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Specialty Contact Lens Fittings

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Why Health Professionals Refer Patients To Us For Customized Contact Lens Fittings

Richmond Hill Optometric Clinic is a contact lens practice that continues to develop great relationships with other practitioners around the Richmond Hill area. We work with corneal specialists and other physicians to offer a continuum of care for their patients with corneal irregularities by providing advanced custom contact lens fittings, even for the most hard-to-fit patients.

Our training and expertise in the area of scleral and other custom-fit contact lenses is the primary reason that other healthcare professionals refer to our practice.

We’re Here For Your Patients

The health care professionals you choose to refer your patients to matters.

You want your patients to visit a practice where they’re offered world-class eye care, professionalism and empathy. That’s why we do the utmost to ensure a quality experience for all of the patients you refer.

We know that patients want to be heard. We set aside time to discuss and evaluate their needs.

Your patients deserve safe and effective treatment, which is why the treatment we provide is evidence-based and utilizes the most advanced technology — all with utmost professionalism and care.

List of Common Corneal Conditions

We evaluate, diagnose and recommend treatment for all types of corneal conditions, including:

  • Keratoconus/Keratoglobus
  • Post LASIK/RK/PRK Ectasia
  • Post PK/INTACS/DMEK/DALK/DSAEK, etc.
  • Post Corneal Cross Linking
  • Corneal Dystrophies, such as Fuchs’ and Map-dot-fingertip corneal dystrophy
  • Severe Ocular Surface Disease (OSD)
  • Aniridia, ICE Syndromes and Trauma
  • Corneal Scarring

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Why Scleral Contact Lenses?

The many benefits of scleral lenses render them a popular and satisfying choice for patients with corneal irregularities who desire clear and comfortable vision.

Custom-designed scleral lenses help patients with a range of corneal conditions achieve dramatic improvements in visual acuity and comfort. The lenses’ oxygen-permeable and fluid-filled chamber protects the eye while providing the moisture and oxygen it needs to stay healthy. This makes scleral lenses the best choice for promoting corneal healing.

Case Studies

Here are a few examples showing the typical patient presentations and the successful outcomes.

*These patient testimonials are meant to reflect actual testimonials of patients but not necessarily our patients.

Post Corneal Graft

Patients with keratoconus or corneal transplants can see clearly by wearing scleral contact lenses; they are the safest and best way to correct vision for irregular astigmatism. Following a corneal transplant, the cornea should not come in contact with a contact lens. This makes scleral lenses the optimal solution, as they vault over the cornea without touching it directly.

John came to our practice seeking a solution for his keratoconus, which affected both of his eyes. He had recently undergone a corneal transplant and had a corneal graft for his keratoconus.

In order to improve John’s visual acuity, we did the following:

We took a topography reading of 11,000 points on each cornea and then designed the lens to individually match all 11,000 points of the patient’s corneas. Because he had a corneal transplant, it was crucial that the lens not touch any part of the graft to ensure maximum comfort.

OCT images were used to measure the clearance in microns, between the back surface of the scleral lens and the front surface of the cornea. This maintains a healthy graft while wearing the contact lenses.

As a result, John was able to achieve 20/25 vision in both eyes. He now has clear, comfortable vision all day and is very pleased with his scleral lenses.

Post LASIK Complications

While LASIK surgery has a high success rate, some patients come out of the surgery with imperfect vision.

Debbi’s primary concern was the reduced visual acuity following refractive laser surgery.

Unfortunately, her post-LASIK resulted in sub-optimal vision. Her LASIK surgeon recommended an enhancement procedure to improve her vision, which led her to undergo subsequent LASIK surgeries. Unfortunately, these attempts left her with extremely poor vision in each eye, and Debbi was desperate to find a solution to her vision problems.

Debbi arrived at our practice after hearing that we specialize in helping people achieve clear vision following poor LASIK results. A comprehensive eye exam found that Debbi’s eyes had a very high prescription and irregular astigmatism following her surgery.

