Contacts

What are contact lenses?

Contact lenses are thin, round lenses that rest on the surface of your eyes to help you see more clearly. Like glasses, contacts correct refractive errors. These are changes to the shape of your eye that prevent light from landing properly on your retina. Refractive errors make your vision blurry.

Contact lenses help people with the following types of refractive errors:

• Nearsightedness (myopia).
• Farsightedness (hyperopia).
• Age-related farsightedness (presbyopia).
• Astigmatism.

Over 45 million people in the U.S. wear contacts. They can help you have crisper, clearer vision. They also move naturally with your eye and don’t get in the way of an active lifestyle. Plus, many people prefer the look of contacts vs. glasses.

Contacts are medical devices. They come with some level of risk, most commonly, eye infections. Learning how to clean and care for your contacts can help you wear them safely.

If you’re interested in contacts, you should schedule an appointment with an eye care specialist. They’ll evaluate your eyes and determine if you can wear contacts. They’ll also discuss the types of contacts available. Each person has different needs based on their eye health, medical history, lifestyle and other factors.

If contacts are suitable for you, your provider will write a prescription for the specific type you need and fit the contacts to your eyes.

Types of contact lenses

There are many types of contact lenses. An eye care specialist can help you decide which type is best for you. The four main factors you need to consider are:

• Lens material.
• Wear schedule.
• Replacement schedule.
• Special features.

Lens material

Contacts can be either soft or gas permeable (GP). Most people choose soft contacts. Here’s what you should know about each type:

• Soft contact lenses. These are contacts made of flexible plastic. Many people feel they’re comfortable and can quickly adjust to wearing them (within a few days). However, these contacts easily absorb pollutants (like lotion or soap from your hands), which can irritate your eyes. They’re also fragile and may tear or rip.
• Gas permeable contact lenses. Gas permeable (GP) contact lenses, also known as rigid gas permeable (RGP) lenses, are harder than soft lenses. But unlike older versions of hard lenses, RGP lenses are made with silicone polymers. This material is durable while still allowing oxygen to circulate to your cornea. RGP lenses keep their shape better than soft lenses and offer clearer vision for some types of corrections. A drawback is they may be less comfortable than soft lenses when you first start using them. Some people need a few weeks to adjust.

Wear schedule

You can choose contacts that are daily wear or extended wear.

• Daily wear. You wear these contacts during the day, but you take them out at night. You should never sleep in daily wear contacts. Doing so raises your risk of an eye infection. Depending on your replacement schedule, you either throw out the contacts at night or you clean and store them according to your provider’s instructions to reuse the next day.
• Extended wear. These contacts you can wear both day and night (while you sleep). You can keep them in continuously for up to 30 days. The exact length varies based on the person and the specific type of lens. Your provider evaluates your eyes and decides how long you can safely keep them in. After each scheduled removal, you should sleep at least one night without your lenses in to let your eyes rest. Extended wear contacts may raise your risk of eye infections. So, it’s important to discuss your risk with your provider.

Replacement schedule

Your replacement schedule is how often you need to replace your contacts. This applies to soft contact lens use only. You wear RGP lenses long-term until your provider determines you need new ones.

There are two main replacement schedules for soft contacts:

• Daily disposable. With this schedule, you wear a new pair of contacts each day. You insert a new pair in the morning, wear them all day and remove them before bed. When you remove your contacts, you throw them out. You should never reuse daily disposables. Doing so can lead to eye irritation or an infection. A daily disposable schedule is ideal if you have allergies. It also lowers your risk of dry eye disease and irritation from contact lens solutions.
• Planned replacement. With this schedule, you wear your contacts all day and remove them before bed. But instead of throwing them out, you clean and store them overnight. With proper care, you may keep using the same lenses for up to 30 days. You should never wear your contacts overnight unless they’re approved for extended wear.

Special features

Some contacts have special features that help manage certain eye conditions or give you added benefits. Some types of contacts that may be appropriate for you include:

