RGP fit (tight vs. loose)

Discussion in 'Optometry Archives' started by Charles, Jun 29, 2006.

  1. Charles

    Charles Guest

    Sorry to keep bugging the group with my RGP's, but things seem fairly
    slow anyway.

    My RGP fit, in my non-professional opinion, is on the loose side. When
    I blink they go up, then slide back down and hang low. If I turn my
    head to the side, they slide toward the ground. I expressed my concern
    to my eye doc on the follow-up check after getting the lenses, but he
    thought I should keep them this way. His rationale, as best I can
    understand, is that he didn't want to make them too tight because of
    possible irritation where the edges touch the eye.

    My vision is great in these lenses, except that I have quite a bit of
    eye watering at times, which makes vision worse. At some times of the
    day, I also get fogginess from dryness (fixable with drops). Also,
    when the lenses ride low, I get effects like light reflecting off the
    top of the lenses when going under overhead lights.

    I'm trying to decide if I should wait this out a little longer, or if I
    should go back and ask _again_ whether these should be tightened up.
    What do the group experts think are the pros and cons of tight vs.
    loose fitting RGP lenses? Do you guys agree that there are patients
    who are better off with low sagging lenses? Is there irritation
    associated with the lenses sliding around that could be contributing to
    my watery eye problem?

    Charles, Jun 29, 2006
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  2. Charles

    Dr. Leukoma Guest

    Not a problem.
    Sometimes, but not always, a low riding lens is indicative of a tighter
    fit. There's certainly nothing wrong in wanting a comfortable fit and
    a stable retinal image.

    "WHEN" the lenses ride low, meaning sometimes they don't? Sometimes,
    too much tearing can cause a lens to ride low. You mentioned dryness,
    which suggests the mechanism whereby the eye becomes dry, the dryness
    triggers corneal irritation, which triggers an episode of tearing,
    which in turn causes the lens to ride low.
    Again, it isn't clear that the lenses are too loose. But, there are
    more options these days, including larger intralimbal lenses that can
    facilitate centration, and corneascleral lenses, i.e. Macrolenses that
    always stay centered, no matter what. If you were my patient, I would
    expect you to come back in this situation.

    Dr. Leukoma, Jun 29, 2006
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  3. Charles

    Dick Adams Guest

    If you were my patient, I'd suggest a pair of simple spectacles, and, with
    a bit of luck, not having to come back for a while. Of course you would
    not be my patient, as I am not a Dr..
    Dick Adams, Jun 29, 2006
  4. Charles

    Charles Guest

    They almost always move towards low. They move somewhat slowly, so if
    I blink often, they keep moving back up and the effect isn't as
    pronounced. Towards the end of the day my eyes seem more dry and the
    lens are more likely to stick between blinks. I just put them in this
    morning and looked right away. They are riding a little low, but not
    as low as after wearing a while. They also stay in place sometimes.

    On one occasion I noticed a lens sticking a little high, so I get the
    impression that the lenses move high when I blink, then start moving
    down. Where they stop seems to depend on how "watery" my eye is at the
    Thanks for the info. I'll probably schedule another visit. I hate
    being the problem patient. I already moved on from my last eye doc
    because I started getting a feeling of "eyes rolling" when I walked in
    for repeated visits. Is RGP a specialized enough area that I ought to
    seek out an expert if I want to be picky and really nail this? I see
    so much promise for great vision with these if I could just solve these
    few little issues.

    Charles, Jun 29, 2006
  5. Charles

    Dr. Leukoma Guest

    One old technique for getting a lens to stay in place is to have it
    stay tucked up under the upper eyelid. It may be that your upper lid
    may actually be catching the upper edge of the lens, and then forcing
    it down when you blink. As well, you may be only partially blinking,
    which then never allows the upper lid to "capture" the lens and pull it
    back up.
    Sounds like you should see an expert, although I'm not versed in how
    you go about finding one. : )

    Dr. Leukoma, Jun 29, 2006
  6. Charles

    Quick Guest

    No, he wouldn't be your patient because you preach
    Zenni's and not wasting all that money on doctors at
    all -- since their sole purpose is to take your money
    right? Just some cheap experimentation on your own
    should take care of anything for half the price. Besides
    contacts are just a vanity item like those name brand
    frames and stuff. I'm sure glad your here to add balance
    to the group Dicky.

    Quick, Jun 29, 2006
  7. Charles

    CatmanX Guest

    What diameter are your lenses? If they aren't sufficiently large, they
    will give blur on blinking and side glances. Use a 10 or 10.5mm lens
    and this will get rid of the edge awareness of your vision.

    Also, the general rule is fitting large and flat (loose) but sometimes
    it can help to tighten the lens up a bit. There will be no ocular
    discomfort from going a little tighter, the edges are polished and will
    not cut into your eye.

    dr grant
    CatmanX, Jun 29, 2006
  8. Charles

    Charles Guest

    Apparently you have some anti-contact agenda. Too bad, since aside
    from my few complaints, my vision hasn't been this good in 10-15 years.
    And, incidentally, the whites of my eyes have never been whiter.

