Contact Lenses: How Do You Get the Right Fit for a Child with Astigmatism?

Updated on November 29, 2018
G.K. asks from Williamsburg, VA
12 answers

For months, we've been trying to find the right contact lenses for my soon-to-be 12-year-old daughter. At the last doctor's appointment, we realized that one of her contact lenses was rotating due an extreme astigmatism, which was causing blurriness and very poor vision. We have another appointment this afternoon to try another brand. Does anyone have experience with this type of problem? How did you solve it? I'm starting to wonder if we need a new doctor. Should this really be so difficult?

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So What Happened?

Okay, every one of you has been extremely helpful. I'm going to get a second opinion. My daughter goes to a very highly respected pediatric ophthalmologist, but once kids start with contacts, they're passed to a optometrist in the same practice. The one we were assigned to is new to the practice. I think you all are right, we need a highly experienced ophthalmologist. And, yes, we may be ordering custom lenses from Ireland too! Thank you!

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R..

answers from San Antonio on

It might just be the brand. I wore them for years with astigmatism no problems until I moved away to college and the climate didn't adjust well to contacts. Being that this was over 20 years ago there have to be even better ones on the market today.

My daughter started wearing contacts at 11 and loves having the choice to wear her glasses or not. Good luck!!

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G.♣.

answers from Springfield on

ETA - It's totally normal for a contact lens to rotate around while on the eye. It's just what they do as one is wearing it. An astigmatism means that the curvature of the eye is irregular, so light hits the eye at different angles. The doctor takes measurements on the curvature and applies them to the contact lens. The lens is shaped specifically for that eye and has weights inside it to make sure it stays in place. So my contacts are heavier on one side, and that's the side that stays down so that the lens sits in the correct position for my curvature. If I lie down on the couch to watch tv, the lenses will rotate and I won't be able to see as well (so if I really want to do that, I have to put on my glasses).

It's possible her astigmatism is very strong and difficult to fit a lens, but if her lens is rotating, it means that the weights are wrong.

Original Answer - I have astigmatisms in both eyes. My doctor was well aware of this before I asked about contact lenses. I could be wrong, but my initial thought is, no this should not be difficult at all!!!

The doctor should have made notes and taken measurements on her eyes and done his/her "best guess" as to exactly how to shape the lens for each eye. A "trial" pair of contacts is then ordered for her to wear for a few days followed by an appointment just to check and make sure the fit is right. If not, adjustments can be made and the correct fit ordered.

I have been to 5 different eye doctors (because I've moved around), and they have all followed relatively the same pattern. Honestly, if they've been practicing for a few years, they usually always get the fit right on the first try.

I'm really having trouble with the fact that your doctor seems to have just now realized that your daughter had an astigmatism. How was this not discovered at the first exam?

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J.K.

answers from Wausau on

Because of her condition being 'extreme' she probably needs lenses that are specifically for astigmatism and wont be able to use the usual type of soft lenses. What kind of doctor is she seeing? An ophthalmologist is the type she needs.

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M.P.

answers from Portland on

I have astigmatism in both eyes. I comfortably wore contacts for years. I did try different lenses until I found the ones that fit. With astigmatism the lenses are weighted on one side so the lenses won't turn around. I don't understand how her lense would be rotating if the prescription included correcting astigmatism. What did the doctor say about the rotating lense? Is he saying that her astigmatism is so strong she can't.be properly fitted? Perhaps she won't be able to wear contact lenses. Perhaps her eyes are too sensitive to be comfortable wearing contacts. I suggest you ask the doctor questions until you understand what he is saying.

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T.D.

answers from New York on

anytime I start to question a Dr of any kind I ask another one for their opinion. All drs are humans and can make errors.
So definitely see another Dr if you question this one.

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D.N.

answers from Chicago on

Different lenses fit differently. You would think that as long as the size is correct, they would fit just right.. I do not have an astigmatism in my eyes but there are some lenses that just don't stay in place for me and the vision is horrible. My daughter had a similar issue, with astigmatism, and it took 3 different lenses to get the right fit. I would ask to have her eyes measured again. My daughter was able to try a sample pair for a week before we ordered the supply so we did not spend money on something that did not fit correctly.

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M.G.

answers from Portland on

ETA: changing my response since I think I missed that you had been trying this for months.

I have astigmatism in one eye. Been wearing contacts since I was your daughter's age. Worn glasses before that.

I have never worn contact for astigmatism in that eye. My optometrists have never suggested it. I've had a bunch over the years (I am middle aged now).

My astigmatism didn't worsen over the years. My vision did, but not my astigmatism.

I have a sister - same thing. My BFF same thing. None of us wore contacts for it.

I have heard they don't work for a lot of people.

I was always able to wear regular disposable lenses without incident.

Is there some reason she has been told she has to wear them? I would get a second opinion if you're getting frustrated.

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J.K.

answers from Chicago on

Everyone in my family is both extremely nearsighted and suffering with astigmatism. My daughter has this very issue that you were describing. It can be extremely hard to fit her. The first step is to make sure you are seeing the very best eye care professional. Even then, the doctor will need to be patient. I have had experience with Eye doctors in the past who think “close enough” is good enough. I personally like to see very well and can’t imagine sticking my children with “close enough.” My hard to fit daughter needs custom-made lenses that come from Ireland. It takes three weeks for them to ship. They are monthly, and a one year supply costs approximately $700. After multiple fittings that weren’t quite right with my daughter reaching into her eyes multiple times an hour to physically rotate the lens her self, the eye doctor was able to position the weighting within the lens so that it sits properly on her eye ball. I have no idea what that actually involves though. Basically, she put the bad contacts in and sat there without touching them. He looked at them several times over 15 to 20 minutes and decided to wear on her eye the low point was that the built in weighting wanted to fall. Then he ordered a new pair where he physically rotated the prescription so that the prescription was correct if the weighting was in her natural low point of her eyeball. Yes, it is true that there are many “off-the-shelf“ products designed for astigmatism today. However, it is quite likely that none of them will work for your daughter if she is having this kind of trouble. Also, do be aware that many “toric“ lenses need to be eased into. The weighting that is built into the lens gives your eyeball a little squeeze to stay in place. I found that when I first started to wear these if I didn’t take them out after 2 to 3 hours I could get the worst migraine imaginable. Good luck!

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M.C.

answers from Chicago on

Some people just don't do well with contact lenses. My mother tried many times, but just couldn't do it. My older son is very particular with his. He had to try several brands and types until he got ones that work for him. The doctors we have gone to give a trial pair to try for a couple of days, and if they don't work will move on to another pair. I don't believe this process should take months though

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D..

answers from Miami on

Could it be that she needs to grow more before wearing contact lenses? Perhaps glasses would be better until her eyes develop more? I agree that you need a second opinion.

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K.K.

answers from Reno on

I began wearing contacts about the same age as your daughter. My astigmatism in both eyes was terrible and my glasses were so heavy due to my prescription. I was a cheerleading tumbler and ran track and glasses just didn’t work for my activities, but I couldn’t see without them. SoI started with soft lenses at a younger age than recommended at the time and had similar results as your daughter. Because of the shape and bumpiness of my corneas, the soft contacts often rolled up and would get caught painfully in my upper or lower eyelid or fly out when I was running track. My dr suggested gas permeable contacts (or hard contacts) and they were weighted to stay in place and not rotate. I wore gas permeable for for 12 years and never had any problems. I then saved up for LASIK and that has been amazing :)

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