oxygen to pass through and reach the front of your eye for a more breathable feel.

Unlike soft lenses, GP lenses don’t contain any water. Because of this, many patients find that their GP contacts dehydrate less often. They’re also more durable because the firm materials make it hard for the lenses to tear.

The Advantages Of Gas Permeable Contact Lenses

Gas permeable lenses give our patients some great benefits. In addition to giving you good vision correction for common vision problems, they also offer:

Breathability

More oxygen means that air can reach the cornea, letting your eye “breathe”. This gives you better comfort for all-day wear.

Affordability

GP lenses are tailor-made for each patient. Although there is an initial higher cost, over time, they’re actually more cost effective since you won’t need to replace them often. Similar to a custom-designed outfit, GP lenses may be priced higher at first, but they provide greater long-term value.

Reduced Likelihood Of Attracting Bacteria

Since they don’t hold water, gas permeable lenses are less likely to have bacteria and harmful buildup. This makes them more hygienic and a healthier choice for your eyes.

However, gas permeable lenses may not be for everyone.

The Disadvantages Of Gas Permeable Contact Lenses

While gas permeable lenses offer benefits to patients with vision correction needs, there are some disadvantages you should know about.

It Takes Time To Get Used To Them

Patients who are used to soft contacts find that it takes a while to get used to GP lenses. That’s because of something called ‘lens awareness’. When you blink, you can feel the edge of the lens in your eye. Lens awareness doesn’t hurt or cause discomfort, but patients report feeling something odd in their eye or sensing a sudden physical reminder that the lens is there.

They Move Around Your Eye

Gas permeable lenses are known to slip off the center of your eye. This usually lasts for mere seconds, but when it happens multiple times throughout the day, it can become irritating very quickly.

Tiny Particles Can Get Underneath

You know that feeling when something is stuck in your eye? This can happen with GP lenses. Tiny pieces of debris can get lodged underneath the lenses, causing pain or discomfort.

If you’ve tried gas permeable lenses and have had any of these experiences, or you’re simply looking for something more comfortable for all-day wear, it’s time to try scleral lenses.

Asian female with finger circling eye, smilingHow Long Do Gas Permeable Contact Lenses Last?

Assuming that your prescription doesn’t change, gas permeable contact lenses typically last up to 1 year. Scleral lenses usually last for up to 3 years, but as with all types of contact lenses, make sure you use the lens case, contact solution and any other materials as instructed by your eye doctor. This will make sure you enjoy continued clear, comfortable vision and make your lenses last longer.

Can You Sleep With Gas Permeable Contact Lenses?

Not surprisingly, according to Dr. Moshe Roth and Dr. Steffani Tiomno, it is ill advised to do so. Wearing contacts overnight prevents oxygen from entering the cornea and can increase the risk of developing corneal infections or ulcers. Always take them out before going to sleep, clean and store them safely.

Can You Sleep With Scleral Lenses?

In most cases, it isn’t recommended. Only sleep in scleral lenses if specifically instructed to by your doctor.

Why Do My Gas Permeable Contacts Get Cloudy?

When gas permeable contacts become cloudy, it’s usually due to tiny particles of dirt or debris that get stuck inside or around the lens. This can also be caused by protein buildup, which can usually be cleaned off, but if that doesn’t work, it may be the quality of GP lenses themselves.

Scleral lenses rarely become cloudy, unless due to a phenomenon called “midday fogging”. This is when tiny debris cause the lenses to fog up. If this should happen, simply remove the lenses and gently rinse them with artificial tears. This usually resolves the issue quickly. You can always contact our office for help, too.

Are Scleral Lenses Better Than Gas Permeable Lenses?

Some patients with misshapen corneas find that scleral lenses give them clear vision for longer periods of time. This happens because of their ability to cover a larger area of the eye without touching the cornea directly. In fact, a recent study from the London South Bank University confirmed that scleral lenses were particularly effective in treating eye diseases due to irregularly shaped corneas.

How Much Do Gas Permeable Contacts Cost?

The cost of gas permeable lenses depends on each patient’s condition and prescription needs. For example, if your eye doctor recommends disposable bifocal contact lenses, an estimated per-box cost for these lenses is $50 to $70 (similar to the cost of disposable toric contacts). GP lenses usually average around $200 a pair.

