If you tried contact lenses years ago and disliked them, it may be time to take another look. Contacts not only have become more comfortable, but you can wear them even if you have dry eyes or presbyopia, also known as the aging eye condition (not to mention the fact that you’ll look more like Superman than Clark Kent).
“The vast majority of people are good candidates for contact lenses,” says Edward S. Bennett, executive director of the GP Lens Institute and a professor at the University of Missouri-St. Louis College of Optometry. “A lot of the resistance comes from fear or anxiety, but when a trained assistant shows you how to put them in and take them out, you realize it’s pretty easy.”
There are many effective options for people over age 50 these days, including:
Soft lenses. More than 90 percent of adult contact lens wearers use soft lenses. The most popular are made with plastics called silicone hydrogel polymers: Up to five times more oxygen flows through these lenses compared to older hydrogel lenses, says Samuel D. Pierce, president of the American Optometric Association (AOA). (Oxygen is important for healthy corneas.)
Daily disposable soft lenses can even relieve dry-eye issues in some older adults. As we age, our eyelids become less elastic, and they don’t completely shut when we blink. The constant exposure to air robs eyes of moisture, but “contacts help seal in moisture, thus keeping the eyes from drying out,” says Pierce. And when you throw out your lenses each day, less debris builds up, which improves comfort.
Hard lenses. Also known as gas permeable lenses (GPs), hard lenses have some benefits: They provide sharp vision, they’re durable, and oxygen easily flows through them. “They provide better vision than a soft lens, and your vision at all distances is as good or better than what you see out of glasses,” says Bennett, who has worn hard lenses for 51 years. The downsides? GPs can require more time to feel comfortable and they’re less likely to stay in place. They’re also more expensive than soft disposable lenses, though they last an average of two years.
Hybrid contact lenses. They provide the comfort of a soft lens with the strong optics of a hard lens. Hybrids have never caught on, possibly because the lenses are more difficult to fit and more expensive to replace, according to Liz Segre, founding editor of AllAboutVision.com.
Multifocal lenses. Multifocals correct nearsightedness and farsightedness, and some will correct astigmatism. “The designs have improved to provide better vision, and you can dispose of them as much as every day if your prescription allows that,” says Bennett.
Candidates for multifocal lenses include presbyopic patients who wear glasses, people who wear contacts but also use reading glasses, and those who wear monovision contact lenses, according to the AOA. With monovision, one lens is for distance and the other is for seeing up close. For some people, however, the results can be blurry. Multifocal lenses are also better for seeing at night and for people who spend long hours using digital devices, writes optometrist Kristopher A. May in Optometry Times.
Lenses for dry eyes. Multiple manufacturers produce contacts specifically for people who suffer from dry eyes. The lenses typically retain moisture longer than regular contacts and have a high water content. Ask your optometrist about the options. If you have really dry eyes, you might be a candidate for scleral lenses, a type of large GP lens that covers the entire cornea (it’s also available as a multifocal lens).
“The scleral lenses are bathed in fluid, and that’s a huge benefit,” says Bennett. Scleral lenses also can help treat corneal disease.
Hygiene Tips for Contact Lens Wearers
1. Don’t sleep in your contacts. On a two-day hunting trip, a 59-year-old man wore his soft contact lenses while sleeping. He developed eye pain the next day and eventually needed surgery for a perforated corneal ulcer. Another man, age 57, wore soft contact lenses continuously for two weeks. He was diagnosed with an infection of the cornea — and needed transplant surgery to save his right eye. These are two of six case studies published in an August 2018 report by the Centers for Disease Control and Prevention (CDC) on corneal infections and sleeping while wearing contacts. One in three contact lens wearers keep their lenses on while sleeping or napping, which can increase the risk of eye infections by six to eight times. Poor hygiene is also a problem: 45 percent of adults replace lenses at longer-than-prescribed intervals, the CDC reports, and between 40 and 90 percent of contact lens wearers do not follow proper hygiene instructions, according to the AOA.
2. Get a prescription. Contact lenses are FDA-approved medical devices, and in the CDC report, three of the six infection cases involved lenses that were purchased without a prescription. Lenses bought from online vendors or other questionable sources can cause bacterial infections, allergic reactions, and even “significant damage to the eye's ability to function,” says Pierce.
3. Keep lenses away from water. Planning to swim or shower while wearing contacts? Bad idea. Germs in the water can stick to your lenses and cause infection, the CDC notes.
4. Use fresh contact solution. Mixing new solution with old solution can reduce its effectiveness as a germ killer. And never rinse your lenses with water or — yuck — saliva. Another germ-busting tip: Replace your contact lens case at least every three months.
5. Wash your hands. Lather up with soap and water, then thoroughly dry your hands before touching your lenses. Always.
6. Undergo an annual eye exam. This becomes even more important as we age, since other health problems can also affect vision. “People with diabetes or hypertension, or who are taking medications that have eye-related side effects, are at greatest risk for developing vision problems,” says Pierce. “Many eye diseases have no early symptoms. They may develop painlessly, and [people] may not notice the changes to vision until the condition is quite advanced.”