    Charles, Jun 30, 2006
  9. Charles

    Charles Guest

    Hard to say for sure, but it looks to me like my eyelid pulls it up,
    then it slides back down. When my eye first opens, it's up.
    Where are you located? I travel for business sometimes...

    Charles, Jun 30, 2006
  10. Charles

    Charles Guest

    I don't know. I don't know if it's universally this way, but no doc
    I've been too has ever volunteered my prescription. I always have to
    ask. I haven't yet asked for my full contact Rx, although I do know
    the power numbers.

    Anyway, I did ask my doc about going larger and he though it was a bad
    idea because they were hanging low, and thus the bottom edge of the
    contact would be into the white area of the eye. When I first got them
    I felt like I saw the edges in all different directions. For whatever
    reason, I now only notice the top edge when they are sagging.
    What I was told was that tight lenses cause long term "wear" at the top
    and bottom edges. Sounds like you don't necessarily agree?

    Charles, Jun 30, 2006
  11. Charles

    Neil Brooks Guest

    Dick is just one big agenda.

    Sorry if I missed this, but what were you wearing before? Glasses?
    Soft contact lenses??

    RGP lenses have a *very* high Dk rating (oxygen transmissibility). The
    last time I tried a pair--though it didn't work for me--all the
    redness disappeared from my eyes, too.

    Incidentally, the ones I tried *were* the intra-limbals mentioned
    above, and I *have* known a few people who were *quite* happy with

    The scleral might be shooting a mouse with an elephant gun in your
    case. I really don't know....
    Neil Brooks, Jun 30, 2006
  12. Charles

    Charles Guest

    Just glasses before. I tried torics a little but never had any luck
    getting consistent good vision.
    It's pretty amazing really. I had glasses before and chronic slightly
    red eyes. Maybe it's just the extra tearing induced by the lenses or
    What's the down side of these other types vs. the run of the mill?
    Just cost?

    Charles, Jun 30, 2006
  13. Charles

    drfrank21 Guest

    A lens that is too steep/tight can "lock" on the
    cornea and cause lens adhesion which aint
    good. There are various fitting strategies
    that can work equally well- I try to get
    an upper lid fit (sup edge tucked under
    the lid) for best comfort for most

    drfrank21, Jun 30, 2006
  14. Charles

    Dr. Leukoma Guest


    Dr. Leukoma, Jun 30, 2006
  15. Charles

    Neil Brooks Guest

    Charles replied:
    Here's where I bow out to the docs for real answers.

    From my limited knowledge, there's not much downside to the

    http://www.lensdynamics.com/Irregular Corneals/Dyna Z Intra-Limbal.htm

    OR: http://tinyurl.com/zqo8e

    or the MacroLens:




    [I don't like their site particularly. Difficult to find ready info,

    The "however" is: it's quite possible that there are larger diameters
    available for the lens you are wearing ... if that turns out to be the
    issue (rather than fit or design).

    Again ... above my pay grade ;-)

    Doc's? If you would??

    [scuse me]
    Neil Brooks, Jun 30, 2006
  16. Charles

    acemanvx Guest

    You have some options there.

    1. If you want to stick with RGP contacts, try a different size and
    base curve. A scaral lens would stay put but its so huge its scary to
    put in your eye!
    2. Go back to glasses. This might not be easy if your pescription is
    high with lots of astigmastim due to spectacle minification and
    3. If you are totally fed up with RGP contacts and really hate glasses,
    theres laser surgury. Its not without risks and trade-offs. You will
    NOT see anywhere as well as you do with RGPs and probably not even as
    well with glasses. But itll greatly improve your uncorrected vision and
    should give you vision good enough to function. Great if you arent too
    picky about perfect vision and just want to ditch those irritating
    acemanvx, Jul 1, 2006
  17. Charles

    Neil Brooks Guest


    Fair warning: Ace woke up in a meadow some years ago ... after a
    tremendous binge on hallucinogenic mushrooms ... and now seems to
    think he's an optometrist.

    Be afraid.

    Be very afraid.
    Neil Brooks, Jul 1, 2006
  18. Charles

    acemanvx Guest

    LOL silly doctor Brooks! I wish I were one, but I am not a doctor.
    acemanvx, Jul 1, 2006
  19. Charles

    Charles Guest

    Don't worry, I read ace's posts for amusement purposes only.

    Charles, Jul 1, 2006
  20. Charles

    Ann Guest

    Ace, you need to go and do something useful in society. We know
    you're a bit odd.. probably got Aspergers like half those on usenet
    but still there must be something you can do. Quit sitting at home
    and surfing the internet.
    Ann, Jul 1, 2006
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