Her best option was to wear scleral lenses as they would correct her astigmatism and farsightedness and were perfectly safe for her corneas, which after multiple surgeries, were scarred.

Since getting fitted for her custom-designed scleral lenses, Debbi is thrilled with how sharp and comfortable her vision has become.

Post-Radial Keratotomy Surgery Complications

Many patients underwent radial keratotomy (RK) surgery to correct myopia and astigmatism during the early days of refractive surgery. Such patients sometimes experienced some refractive error in the form of nearsightedness, farsightedness, or irregular astigmatism. Those with irregular astigmatism experience blurred, distorted vision that cannot be corrected with glasses. These are among the more serious and frequently occurring complications following corneal refractive surgery.

Matthew, a 52-year-old teacher, underwent bilateral RK surgery in 1995. Though the initial results were positive, within two years his vision deteriorated. He developed corneal ectasia, and complained of blurred vision, discomfort and red eyes when wearing contact lenses.

The slit-lamp examination revealed damaged corneas that had severe staining along the incision lines and around the cornea at the limbus. This was a result of the fit of the GP lenses he was wearing at the time. These lenses were touching the anterior elevations of the cornea and did not allow for enough tear exchange.

Fitting a scleral lens was the best option to treat Matthew’s damaged corneas, alleviate discomfort and improve his vision.

At the one-year visit the patient had improved visual acuity and quality. The fitting of a well-designed semi-scleral GP contact lens filled with a saline solution created a healthy environment behind the lens, which in turn allowed the cornea and limbus to heal. The scleral lenses also helped protect the RK incisions from further abrasions caused by blinking.

As this case demonstrates, patients who developed irregular corneal surfaces following refractive surgery can benefit from a customized scleral contact lens designed to improve their wearing comfort and vision.

Who We Work With

We work with many practitioners including:

  • Family doctors
  • Local hospitals
  • Optometrists
  • Ophthalmologists
  • Corneal specialists

Feel free to contact us for more information or with any inquiries. We look forward to providing your referred patients with world-class eye care.

Our practice serves patients from Richmond Hill, Markham, North York, and Vaughn, Ontario and surrounding communities.
Request A Scleral Lens Appointment Today
Can Scleral Lenses Help You? Find Out! 833-700-2133

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Choosing an Optometrist vs. an Ophthalmologist for Contact Lenses

If you need new contact lenses or are thinking of trying them out for the first time, who do you turn to? An optometrist or an ophthalmologist? To know with whom to set up an appointment, it’s important to understand the differences in eye care professionals.

The Difference Between Ophthalmologists and Optometrists

What is an Ophthalmologist?

An ophthalmologist is a medical doctor (MD) who examines eyes and performs vision-related surgical procedures. Ophthalmologists generally complete 4 years of college, 4-5 years of medical school, one year of internship, and at least three years of residency in ophthalmology. Their advanced medical training provides them with the expertise to diagnose eye diseases, offer treatments, conduct scientific research on vision disorders, and prescribe medication.

Though ophthalmologists can fit patients with eyeglasses and contact lenses, they often refer their patients to an optometrist on their team to correct any refractive errors, such as myopia (nearsightedness), hyperopia (farsightedness), astigmatism, or presbyopia (farsightedness related to aging). Optometrists are usually the ones to screen patients for LASIK and work alongside LASIK surgeons to coordinate the surgery.

What is an Optometrist?

optometrist caucasian od bigAn optometrist is a healthcare professional who has earned the Doctor of Optometry (OD) degree. Optometrists have to complete a four-year college degree program in the sciences coupled with four years of post-graduate professional training in optometry school.

Optometrists examine eyes for vision and health problems, diagnose and treat certain eye diseases and conditions, and prescribe and fit patients with glasses or contacts for common refractive errors. Certain optometrists provide alternative services, such as vision therapy, low vision care, dry eye treatment and myopia control. Optometrists can also provide pre- and post-surgery care, such as LASIK, PRK, corneal transplant, among others.

