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biscuit
medicine forum Guru Wannabe
Joined: 24 Apr 2005
Posts: 296
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 Posted: Thu Jun 29, 2006 12:52 am Post subject:
RGP fit (tight vs. loose)
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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?
-- |
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Dr. Leukoma
medicine forum Guru
Joined: 30 Apr 2005
Posts: 1283
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| Posted: Thu Jun 29, 2006 11:52 am Post subject:
Re: RGP fit (tight vs. loose)
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Charles wrote:
| Quote: | Sorry to keep bugging the group with my RGP's, but things seem fairly
slow anyway.
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Not a problem.
| Quote: |
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.
|
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.
| Quote: |
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.
|
"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.
| Quote: |
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?
|
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.
DrG |
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Dick Adams
medicine forum Guru
Joined: 12 Oct 2005
Posts: 300
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| Posted: Thu Jun 29, 2006 12:31 pm Post subject:
Re: RGP fit (tight vs. loose)
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"Dr. Leukoma" <drg@leukoma.com> wrote in message news:1151581970.144272.206690@75g2000cwc.googlegroups.com...
| Quote: |
Charles wrote:
Sorry to keep bugging the group with my RGP's ...
[ ... ]
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.
|
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..
--
Dicky |
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biscuit
medicine forum Guru Wannabe
Joined: 24 Apr 2005
Posts: 296
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| Posted: Thu Jun 29, 2006 12:55 pm Post subject:
Re: RGP fit (tight vs. loose)
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Dr. Leukoma wrote:
| Quote: |
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.
"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.
|
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
time.
| Quote: |
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?
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.
|
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.
-- |
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Dr. Leukoma
medicine forum Guru
Joined: 30 Apr 2005
Posts: 1283
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| Posted: Thu Jun 29, 2006 1:02 pm Post subject:
Re: RGP fit (tight vs. loose)
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Charles wrote:
| Quote: |
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
time.
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.
| Quote: |
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.
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Sounds like you should see an expert, although I'm not versed in how
you go about finding one. : )
DrG |
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Quick
medicine forum Guru
Joined: 19 Jun 2005
Posts: 343
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| Posted: Thu Jun 29, 2006 6:09 pm Post subject:
Re: RGP fit (tight vs. loose)
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Dick Adams wrote:
| Quote: | "Dr. Leukoma" <drg@leukoma.com> wrote in message
news:1151581970.144272.206690@75g2000cwc.googlegroups.com...
Charles wrote:
Sorry to keep bugging the group with my RGP's ...
[ ... ]
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.
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..
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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 |
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CatmanX
medicine forum Guru
Joined: 17 May 2005
Posts: 367
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| Posted: Thu Jun 29, 2006 9:10 pm Post subject:
Re: RGP fit (tight vs. loose)
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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 |
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biscuit
medicine forum Guru Wannabe
Joined: 24 Apr 2005
Posts: 296
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| Posted: Thu Jun 29, 2006 11:40 pm Post subject:
Re: RGP fit (tight vs. loose)
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Dick Adams wrote:
| Quote: |
"Dr. Leukoma" <drg@leukoma.com> wrote in message
news:1151581970.144272.206690@75g2000cwc.googlegroups.com...
Charles wrote:
Sorry to keep bugging the group with my RGP's ...
[ ... ]
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.
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..
|
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.
-- |
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biscuit
medicine forum Guru Wannabe
Joined: 24 Apr 2005
Posts: 296
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| Posted: Thu Jun 29, 2006 11:41 pm Post subject:
Re: RGP fit (tight vs. loose)
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Dr. Leukoma wrote:
| Quote: |
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.
|
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.
| Quote: |
Sounds like you should see an expert, although I'm not versed in how
you go about finding one. : )
DrG
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Where are you located? I travel for business sometimes...
-- |
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biscuit
medicine forum Guru Wannabe
Joined: 24 Apr 2005
Posts: 296
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| Posted: Thu Jun 29, 2006 11:46 pm Post subject:
Re: RGP fit (tight vs. loose)
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CatmanX wrote:
| Quote: | 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.
|
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.
| Quote: | 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.
|
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?
-- |
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Neil Brooks
medicine forum Guru
Joined: 24 Mar 2005
Posts: 1148
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| Posted: Thu Jun 29, 2006 11:51 pm Post subject:
Re: RGP fit (tight vs. loose)
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On Thu, 29 Jun 2006 23:40:04 GMT, "Charles" <nospam@nospam.com> wrote:
| Quote: | Dick Adams wrote:
"Dr. Leukoma" <drg@leukoma.com> wrote in message
news:1151581970.144272.206690@75g2000cwc.googlegroups.com...
Charles wrote:
Sorry to keep bugging the group with my RGP's ...
[ ... ]
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.
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..
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.
|
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
Macrolenses.
The scleral might be shooting a mouse with an elephant gun in your
case. I really don't know.... |
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biscuit
medicine forum Guru Wannabe
Joined: 24 Apr 2005
Posts: 296
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| Posted: Fri Jun 30, 2006 12:07 am Post subject:
Re: RGP fit (tight vs. loose)
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Neil Brooks wrote:
| Quote: |
Sorry if I missed this, but what were you wearing before? Glasses?
Soft contact lenses??
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Just glasses before. I tried torics a little but never had any luck
getting consistent good vision.
| Quote: | 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.
|
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
something?
| Quote: | Incidentally, the ones I tried were the intra-limbals mentioned
above, and I have known a few people who were quite happy with
Macrolenses.
The scleral might be shooting a mouse with an elephant gun in your
case. I really don't know....
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What's the down side of these other types vs. the run of the mill?
Just cost?
-- |
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drfrank21@gmail.com
medicine forum addict
Joined: 17 Sep 2005
Posts: 69
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| Posted: Fri Jun 30, 2006 12:09 am Post subject:
Re: RGP fit (tight vs. loose)
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Charles wrote:
| Quote: | 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?
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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
patients.
frank |
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Dr. Leukoma
medicine forum Guru
Joined: 30 Apr 2005
Posts: 1283
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| Posted: Fri Jun 30, 2006 12:22 am Post subject:
Re: RGP fit (tight vs. loose)
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Charles wrote:
| Quote: |
Where are you located? I travel for business sometimes...
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http://www.copfameye.com
DrG |
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Neil Brooks
medicine forum Guru
Joined: 24 Mar 2005
Posts: 1148
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