Scleral lenses are custom-made for each patient. This is because every patient’s cornea has a unique shape, so each scleral lens must fit the eye exactly. Because of this personalized fit, the cost of scleral lenses is usually higher than standard contact lenses, which are mass produced. However, sclerals last up to 3 years, so they’re more cost-effective in the long term.

If you have a corneal disease, your insurance coverage may pay for scleral lenses. For specific insurance questions, contact The Family Eye Care Scleral Lens and Keratoconus Center.

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Most People Prefer Scleral Lenses Over Gas Permeable Lenses

Like gas permeable lenses, scleral lenses are also made from rigid materials, but that’s where the similarities end. Scleral lenses are specially-designed contact lenses with 2 unique features: a large diameter and a tiny, built-in reservoir of water.

Scleral lenses have a larger diameter than traditional lenses, giving them the ability to rest over the entire area of the sclera (the white part of your eye), but without directly touching the cornea. They also contain a tiny pool of artificial tears, which is built in to the lens. This constantly lubricates your eyes for superior comfort all day long.

Speak with Dr. Moshe Roth and Dr. Steffani Tiomno to see if you’re a candidate for scleral lenses.

So if you have dry eyes, keratoconus, or other corneal conditions and your GP lenses aren’t cutting it, or you’re ready for an upgrade of comfort and long-term value, it’s time to try scleral lenses. Schedule a consultation with Dr. Moshe Roth and Dr. Steffani Tiomno today.

Our practice serves patients from Old Bridge, East Brunswick, Woodbridge, and Edison, New Jersey and surrounding communities.
Book An Appointment
Call Us 844-450-6850

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Where Do Scleral Lenses Fit In Your Dry Eye Treatment Protocol?

Dry Eye Syndrome (DES) is among the top drivers that lead patients to seek help from eye care professionals trained in treating dry eyes.

Dry Eye Syndrome (DES) is a highly common condition that occurs when your tear glands don’t produce enough tears or when your tears evaporate too quickly. This condition can be temporary or chronic and is characterized by dry, itchy, stinging and irritated eyes.

Curiously, a recent survey revealed that out of the more than 30 million adults who have symptoms of Dry Eye, only half of those are diagnosed and an even smaller number receives the medical attention they need. These numbers are a concern since there are millions of people needlessly suffering from a treatable condition.

If you’re suffering from dry eye, contact Family Eye Care today. We offer effective and lasting treatments that are sure to improve your quality of life.

Signs and Symptoms of Dry Eye Disease

Dry eyes can be caused by several factors, such as aging, medication, environmental changes, hormonal changes, allergies, among others. The most common ocular signs and symptoms include:

  • Crusty eyelids
  • Dryness
  • Grittiness
  • Itchy eyes
  • Redness
  • Stinging
  • Tearing
  • Blurred vision
  • Burning
  • Intense eye pain
  • Photophobia (sensitivity to light)
  • Sensation of something stuck in the eye

How Can Scleral Lenses Help With Dry Eye?

Scleral lenses are customized rigid lenses that tackle three factors simultaneously: they provide vision correction, they protect the eye and serve a therapeutic purpose by lubricating the eye.

Due to their large shape, unique features and customized fitting, scleral lenses offer an excellent solution for dry eyes. They decrease pain, discomfort, eye redness and itchiness in those with dry eyes.

While scleral lenses can provide relief to patients suffering from DES, the question is deciding on the right time to incorporate scleral lenses into a dry eye treatment plan.

Scleral lenses should not be the primary treatment method

Despite their countless benefits, scleral lenses should not be the primary therapy or treatment method for patients with mild to moderate dry eye syndrome. Eye practitioners often advise to try out prior treatment options first.

Additional Dry Eye treatment methods include:

  • Environment modifications
  • Improved eyelid hygiene
  • Nighttime goggles
  • Nighttime eye lubrication
  • Prescription dry eye medications
  • Preservative-free eyedrops

Scleral contact lenses as a tertiary therapy

Scleral lenses should only serve as tertiary therapy after overnight treatment options and prescription medications such as moisture goggles or ointment have been exhausted. That said, scleral lenses should be incorporated before the long-term use of steroids, surgical punctual occlusion and] amniotic membrane grafts.