Optometrists in the United States are licensed to prescribe medications for certain eye conditions and diseases, though the scope of medical care that they can provide varies from state to state.

Why Choose an Optometrist?

If your eyes are healthy and don’t require specialized surgical treatment, visiting an optometrist is the obvious choice. Moreover, beyond performing routine eye exams, optometrists can detect, diagnose and manage eye diseases that require medical and non-medical treatment.

These treatments include, but are not limited to:

Dry Eye Treatment, Vision Therapy, Low Vision Management, Myopia Control, Specialty Contact Lens Fitting, Management and/or treatment of various corneal conditions and irregularities.

Think of your optometrist as a primary care physician for your eyes. When in need of a routine eye check-up, or if you’re dealing with an eye condition or notice your vision changing, it’s time to visit the optometrist.

If you’re interested in fitting specialty or traditional contact lenses to aid with specific eye conditions or misshapen corneas, Dr. Radhika Chawla at the Richmond Hill Optometric Clinic and Keratoconus Center can help.

Fitting Contact Lenses

Girl Putting in Contact 1280×853Whether you’re a first-time lens wearer or you’ve recently had a prescription change, it’s essential to ensure a proper fit. When lenses are not properly fitted, it can prove to be uncomfortable and can lead to vision problems, infections, or scarring. That’s where we come in.

To ensure a proper contact lens fitting, Dr. Radhika Chawla will perform a comprehensive eye exam to check your level of refractive error and will also check for any conditions that could interfere with wearing contact lenses. The shape of your eye and personal lifestyle are also important factors in determining the right lens for you. If you spend a significant amount of time outdoors or lead an active lifestyle, that may require a different lens type. Following a proper assessment, the doctor will ensure the best fit for your eyes and overall vision health.

Moreover, your optometrist will show you how to insert and remove lenses, and generally, how to properly care for them. Additional follow-up appointments may be needed in order to monitor and assess the fitting and overall comfort level.

Specialized in fitting traditional and specialty contact lenses, Dr. Radhika Chawla find the proper fit for all patients, from the simple near-sighted first-time wearer to the complex astigmatic, bifocal or diseased cornea patient. Visit us at the Richmond Hill Optometric Clinic and Keratoconus Center for a contact lens fitting.

Our practice serves patients from Richmond Hill, Markham, North York, and Vaughn, Ontario and surrounding communities.
Request A Scleral Lens Appointment Today
Can Scleral Lenses Help You? Find Out! 833-700-2133

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Are There Other Contact Lens Alternatives?

Several eye conditions and diseases can make it hard, even impossible, to wear standard contact lenses. For patients who suffer from these conditions, achieving clear vision can be difficult. That’s where scleral contact lenses and other specialty contact lenses come in.

Below you’ll find information about some of the other contact lenses we offer that are suitable for hard-to-fit eyes. Please contact us if you think any of these options would be suitable for you, or if your current lenses are giving you any trouble.

Our practice serves patients from Richmond Hill, Markham, North York, and Vaughn, Ontario and surrounding communities.
Request A Scleral Lens Appointment Today
Can Scleral Lenses Help You? Find Out! 833-700-2133
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Are Your Contact Lenses Uncomfortable?

Most people are familiar with the traditional soft lenses which provide clear vision for those with nearsightedness (myopia), farsightedness (hyperopia), or astigmatism. In certain cases, particularly for those with corneal irregularities or astigmatism, Gas Permeable (GP), Rigid Gas Permeable (RGP) or Scleral Lenses are recommended.

Some people experience discomfort when wearing gas permeable lenses. For those patients, scleral lenses may be a more successful alternative.

What Are Gas Permeable Contact Lenses?

