Are keratometers req'd for soft contacts lens fitups?

Question

I was fitted for Soflens Toric 66's about 3 years ago. I have been prescribed these contacts every year. during this time I had pretty good luck with the contacts except this year. a few months ago I was given a prescription for these soft contacts and experienced discomfort and distorted vision so I wore my glasses. The distorted vision went away after 2 weeks while wearing glasses. I put a new set of contacts in. a few days later had pain and distorted vision again. Went to see my eye doctor and he said to see a specialist. That morning for seeing the specialist I put my contacts in for the day and felt fine. I took them out at the specialists. They used a keratometer and wanted the curvature measurements from my prescription earlier this year. I said they didn't used a machine to measure curvature, just the slit lens and a phoropter. They said the contacts I have been wearing are leaving a compression into my eye which takes about a week or two for my eye to reshape itself.

Answer 1

the pickier CL use some type of curve measurement, yes.  the sloppier ones dont.  it is not absolutely necessary to use it all the time, but most of the time most good practitioners do use it

Answer 2

Your specialist is correct.  Trying to fit a contact lens on the FIRST attempt without a keratometer to measure the curvature of your cornea is like a shoe salesman just throwing you a pair of shoes and saying "put these on and wear them a few days and see if they hurt or not".  Corneal curvatures do tend to be pretty stable over time, though.  So, once the doctor has found a good fit for you it is not as important to continue to do curvature readings as long as you are having no problems with the fit nor metabolism of the eye.  If you start to have any problems, though, it is wise to step back and recheck everything to assure you know exactly what could be causing the problems.

Answer 3

Keratometers measure the curves of about a 3mm distance on your cornea.

There are manual keratometers, such as that used by the specialist you saw, and there are also automatic machines that take these "K" readings along with other measurements of your eye (such as an autorefraction)... So you may not have realized if your contact lens fitter took these readings or not because the machinery may have been different. Just ask them for the measurements and they'll (hopefully) have something on file.

Regardless, it is clear that the lens you were wearing was too tight. The lenses choosen for you were based off the old parameters of your contacts, and while it may have worked for you in the past, your eyes have gone through changes and after your specialist gives you the OK i'd suggest getting a whole new fit-  That means having all of the measurements taken again and fitting you according to the new, current specifications of your eye.

Be sure to let whoever gave you that new contact lens prescription know that you've had this problem so if you choose to continue to see them, this type of thing doesn't happen in the future. Also, just ask if they have your "K" readings because most places (especially if you got your eye exam there) obtain this information through an automatic machine, unlike the specialists that use the manual keratometers.

Good luck!