Fitting contact lenses for complex eye conditions and high prescriptions is rarely straightforward. Although what we do is technically a science, there is an ‘art’ to fitting specialist contact lenses. No eye or patient is the same and what works for one person will not necessarily work for the next. It often involves constant adaption of ideas and processes and thinking ‘outside the box’. Some practitioners will specialise in one or two types of complex lens; however, we have been lucky enough to work with many lens manufacturers and designs. I am not, therefore, restricted to trying to make one lens work for everyone. We can find the right thing for your eyes. Many patients we see have tried many lens options by the time they get to us and we have to find a new approach.

It is important to set reasonable expectations. For some patients with advanced keratoconus or distorted corneas following refractive surgery, it is not always possible to restore perfect vision. So some glare, for example, may still persist. For others it will take numerous consultations and adjustments before the final lenses are established. In other cases the lens(es) initially issued may be found to be sub-optimal at a later appointment and re-fitting with a different lens type may be required. Over time your lenses might need to be adjusted to keep up with any changes your eyes may be going through.

Typically, for a complex contact lenses fitting, you can expect this sort of schedule:

• Initial consultation: Eye assessment involving careful measurements and scans of your corneas. We will discuss your visual needs, lifestyle and day-to-day activities. Various lens options will be talked through. We will try the best contenders on your eyes and together decide which lenses might work best. In some cases you will ‘test’ the lenses for an hour or two. We will order lenses for you at this point which often have to be custom made. Some are imported from the United States and may take up to three weeks to arrive. Others from the UK so arrive in a few days.

• Collection appointment: When the lenses arrive you will come in again to try them. We will check that they fit as planned and correct your vision as expected. If they are acceptable we will teach you how to insert, remove and look after your lenses. You will then take them away for a week or two to try them out in the ‘real world’. If the new lenses are not satisfactory, we will re-order them with any necessary modifications.

• Follow-up/ 2nd Collection appointment: Once you have had a chance to try your new lenses, you will come in again so we can see how you’ve been getting on. If all is good, you will keep them and return for another follow-up in 1-2 months. If any modifications are needed we will re-order with any necessary changes or perhaps try a different lens type.
• 2nd Follow-up / 3rd Collection appointment: Same process.
• Regular check-ups: Once the fitting is completed you will be required to come for a check up every 6 months. This will be in addition to routine eye examinations.

The fitting process may be over two visits. However, it may take months before the perfect lenses are found. Once we find the optimal lens, with regular six monthly check-ups and good lens hygiene, you should be able to wear your lenses for as long as you wish. The fitting process for healthy eyes with high prescriptions or multifocal lenses is usually very straightforward.

Different lenses will need to be replaced at different intervals. Some soft lenses will last around 3 months, in contrast scleral lenses can last over 2 years. We will go over all of this at your initial consultation.

Lenses are paid for at the initial collection appointment. If they don’t work-out and we need to change them, as long as you return them to us within their warranty period, you will not need to pay again for a replacement.