• Hybrid contact lenses. These contacts have a durable RGP center surrounded by an outer ring of soft material. Hybrid contacts may be more comfortable for you than RGP contacts while still providing crisp, clear vision. This type may be suitable for people who have irregularly shaped corneas due to astigmatism, corneal ectasia or other conditions.
• Toric contact lenses. Toric lenses are special lenses for people with astigmatism. They’re made from the same material as other contacts and come in soft or RGP forms. Like bifocal glasses, toric lenses have two powers. One corrects for astigmatism, and the other for myopia or hyperopia.
• Multifocal contact lenses. These contacts improve distance and close-up vision at the same time. They’re ideal for people who have both nearsightedness and age-related farsightedness (presbyopia). Each lens has two or more prescriptions (powers) to correct your vision at different distances.
• Scleral contact lenses. Scleral lenses are a form of RGP lenses. The main difference compared with standard RGP lenses is that scleral lenses are larger. So, their edges rest on the white part of your eye (sclera) rather than your cornea. There’s a small gap between the lens and your cornea, which allows your eye to stay lubricated. Scleral lenses help people with dry eye disease and various conditions affecting the cornea.
• Orthokeratology (Ortho-K) contact lenses. These are specialty hard lenses that you wear only while you sleep. They change your cornea’s shape to correct vision problems (usually nearsightedness). Wearing Ortho-K lenses at night can help you have clearer vision for most or all of the next day. Your provider decides how often you should wear your lenses to meet your vision needs.
• Cosmetic (decorative) contact lenses. Cosmetic lenses change the appearance of your eyes. They may also improve your vision, but not always. Some cosmetic lenses simply change your eye color or make your eyes resemble those of an animal or other creature. These can be fun, but only if you recognize the risks. All cosmetic lenses require a prescription even if they don’t change your vision. They also require proper care and usage. Never buy cosmetic lenses from shops that don’t require a prescription. Such sales are illegal in the U.S., and wearing nonprescription contacts may severely damage your eyes. Talk to your provider if you’re interested in cosmetic lenses.

Who shouldn’t wear contacts?

While contacts have many benefits, they may not be right for you if you:

• Have dry eye disease.
• Deal with recurrent eye infections.
• Have severe allergies.
• Spend a lot of time in areas with dust or fumes.
• May not be able to clean and care for your contacts.

Ask your provider if there are any reasons why you should avoid using contacts.

What are the disadvantages of contact lenses?

Contacts help many people, but they require extra thought and care. If you wear glasses, you can simply put them on your face and get on with your day. But as a contacts wearer, you need to:

• Carefully clean your contacts and case according to your provider’s instructions.
• Have more frequent follow-ups with your provider.
• Learn how to insert and remove your contacts.
• Be aware of signs of complications.

Complications of wearing contact lenses

Contact lenses are medical devices. Like all medical devices, they carry some risks. Wearing contacts can raise your risk of the following complications:

• Microbial keratitis. This is a rare but serious infection of your cornea. It can happen if you leave your contacts in for longer than prescribed or don’t clean them well enough. Tiny organisms such as an amoeba can get into your eye and cause damage. Prompt treatment can help you recover. But in extreme cases, infection can cause blindness or require a corneal transplant.
• Corneal abrasion. A corneal abrasion is a scratch on your cornea that may heal on its own in a few days. In more serious cases, germs can enter the damaged part and lead to emergencies like corneal ulcers.
• Contact-lens-induced acute red eye (CLARE). This is when your eyes become red and irritated from your contacts. It can happen if you sleep in contacts not prescribed for overnight wear or if you don’t replace them as often as needed. Usually, CLARE goes away if you stop wearing your contacts for a while. Your provider may also give you eye drops to soothe your eyes and help them heal.
• Giant papillary conjunctivitis (GPC). This is a condition that causes redness, irritation and swelling on the inner side of your eyelid. Small bumps may also form. To treat GPC, you need to stop wearing your contacts for several weeks. You may also need eye drops or ointments. In some cases, you need to limit how long you leave your contacts in or switch the type. Using preservative-free lens solutions can also help.

How can I safely wear contacts?

Ask your provider for advice tailored to your specific needs. In general, these tips can help lower your risk of complications:

• Wash your hands. Before you touch your contacts, thoroughly wash your hands and dry them with a clean, lint-free towel. Choose a soap that’s free of lotions, oils or perfumes. These soaps may leave a film on your hands, which can transfer to your contacts and irritate your eyes.
• Clean your contacts and storage case. Your provider will tell you how to clean your contacts and their case. It’s essential to follow these instructions closely to avoid serious infections. Never use water or saliva (spit) to clean your contacts or case. These substances contain germs. Only use contact lens cleaning solution. Your provider will tell you which kind to use.
• Keep water away from your contacts. Water and your contacts should never mix. Even if it looks clean, water can contain microscopic germs that can cause eye infections. Don’t wear your contacts while swimming, bathing or using a hot tub.
• Remove your contacts before bed. Be sure to take out your contacts before you go to sleep unless you have a type medically approved for overnight wear. People who wear contacts overnight face a higher risk of eye infections.
• Follow the replacement schedule for your contacts and case. Your provider will tell you how often you need to replace your contacts and their storage case.

