contact lens fitting guide

Contact Lens Fitting Guide: What Happens During Exam

Contact lens fitting is the first step in moving from eyeglasses to contact lenses.  The fitting process involves a few different steps, and it is usually done by an eye doctors. Part of the fitting and training may also be done by someone who has been trained in contact lens fitting under the supervision of a doctor.

Contact Lens Fitting: Comprehensive Eye Exam

Usually the eye doctor will first do a regular eye exam. This will include checking the front part of your eye including your cornea and your anterior chamber. Then they will typically dilate you and check the back of the eye. Dilation is important to check for eye health conditions like glaucoma and retinal problems.

A comprehensive eye exam is needed before a contact lens fitting. This is because you want to ensure that the patients blurry vision is from a refractive error and not because of some other eye issue. 

Having other eye problems does not rule someone out from wearing contacts. But, it is a good idea to address eye health issues as well so that the patient can have clear vision. 

Contact Lens Fitting: Vision Correction & Trial Lenses

The refraction is the part of the contact lens fitting where the eye doctor figures out what the prescription will be for your new contact lenses. Soft contacts are far less complicated to fit than specialty contacts like scleral lenses. 

Prescription Measurement

First the eye doctor will measure the sphere correction of your prescription glasses. Then, the doctor will see if you have any astigmatism in your prescription. Prescription measurement is always the first step of a contact lens exam.

For most patients, their glasses prescription and contact lens prescription will be the same. In some patients who have high levels of astigmatism or high levels of sphere correction, or both, the contact lens prescription may be a little different than the glasses prescription.

Trial Contact Lenses

Before a contact lens prescription is given to you for the first time, your doctor will typically have you try trial contact lenses. The best lenses for a patient are ones that are comfortable, move well over the eye, and give the patient clear vision. 

Trial And Error

Trial and error is the most common way contact lenses are fit in most offices. There are many types of contacts for all types of prescriptions and usually the doctor can find a sample lens that will work for you during your visit.

Additional Testing

In some cases where a patient has tried multiple lenses, and they still can not find a lens that works for them, the contact lens consultation may also require a corneal topography. This can help the doctor to better determine what curvature of a contact lens would be best. Other measurements that may be done when needed include keratometry and measuring the pupil and iris size. However, these are based on a patient’s individual needs and are not always required.


In the vast majority of cases, a healthy fit can be determined simply by using slit lamp to observe how the lens moves over the eye. If it seems to move fine and the patient feels good in the lenses, then that means its a good option for the patient. After trying a few different types of lenses, your eye doctor will narrow down the one with the best fit for you.

Contact Lens Teaching

Once your doctor has figured out which contact lens brand and size is good for you, you will have to learn how to get the trial pair of contact lens in and out of the eye. Typically, this teaching is either done by the eye doctor or a member of their staff who has been trained to help patients take contact lenses in and out. 

You will want to be able to put your contacts in and get them out at least once before you attempt to do it at home. This can help to avoid a situation in which a contact lens is stuck in the eye and you are unable to get it out.

Contact Lens Prescription

Your contact lens eye exam will end with your doctor giving you your contact lens prescription. This prescription will have your eye prescription on it, which is similar to a glasses prescription, but it will also have additional information. 

The additional information on the contact lens prescription includes the brand of the lens, the base curve of the lens, and the diameter of the lens. The base curve and the diameter are what make up the contact lens size. 

Contact Lens Fitting: Follow Up & Contact Lens Renewal

After the initial visit, the next step will be to follow up in your new lenses.

Follow Up Appointment

Once you have been given you contact lens prescription, your doctors office can order the lenses for you or you can order them online. You will be scheduled for a follow up to see how you are doing in your new contact lenses. 

The time between the initial contact lens fitting and the follow up visit is a trial period to test the fit and performance of the lenses. During this time, contact lens wearers are encouraged to monitor their experience closely, noting any discomfort, vision issues, or signs of eye irritation. 

