Contact lenses came up several years ago with the aim of improving patients’ quality of life and, in some cases, even making their vision better. Contact lenses must be adapted by contactology specialists who, before giving their adaptation approval, take into account not only optical parameters (corneal diameter and radius of curvature of the cornea) but also consider the patient’s tear quality, the topography of the cornea and the absence of conjunctival and palpebral pathology, initially choosing, both the type of contact lens to be used and the recommended wearing time.

The evolution of materials as well as their design have outstandingly progressed during the last 25 years. Therefore, nowadays it is truly difficult to find someone we can’t adapt contact lenses to. We could say that, currently, there are contact lenses “à la carte” available and we can customise them according to the patient needs and the specific characteristics of each eye. Even though there exist rigid contacts, their usage is limited to eyes with a specific corneal pathology and can be considered almost fallen into disuse. Gas permeable semi-rigid lenses are applied to patients with a significant degree of astigmatism who can’t be corrected with soft contacts and, despite of the fact that, optically, they are very good indeed, they aren’t too comfortable. Currently we are adapting soft lenses to most patients. Different models of them are manufactured: spherical ones (for myopia and hypermetropia), toric ones (to solve associated astigmatism) and also multifocal ones (to correct associated presbyopia). This sort of contacts is very well tolerated. They can be worn all day through (no more than 12 hours on average) and they even admit the addition of the astigmatism power if needed. There are daily, weekly, monthly and yearly use lenses available and their indication depends on the eye characteristics and the needs and/or activities of the patient. There are, for instance, people who just want to use contacts for practising sport occasionally, in which case we prescribe daily use lenses. There are other people who want to use them every day whom we prescribe monthly or yearly use contacts.

There is a generalised tendency to using disposable lenses, that is to say, contacts that once they have reached their established utilisation period, must be thrown away. This fact has favoured an improvement from the hygienic point of view, and has minimised their preservation (years ago, several maintenance products used to be necessary). It must be born in mind, that the usage abuse of contact lenses may irremediably damage the cornea and because of that, the utilisation patterns we provide our patients with must be strictly fulfilled.

The adaptation of children to contact lenses has undergone a substantial transformation in the latest years enabling us, by means of the current models, to prescribe them to ever-younger patients with excellent results. We have been doing so for more than 20 years now, with outstanding success. In order to achieve so, a pretty good motivation on the part of the children is essential. It takes a great deal of patience from us too, above all, when teaching them how to put them in and how to take them out. Presently we are able to adapt contacts to children from the age of 10-12 onwards. Before deciding on the adaptation, we hand parents in a questionnaire to find out if their children are eligible for wearing contact lenses. The above-mentioned survey consists of four questions we have named by the acronym CORA which stands for: Clean, Organised, Responsible and Autonomous. If children don’t fulfil some of the required qualities, we postpone the adaptation until they do. At the García de Oteyza Ophthalmologic Clinic, we adapt contact lenses granting a subsequent thorough ophthalmologic monitoring to our patients.