Modern-day hard contact lenses often provide sharper vision than eyeglasses or soft contact lenses. Gas permeable lenses are made of hard plastic materials and are called ‘permeable’ because they transmit oxygen to the cornea, thus keeping it healthy. GP lenses are ideal for individuals with astigmatism that may have been told that they cannot wear soft contact lenses.

The rigid nature of the lens holds its shape on the eye, which allows for more clear and stable vision correction. Though it takes a little bit of time to get used to wearing GP contacts, the clarity of vision and durability that these lenses provide make it worthwhile. Gas permeable lenses are uniquely fitted to each patient and take about a week to manufacture.

What are Scleral Contact Lenses?

Custom designed scleral lenses help patients with sensitive eyes or corneal irregularities achieve dramatic improvements in visual acuity and comfort. Scleral lenses vault over the cornea and rest on the sclera instead. This creates a new optical surface and prevents discomfort by minimizing irritation to the cornea. Moreover, the reservoir of pure saline solution between the back surface of the lens and the front of the cornea ensures that the eye is always in a liquid environment – making it optimal for health and comfort. This unique design makes scleral lenses the ideal lens for comfort, sharp vision and healthy eyes.

We recommend scleral lenses for the-hard-to-fit eyes, those with keratoconus, or astigmatism, or for people with a medium-high astigmatism that other contacts can’t comfortably correct. Scleral lenses are also perfect for anyone wanting to wear comfortable lenses while keeping eyes hydrated all day.

Below are the advantages and disadvantages of wearing GP lenses. This information can better assist you in making a better decision with regards to whether to choose one over the other.

What are the Advantages and Disadvantages of Wearing Gas Permeable Lenses?

Advantages of Gas Permeable Contact Lenses

Gas permeable contact lenses have a number of distinct advantages over typical soft contact lenses. In many instances of various eye conditions, a GP contact is required as soft contacts will not be comfortable or deliver the vision correction required. Here are some advantages.

Health & Hygiene

close eye with scleral lenseBecause these lenses are oxygen permeable, they provide the wearer with better comfort and a healthy cornea. Their ability to transmit oxygen reduces eye problems, such as dry eyes, which is caused by diminished oxygen transmission to the cornea – common among most soft lens’ brands or hard (non-GP) lenses.

GP lenses are made from a firm plastic material and retain their shape when you blink. This tends to provide sharper vision than pliable soft lenses and are extremely durable; unlike soft contact lenses, they don’t tear easily. They are easy to clean and disinfect, and when properly cared for, a pair can last a year or more.

Gas permeable lenses are made of materials that do not contain water and thus don’t absorb water from your eyes. Moreover, they harbor fewer protein and lipid deposits from your tear film than other contact lenses do, which renders these lenses a more hygienic and healthier alternative for your eyes.

Enhanced Comfort With Scleral Lenses

GP lenses have a smaller diameter than soft contacts, meaning that they cover less of the surface of your eye. While this may take some time to get used to initially, ultimately, many wearers may find that these lenses become comfortable over time.

Improved Visual Clarity

Due to their rigid material, GP lenses have a smooth surface and maintain their shape, moving along with the eye to hold their place. This provides sharp and stable vision. Furthermore, because they do not dehydrate, they don’t cause reduced vision, which is usually the case with traditional contact lenses. GP lenses can be worn on all eyes, but are particularly fitting for those with astigmatism or bifocal needs.

Cost of Gas Permeable Lenses

GP lenses are durable and long-lasting. Though costs are initially higher than traditional contact lenses, in the long term they are more cost-effective, and unlike disposable lenses, they don’t require ongoing replacement.

So why doesn’t everyone wear gas permeable lenses? Primarily because soft lenses are instantly comfortable, whereas GP lenses require an adaptation period before they reach the same level of comfort.

Disadvantages of Gas Permeable Contact Lenses

Sometimes, whether due to sensitivity, corneal irregularities, or various eye conditions, a gas permeable contact lens isn’t the ideal solution and scleral lenses may be required or preferred.