Some of the other tertiary therapies that can be recommended alongside scleral lenses include:

  • Autologous/allogeneic serum eye drops
  • Oral secretagogues
  • Soft bandage contact lenses

Like scleral lenses, these treatment procedures are highly effective, but should only be used if the primary and secondary therapies fail to improve the patient’s Dry Eye condition.

If you experience any eye pain or regular ocular discomfort, book your appointment with Family Eye Care today.

Our practice serves patients from Old Bridge, East Brunswick, Woodbridge, and Edison, New Jersey and surrounding communities.


Book An Appointment
Call Us 844-450-6850

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Who Fits Specialty Contact Lenses?

If you have been told that contact lenses are not an option, speak with an optometrist trained in fitting specialty contact lenses. Dr. Moshe Roth and Dr. Steffani Tiomno at Family Eye Care can offer several alternative high-quality options for rare or severe eye conditions.

How Is an Optometrist Trained in Fitting Specialty Contact Lenses Unique?

Every optometrist can fit conventional contact lenses. However, specialty contacts are another story, and few optometrists have undergone the necessary training in fitting specialty lenses, such as scleral lenses, hybrid lenses, or custom rigid gas permeable lenses.

Scleral lenses are custom-fit to each patient’s individual cornea. This requires the optometrist to acquire more in-depth knowledge in areas traditionally belonging in the field of a corneal specialist.

Moreover, special equipment is needed to fit specialty lenses. The optometrist uses different devices to assess whether a particular specialty lens is a good fit and to precisely measure a cornea’s unique shape.

When Should You See an Eye Doctor for Specialty Lenses?

Many of our patients have experienced discomfort or complications when using traditional soft contact lenses. In these cases, wearing scleral lenses offer more comfort yet provide the same visual acuity or better.

If you have an eye condition that prevents you from wearing regular contact lenses, such as corneal irregularities (i.e. keratoconus), post corneal transplant, severe dry-eye, or an unusually high refractive error, scleral contact lenses may be a good fit.

Special lenses may also help patients cope with complications following surgery or improve remaining refractive errors. Dr. Moshe Roth and Dr. Steffani Tiomno can help you evaluate your alternatives.

young man thinkingConditions Special Lenses Can Treat

  • Keratoconus
  • Astigmatism
  • Dry Eye
  • Post-Refractive Surgery (LASIK, RK, PRK)
  • Corneal Dystrophy and Other Chronic Eye Diseases
  • High Refractive Errors

Fitting Specialty Lenses

Specialty lenses require specific diagnostic equipment. Only a precise image of the cornea’s surface can ensure optimal fitting of the individual lens for perfect vision.

At Family Eye Care, we use an advanced digital topographer to measure your cornea during your initial eye exam. This digital device produces high-resolution corneal imagery and provides the parameters to design your customized lenses. Your specifications are then sent to a contact lens lab, which produces a set of lenses designed specifically for your eyes.

After ensuring the lenses are a perfect fit, Dr. Moshe Roth and Dr. Steffani Tiomno will instruct you on how to insert, remove and take care of specialty contact lenses, since handling them calls for a little more precision and caution than traditional lenses.

Interested in Specialty Contact Lenses?

At Family Eye Care, we can provide accurate and current information about specialty contact lenses as well as a broad scope of general contact lens products. We have the equipment needed to assess suitability and fit every type of lens.

Optometrists, such as Dr. Moshe Roth and Dr. Steffani Tiomno, are experienced in fitting specialty contact lenses for rare eye conditions. For us, these are not exceptions, but our every-day profession.

Contact us today to find out which contact lens alternatives are most suitable for your specific condition. Family Eye Care will make sure you receive individual consultation and care.

Our practice serves patients from Old Bridge, East Brunswick, Woodbridge, and Edison, New Jersey and surrounding communities.

Resources:



Book An Appointment
Call Us 844-450-6850

Learn More About Scleral Lenses

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What are Scleral Lenses?

Scleral Lenses for Keratoconus Thumbnail.jpg

Scleral Lenses for Keratoconus

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Corneal Disease and Scleral Lenses

beautiful eyes1.jpg

Who Wears Scleral Lenses?

Specialty FAQ Thumbnail.jpg

Scleral Lenses: FAQ

tips and researches Thumbnail.jpg

Tips and Resources

Scleral Lens Blog Thumbnail.jpg

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Read Our Latest Posts

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