How do I put in contact lenses?

The longer you use contacts, the easier it’ll become to put them in. Your provider may give you some tips. Below are general steps you can follow.

1. Wash and rinse your hands thoroughly. This should always be the first thing you do.
2. Choose which eye to start with. Start with the same eye every time to avoid mixing up your lenses. Also, choose which hand you’ll use to insert the lens (typically your dominant hand).
3. Rinse the lens. Remove the first lens from the storage container and place it in the palm of your hand. Rinse it with rinsing solution (not water). If you cleaned your lens the night before and stored it in solution, you may just remove it without rinsing.
4. Inspect the lens. Place the lens on your index finger and check it for dust, tears or other damage. Also, check if it’s inverted (inside out). An inverted lens will have edges that flare out. In the correct position, the lens edges should appear almost straight or turn in.
5. Hold your eyelids in place. Hold your upper lid with the hand not holding the lens. Secure your lower lid with the middle finger of the hand holding the lens.
6. Bring the lens toward your eye. Slowly bring the lens toward your eye while looking “through” the lens and finger. Gently place the lens squarely on your cornea. Don’t blink until the lens is in place.
7. Release your eyelids. Do this slowly. Release your lower lid first, then your upper lid. Blink a few times. You should be able to see clearly through the lens, and it should feel comfortable on your eye.
8. Repeat with your other eye. Follow these same steps for your other eye.

How do I remove my contact lenses?

To remove your contacts, follow these steps:

1. Wash and dry your hands thoroughly.
2. Pull down your lower lid with the middle finger of your preferred hand.
3. Use the tip of the index finger on your preferred hand to lightly touch the bottom edge of the lens.
4. While looking up, slide the lens down onto the white part of your eye.
5. Use your index finger and thumb to gently pinch the lens off the white part of your eye.

What are some tips for contact lens beginners?

If you’re just starting out with contacts, you probably have many questions. And you’ll think of more as you go along. Below are some answers to common questions.

Should I put in contacts before or after applying my makeup?

Always put your contacts in before applying makeup or facial lotion. This lowers the risk of getting cosmetics on your contacts or trapped in your eye. You should also wait to apply hand or body cream until you put in your contacts.

Can you put contact lenses in with long fingernails?

Keeping your fingernails short will help you insert and remove contacts more easily. If you wish to keep long nails, talk to your provider about how to safely work with your contacts.

What if I fall asleep with my contacts in?

Always try to remove your contacts before going to sleep unless your prescription allows nighttime wear. But if you fall asleep before removing your contacts, don’t panic.

When you wake up, check to see if the lenses move freely on your eyes. If they do, remove them and keep them out for several hours. If the lenses don’t move, wait about 10 minutes for your eyes to re-wet. Or place re-wetting drops in your eyes. Once the lenses move freely, remove them.

Do I still need glasses if I wear contacts?

Yes, you should always keep a pair of glasses that has your current prescription. You may need to wear glasses if you have a tear in a contact lens or if you develop an eye infection. It’s a good idea to carry your glasses with you at all times in case you need them.

Can your contact prescription change?

Your contact prescription, like your glasses prescription, can change over time. This is because your vision can naturally change over the years.

People under age 21 are likely to have changing prescriptions as their eyes continue to grow. People over age 40 may develop presbyopia (aging-related changes to their vision).

Talk to your provider about the vision changes you may expect.

When should I call my eye doctor?

Call your eye care provider if you have:

• Pain or discomfort in one or both eyes.
• Redness in one or both eyes.
• Sensitivity to light.
• Blurry vision that starts suddenly.
• Eyes that are more watery than usual.
• Discharge (fluid) coming out of your eyes.

A note from Cleveland Clinic

Contacts can help you see the world in a whole new way. If you’re new to contact lenses, you might have many questions. Some of these questions might make you feel stressed, even if you’re excited about the process overall. It’s normal to feel some hesitation when trying something new. Talk to your provider about your concerns. They’ll help you get the answers you need so you can begin enjoying your lenses.

If you’ve been wearing contacts for a while, you might want to try a different type. This is especially true if your eye health or vision changes over the years. Talk to your provider about your options and see if another type might be better for your needs.

For both novices and veterans, proper care and usage of your contacts should be your top priority. After wearing contacts for years, it can be easy to cut corners or think it’s OK to bend some rules. But veering from your provider’s guidelines can damage your eye health. Talk to your provider if you have any questions about how to care for your contacts, how long to leave them in or when to replace them.