If any issues arise, the optometrist can adjust the lens material, design or fit in response to the wearer’s feedback. The goal of the trial period is to achieve a comfortable fit while making sure the patient has clear vision.

Renewing Your Contact Lenses

If you are happy in the type of contacts that you were originally prescribed, then there is no need to change brands or sizes. Most patients stay in the same soft contact lenses year over year. 

Typically, during a follow-up appointment, your doctor will provide you with an up to date prescription. This prescription may have new numbers on it but in most cases the type of lenses are not changed. Unless the doctor wants the patient to change from monthlies to dailies or from 2 week lenses to daily lenses, there’s usually no reason to change brands. 

Contact Lens Fitting: Types Of Contacts

Contact lenses come in a variety of shapes and materials to cater to different preferences and eye conditions. 

Contact Lens Material

The two main categories are soft and rigid gas permeable (RGP) or hard lenses. Soft lenses are popular for their comfort, while RGP lenses can provide some patients with improved visual acuity for certain eye conditions. 

Further, there are some specialty contact lenses as well like scleral lenses. These are designed for specific eye conditions or irregular corneas. 

The most common type of contact lens is the soft contact lens. If you are someone who needs a hard contact lens fitting, be sure to ask this to the doctor’s office before scheduling your eye examination. Not all offices will have someone that is skilled at fitting RGP lenses or specialty contact lenses.

Contact Lens Options According To Length Of Wear

How long you can wear your corrective lenses depends on the type of lenses you choose and their different replacement schedules. There are daily contact lenses, monthly contact lenses, extended contact wear lenses, and 2 week lenses. Daily lenses are the best since they are the least likely to become infected. Extended wear contact lenses may have a higher rate of infections when left in the eye overnight. 

Colored Contacts, Toric Lenses And Multifocal Lenses

For certain special occasions you may want to get a contact lens that can change your eye color. Another type of contact lens is a toric lens which can correct for astigmatism. Finally, if you have trouble reading at both near and far, multifocal contact lenses may be a good option for you.

Contact Lens Fitting: Caring For Your Contacts

Taking proper care of your contact lenses is crucial in maintaining healthy eyes. 

Contact Lens Hygiene Tips

When cleaning, follow a simple routine: place the lens in the palm of your hand, add a few drops of solution, and gently rub the lens with your clean fingertips, avoiding contact with your nails. This will help remove any debris or bacteria. Make sure to replace your contact lens solution daily and follow the manufacturer’s guidelines for how frequently to replace your contact lenses.

If you have trouble remembering to take your contact lenses out at night, then choose daily disposables may be the best contact lens for you. Remember to never sleep, swim, snorkel, or shower in your contact lens. This can cause corneal infections like corneal ulcers. 

Contact Lens Related Problems

In some patients dry eyes can make contact lens wear difficult. If you have a history of dry eyes, your eye doctor will evaluate the surface of your eye and also perform a tear film evaluation.

Additionally, be mindful of certain eye drops when wearing contacts, as some drops can cause problems or negatively interact with the lens3. If you’re unsure about compatibility, consult with your eye care professional for recommendations.

Contact Lens Fitting: Summary

If you are just starting to wear contact lenses, you will need a contact lens fitting to find the right fit initially. Your eye health problems will be the first thing to be assessed and addressed before the fitting and during a standard eye exam. A proper fitting will include assessing which contact lens is best for your eye shape and the curvature of your cornea. Also, in order to be a good candidate for contact lens wear, you will need to be able to take contact lens in and out of your eye. 

Additionally, caring for your lenses is very important because there are some very serious eye infections that are associated with poor hygiene when it comes to contact lens wear. Remember, the health of your eyes and the surface of the eye are paramount when choosing medical devices like contact lenses. Your eye care professional might recommend a number of follow-up visits to ensure the lenses are the best fit and to monitor the health of your eyes over time. Successful contact lens wear means a patient has  optimal comfort and clear vision in their contact lenses.


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