Contact Lenses

A contact lens (also known simply as a contact) is a corrective, cosmetic, or therapeutic lens usually placed on the cornea of the eye. Leonardo da Vinci is credited with describing and sketching the first ideas for contact lenses in 1508, but it was more than 300 years later before contact lenses were actually fabricated and worn on the eye. Modern soft contact lenses were invented by the Czech chemist Otto Wichterle and his assistant Drahoslav Lím, who also invented the first gel used for their production.

People choose to wear contact lenses for many reasons, often due to their appearance and practicality. When compared with spectacles, contact lenses are less affected by wet weather, do not steam up, and provide a wider field of vision. They are more suitable for a number of sporting activities.

Corrective Contact Lenses:

A corrective contact lens is designed to improve vision. In many people, there is a mismatch between the refractive power of the eye and the length of the eye, leading to a refraction error. A contact lens neutralizes this mismatch and allows for correct focusing of light onto the retina. Conditions correctable with contact lenses include myopia (near or short sightedness), hypermetropia (far or long sightedness), astigmatism and presbyopia. Contact wearers must usually take their contact lenses out every night or every few days, depending on the brand and style of the contact. Recently, there has been renewed interest in orthokeratology, the correction of myopia by deliberate overnight flattening of the cornea, leaving the eye without contact lens or eyeglasses correction during the day.

Cosmetic Contact Lenses:

A cosmetic contact lens is designed to change the appearance of the eye. These lenses may also correct the vision, but some blurring or obstruction of vision may occur as a result of the color or design. In the USA, the Food and Drug Administration frequently calls non-corrective cosmetic contact lenses decorative contact lenses. These types of lenses tend to cause mild irritation on insertion, but after the eyes become accustomed, tend to cause no long term damage.

Theatrical contact lenses are a type of cosmetic contact lens that are used primarily in the entertainment industry to make the eye appear confusing and arousing in appearance, most often in horror film and zombie movies, where lenses can make one’s eyes appear demonic, cloudy and lifeless, or even to make the pupils of the wearer appear dilated to simulate the natural appearance of the pupils under the influence of various illicit drugs.

Therapeutic Contact Lenses:

Soft lenses are often used in the treatment and management of non-refractive disorders of the eye. A bandage contact lens protects an injured or diseased cornea from the constant rubbing of blinking eyelids thereby allowing it to heal. They are used in the treatment of conditions including bullous keratopathy, dry eyes, corneal ulcers and erosion, keratitis, corneal edema, descemetocele, corneal ectasis, Mooren’s ulcer, anterior corneal dystrophy, and neurotrophic keratoconjunctivitis. Contact lenses that deliver drugs to the eye have also been developed.

Wear Time:

A daily wear contact lens is designed to be removed prior to sleeping. An extended wear (EW) contact lens is designed for continuous overnight wear, typically for 6 or more consecutive nights. Newer materials, such as silicone hydrogels, allow for even longer wear periods of up to 30 consecutive nights; these longer-wear lenses are often referred to as continuous wear (CW). Generally, extended wear lenses are discarded after the specified length of time. These are increasing in popularity, due to their convenience. Extended- and continuous-wear contact lenses can be worn for such long periods of time because of their high oxygen permeability (typically 5-6 times greater than conventional soft lenses), which allows the eye to remain healthy.

Extended lens wearers may have an increased risk for corneal infections and corneal ulcers, primarily due to poor care and cleaning of the lenses, tear film instability, and bacterial stagnation. Corneal neovascularization has historically also been a common complication of extended lens wear, though this does not appear to be a problem with silicone hydrogel extended wear. The most common complication of extended lens use is conjunctivitis, usually allergic or giant papillary conjunctivitis (GPC), sometimes associated with a poorly fitting contact lens.