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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7746
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Why do some people who have to wear a contact lens~ when they

Customer Question

Why do some people who have to wear a contact lens~ when they do not have an implant~ also have to wear glasses besides~in my case the Optomitrist just seems to give me the thick contact~I got a normal one for distance in the right eye~ it was so nice ~ yet I could not see close and had to use reader glasses~ also I could not remove the contact and had to go to out patients~ I guess it is practice I need~ as for 30 years I have been used to such a thick one~my right eye seems very sensitive to touch~:-(
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Rick replied 1 year ago.
Hi. I'm online and happy to answer your question today. Thank you for requesting me.

Since you are aphakic (no lens inside your eyeball), but have a lens in your other eye you need to wear a thick contact lens on your aphakic eye so that your two eyes can work together.

If you tried to wear glasses only your aphakic eye would need a really thick plus powered lens and your "normal" eye would only need a thin lens. This would cause a condition called aniseikonia, where the image size on your retina is so different from one eye to the other that you would not be able to function. I actually did research on this condition when I was an ophthalmology resident....

Here is a good article on this topic:

http://en.wikipedia.org/wiki/Aniseikonia

Also, due to presbyopia, you need reader glasses :(

As we discussed before, even with your history of glaucoma I bet you would do well with a secondary lens implant. This would go a long way toward solving all the difficulties you are having with this lens issue.

Even though you wrote your answer in the "free" section in order for me to get credit (at no cost to you) it is important for you to mash the excellent feedback button :)

Let me know if there is anything else I can do to help.
Customer: replied 1 year ago.

Thanks for the so very good answer~ I realize the glasses I would have to wear would be almost like Coke bottle ones in the cataract eye~ years ago that was all they had~ but the lady I know wears a contact like me ~in both of her eyes~ she did not want the Implants for whatever reason~so along with her two contacts she also had to wear normal glasses~when I see the Specialist again I shall ask her about getting an implant~I have such a crazy story~ as even though I am older I have 20- 20 vision up close in my right eye~so when I wear my new thin contact I then can't see close up anymore~ so she said I have to wear reader glasses then~it does not seem to make sense~for vanity reasons maybe I should just stick with glasses for that right eye for distance~TV and so on~ although it was nice to be able to see far and feel comfortable~as the thinner lens one can not feel as much as a thick one~the Optomitrist said I had a small cataract in my right eye and thus I could see well so close up and yet the Ophthalmist said I did not have a cataract~ it seems she would know best~do contacts come in bifocal~in other words could she not give me a contact lens that would work for both things~ far and close~ or again is it age related~Martha

Expert:  Dr. Rick replied 1 year ago.
I am glad you have such excellent vision in your aphakic eye. But, alas, your difficulties are grounded in the physics of light and optics.

You are right....the ophthalmologist is the one to trust on issues of cataract....

Contacts do come in bifocal and you could probably be fit with a bifocal contact for your eye that has a natural lens in it. I'm not sure, to tell you the truth, if they make bifocal aphakic contact lenses.

You and I have both lived so long that we need reading glasses.....it is a fact of life. :(

But, bifocal contacts may work for you....

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. And please let me know if the rating system gives you any troubles.
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7746
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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