Requires an adaptation period

To achieve maximum comfort with GP lenses, you need to wear them regularly. If not worn for a week, you’ll require a few days to adapt and get comfortable wearing them again. This distinguishes them from soft contact lenses, which, even if not worn for a long period of time, are comfortable upon insertion.

Unstable on the eye

GP lenses are smaller in size than soft lenses, which means that they are sometimes prone to shifting or popping out. If stability is essential, scleral lenses are a better bet.

Dust and debris

Happy Girl Fingers Near Eyes 1280x853Because gas permeable lenses move on the eye with every blink, there is a higher risk of dust and debris getting lodged under the lenses. This can lead to discomfort and potential corneal abrasion.

If you’ve tried gas permeable lenses and have experienced any of the above, or if you’re seeking a more comfortable alternative to wear all day, it’s worth looking into scleral lenses.

Visit us to find out how scleral lenses can be a better option for you. At the Richmond Hill Optometric Clinic and Keratoconus Center, our eye doctors specialize in fitting custom contact lenses, including sclerals, which provide excellent, effective vision correction for many hard-to-fit eye conditions, such as keratoconus and irregular corneas. We also recommend scleral lenses for astigmatism, when other types of contacts don’t work well.

We fit sclerals for patients from the Richmond Hill area, as well as Markham,North York, Vaughn and throughout Ontario.

What are the Benefits of Wearing Scleral Lenses?

Scleral lenses provide the very best level of comfort, visual acuity and stability.

Stable Vision

With scleral lenses, you’ll experience consistently clear vision. Their large diameter ensures that they stay centered and stable on your eye. Their size also prevents scleral lenses from popping out easily, even if you play sports or lead a very active lifestyle.

Long-Lasting Lenses

Constructed from high quality, durable materials, these gas permeable lenses typically last for the long haul. Therefore, while the initial cost of scleral lenses may be higher than standard contacts, you’ll benefit from the maximum value for your money.

Safe and Easy-to-Use

The large size and rigid material make scleral lenses much easier to insert and remove from your eyes. These features also reduce the risk of accidentally injuring your cornea while you handle your lenses.

Comfort for Dry Eyes

While the scleral lenses vault over your cornea, they contain a pocket filled with moisturizing tears. This wet, lubricating cushion offers a very comfortable wearing experience, as well as healthier eyes. In addition, because sclerals don’t touch your corneal surface, rubbing is [minimized] and your risk of corneal abrasions is drastically diminished.

Wide Visual Field

The wide optic zone provides wearers with a wider, more precise peripheral vision. They also reduce sensitivity to glare and light.

Cost-effective

Scleral lenses are custom-fit to each eye. Though the fees for fitting sclerals and the cost of the lenses are higher than standard lenses, their life span and benefits make the cost worthwhile.

Though coverage rates and restrictions vary among providers, if considered a medical necessary, most insurance companies will reimburse the cost of scleral lenses. Consult with our eye care team at the Richmond Hill Optometric Clinic and Keratoconus Center to discuss your specific payment options and cost of scleral lenses.

Are Scleral Lenses Better Than Gas Permeable Lenses?

In terms of comfort, visual clarity and stability, scleral lenses are superior to gas permeable lenses. In cases of corneal irregularity or severe sensitivity, scleral lenses are often the only viable option. However, they are more costly than GP lenses as well.

The question of which contact lens is best for you should ultimately be decided in conversation with us. Trained in fitting specialty contact lenses of various types, from the simple near-sighted first-time wearer to the complex astigmatic, bifocal or distorted cornea patient, Dr. Radhika Chawla will consult with you about your best options.

Our practice serves patients from Richmond Hill, Markham, North York, and Vaughn, Ontario and surrounding communities.
Request A Scleral Lens Appointment Today
Can Scleral Lenses Help You? Find Out! 833-700-2133