Contact Lens Fitting vs. Eye Exam (2022 Ultimate Guide)

Contact lenses are not one-size-fits-all. When we visit our optometrist for a new pair of glasses, we’re used to having our glasses meticulously fit. The frames are adjusted to the bridge of our nose, the lenses are centralized to the middle of our eyes, and the arms of the frame are adjusted to sit properly on our ears. A similar type of precision is needed to properly fit contact lenses as well.

Even those of us that are full time glasses wearers, we do still occasionally rely on contacts — whether it be for sports, convenience, lifestyle, or otherwise. For all contact lens wearers, a contact lens fitting is vital to ensure that the lenses fit each eye properly, your vision is good for distance and near, and your eye health is maintained. 

So what does that mean for your annual optometrist visit?

What’s the Difference Between an Eye Exam and a Contact Lens Exam?

What Is a Comprehensive Eye Exam?

An eye exam is not the same as a contact lens fitting. If you currently wear contacts, or would like to start, you need both an eye exam (a complete assessment of your refractive status, binocular system and eye health) and a contact lens fitting.

A comprehensive eye exam is performed by an eye doctor, also known as an optometrist, and is the primary source of eye care. Similar to a physical, we look at your entire visual system and ocular health. A comprehensive eye exam provides our optometrists a close-up look at your ocular tissue, blood vessels, nerves and visual pathway, all of which may contain clues to conditions that could pose a serious risk to your health. Depending on your personal health history and other factors, our comprehensive eye examination may include a variety of assessments and tests. Learn more here.

What Is Involved in Contact Lens Fitting?

Your eye doctor will measure the curvature of the cornea (the front surface of the eye) to check that the curve of the contact lens properly fits the curve of your eye. A keratometer, topographer or autorefractor can be used to measure the curvature to determine what the appropriate curve is for your contact lenses.

Sounds simple right? In the hands of an optometrist it is, but there is much more involved to ensure an appropriate fit. Once the right curve is chosen, the contact lens is placed on the eye and assessed. We are looking to see if the contact lens is centered on the eye, how blinking affects the contact lens movement and most importantly, how well you can see in the distance and near with each eye. Contact lens fitting is vital for your long term eye health, vision and comfort when wearing contact lenses routinely.

Contact Lens Fitting

Is a Contact Lens Fitting Necessary?

Yes! Imagine getting a new pair of glasses but the frame is too wide so it continuously slips off the bridge of your nose. Or the arms are too short to reach behind your ear, skewing how the glasses fit on your face and hindering your vision. The same can happen with improperly fitted contact lenses. Poorly fit contact lenses can lead to a myriad of issues such as blurry vision, eye strain, headaches, red or dry eyes and infection. 

A contact lens fitting is even more crucial if you have been diagnosed with any of the following:

  • Nearsightedness (Myopia). Distant objects are blurry. When your cornea curves too sharply or your eyeball is too elongated, light rays focus in front of your retina and this results in distance vision blur.
  • Farsightedness (Hyperopia). Nearby objects are blurry. When your cornea is too flat or your eyeball is underpowered, light focuses behind the retina instead of on it, resulting in blurry near vision,
  • Astigmatism. When the cornea curves or flattens unevenly, it disrupts the focusing ability for near and distant vision, causing overall blurry vision.

All of the above are considered refractive errors which are classified as very common eye disorders that are a result of your eyes shape, power and genetic composition. In fact, astigmatism is one of the most common vision problems that impacts more than 150 million Americans.

If your eye has a curvature imperfection (or more oval shaped), light is angled more in one direction than another and this provides only partial focus on an object. This curvature and non-ideal refraction of light, causes objects to look blurry, wavy or distorted. In order for your contacts to be able to counteract this imperfect curvature, you need a contact lens fitting to ensure an appropriate fit.

Contact Lens Fitting

How Long Does a Contact Fitting Take?

The great news is that most contact lens fittings can be combined with your comprehensive eye exam and it only adds about 10 minutes to your appointment. More time will be needed for first time wearers or those being fit in multifocal contacts.

What Happens if You Wear the Wrong Size Contact Lenses?

  • Dislodged Contact. If the diameter (width of the contact lens) is too wide or the base curve is too flat, the contact lens will fit loose on your eye and can slip out of place or dislodge when you blink or rub your eyes. 
  • Discomfort. If the diameter is too small or the base curve is too steep, this will result in a tight fit and will cause discomfort.
  • Scratched Eye. The wrong size lenses can cause an abrasion on your cornea. This is why it is not recommended to swap coloured contact lenses with friends. 
  • Reduced vision. Improperly fit contact lenses can cause lipid or protein deposit accumulation over time — even if you properly clean and care for your lenses. While protein build up in your eye doesn’t sound so bad, excessive amounts can lead to discomfort, reduced vision and increased risk of infection.
Contact Lens Fitting

How Can You Tell if Your Contacts Are Not the Right Size?

If you can constantly feel your contact lenses, also known as “lens awareness”, it could mean they are poorly fitted. Lenses come in all shapes, sizes, diameters and curvatures. If you feel like there is always something in your eye or your eyes are always red with contact lenses on, the lens diameter or base curve could be incorrect and need to be adjusted. 

The top types of contact lens discomfort include:

  • Stinging, burning, and itchy eyes
  • Feeling like something is in your eye
  • Excessive tearing
  • Abnormal eye secretions
  • Eye redness
  • Disrupted vision
  • Blurry vision or halos around objects
  • Light sensitivity 
  • Eye strain or headaches
  • Dry eyes

If You Notice Any of These Symptoms, Here’s What You Need to Do

  1. Don’t Wait, Immediately Remove Your Lenses. Your lens may be damaged, have dirt, an eyelash, or another foreign body that is irritating your eye. Clean, rinse, and disinfect the lens before reinserting it. 

If the problem persists after you’ve cleaned the lens, immediately remove it and consult your Burnaby optometrist. 

2. Seek Professional Help. Remove your lenses, put on your glasses and immediately seek help from your optometrist to avoid risk of infection and any permanent damage to your vision and eyes.