by Patrick Sills

Created on: August 30, 2009

I haven't been on the other side of a fitting table for a while, but I was once a certified optician. In addition to the obvious task of helping patients choose appropriate frames for eyeglasses, I also dispensed contact lenses to first-time wearers. Back in the early 1970's, I was a 13-year-old boy about to try my very first contact lenses. In those days, the selection of available lenses was quite limited. Basically, there were 2 types; soft or hard. The hard lenses were made of a rigid plastic material and had a very narrow diameter. The lens would be just wide enough to cover the pupil in a normally illuminated room. Soft lenses at that time were relatively new. They were far more comfortable. As the name implies, they were made of a softer, flexible material that furthermore absorbed water. They were larger in diameter; typically covering the entire iris (the colored part of the eye). At any rate, contact lenses either fit well in those days; or they didn't. Mine? They didn't fit very well, and before long, my eyes were so bloodshot from the ensuing irritation of constant lens movement and my lackluster cleaning practices that I appeared to be stoned most of the time!

I switched back and forth from contacts to glasses for many years. In the 1980's I became an optician and quickly learned about diameters and base curves for contact lenses. By this time, there was a huge variety of contact lens manufacturers and styles. The base curve is the single most important feature of a contact lens when regarding comfort. This is simply the curvature of the lens itself. The object is to match the base curve with the curvature of the patient's eyeball to ensure the best fit. If the selected base curve is too flat, the lens will adhere only to the center of the patient's eye and will flap on the sides. If it is too steep, it will adhere to the sides and be loose in the center. In either scenario, the wearer will have problems in short order.

Therefore, when getting fitted for contact lenses for the first time, the optometrist (or opthamologist) will prescribe a temporary trial pair of lenses. In 7-10 days, the patient will return for a follow-up to make sure the lens fit and visual acuity is correct. Think of having surgery and returning for a follow-up to make sure that your stitches are healing; and you'll get the idea.

If you have worn contacts before, it is quite helpful to provide prescription information to a new examiner. Now here's the problem, and I've never

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