Eye Exam for Contacts

Cannon EyeCare can do your eye exam for contacts in Seattle, WA.

If you need glasses to sharpen your vision, you can almost certainly wear contact lenses.  The doctors at Cannon EyeCare can do your eye exam for contacts.  We always strive to fit healthy contact lenses and encourage our patients to use them in a responsible manner.  When you wear a prosthetic lens on the front of your eye, you might as well wear it in a healthy manner.  We will inquire about your current lens wearing habits so that we can make sure you are not putting your eye health at risk.

An eye exam for contacts will provide you with all the health checks described in the ‘EyeGlass Exams” service type, plus you will have a contact lens fitting.  Washington state law requires that all patients have their eye health checked prior to being fit in contacts, so it is not legal (or safe) to do a contact lens fitting alone without an eye exam.  This regulation is really there to keep you, the patient, safe.  The goal here is to ensure that the eye is healthy enough to wear a prosthetic contact lens.

Your eye doctor will likely look at your current lenses on your eye to see how they fit.  So, if possible wear your current contact lenses in to the office.  If the lenses were not prescribed by Cannon EyeCare, please bring documentation of what the current lenses are (both brand and power) to your appointment.  Giving your doctor data on what you have now and how well it works for you can assist them in finding the optimal lenses for your eyes.   By bringing in your old documentation, you are allowing us to fine tune your Rx, instead of trying to reinvent the wheel.  That being said, if you don’t have documentation of your old powers, we can still fit you in contacts.

There are always new contact lens designs and materials coming out, so there may be some discussion of a switch – even if you like your current lens.  As a general rule though the eye doctors at Cannon EyeCare will keep you in your current lens as long as it is a healthy option and you are happy with it.  We have to perform extra testing to evaluate your contact lens powers and the fit (how the lens interacts with your eye).  Therefore, even if your contact lens Rx is unchanged from last year, there will be a fee for each year’s contact lens evaluation.  Follow-ups and trial lens costs are included in this initial fit fee, so follow-ups are a no-charge visit.  Often we will sent a patient home with lenses that we are confident will work well, and ask them to email or phone in to approve the final powers.

Spherical contact lens fits utilize single vision lenses without astigmatism on both eyes and are relatively straightforward most of the time, so our fee is just $80.  Toric contact lens fits utilize more complex lenses to focus the light in an eye with astigmatism.  Toric contact lens fits are usually $95, or $120 if we need to utilize specialty lenses.  Multifocal or monovision contact lens fits are also rather complex and may require a follow up or two to get things dialed in, so the fee for that type of fit is $120.  Your vision insurance may or may not cover contact lens fits.   If you are not using vision insurance, there will also be a $175 fee for the standard eye exam and refraction in addition to the contact lens fitting fees above.  Very few patients wear hard contacts these days, but we can fit them, and the fees are somewhat higher than those for soft lenses.

Lots of patients ask if they can still wear contacts if they need bifocal glasses.  Typically these patients are over 40 years of age, and have trouble with their near vision due to a natural process called presbyopia.  There are three basic strategies we can utilize to keep contact lens wearers seeing well at both distance and near.  The simplest way to go is to have the patient wear distance contacts in both eyes, and then put on over-the-counter reading glasses for computer or near work.  This strategy gives really good distance and near vision, but many patients will ask what is the point of wearing contacts if they have to wear glasses over top much of the day.  That is a really good question, which leads us to a discussion of Monovision or Multifocal contacts.  Again, each of these strategies has its advantages and disadvantages.

Monovision is a setup wherein the eye doctor will determine your dominant eye (we all have a dominant eye – it’s kind of like being right or left handed).  Then the optometrist will fit a contact on your dominant eye that is dialed in for distance.  The other (non-dominant) eye will have a lens that is focused up close at your computer or reading distance.  This strategy often works well even if the patient needs astigmatic lenses.  It can take a few days to adapt, but over 80% of patients who give it a good college try will adapt and do quite well in monovision contacts.  One of the downsides to monovision is your depth perception can be reduced, especially the first week so.   This is not a great strategy for people who need to catch a softball on the weekends, thread a needle every night, etc.  We actively discourage this setup for dentists and surgeons.

Another downside to monovision is that there are really three different distances that we all work at: distance, intermediate/computer, and near/reading.  Yet there are only two eyes, meaning either your computer or reading distance will be a little off, even when monovision is fully optimized.  That being said, this is a great strategy that has been used for decades and continues to be very effective for many patients.

Alternatively, there is the high-tech option of multifocal contacts.  This strategy utilizes the latest and greatest technology available to dial in pretty clear, functional vision at all distances.  In this strategy, both of your eyes have a multifocal lens that has powers for distance, near, and computer distance built in.  Many patients ask how the lens can have many different focal powers.  The technology is basically set up with concentric rings that give a different effective power at different radii of the lens.

With multifocal contacts, your vision won’t be perfect at any distance, but it should be functional at all distances.  Many patients will tell us they can see the street signs about as early as the passenger in their car, but there’s just a little bit of shadowing on all of the letters.  We like to talk to our multifocal patients about the ‘80% rule’ prior to trying the lenses.  This rule of thumb is really about setting expectations at the right level.

The 80% rule states that with a successful fit in multifocal contacts, you should be able to see what you need to see without pulling out reader glasses about 80% of the time.  You should be happy with your vision in contacts at least 80% of the time, meaning you can see everything you need to see at least 80% of the time.  Modern multifocal lenses are really quite impressive when worn by patients with an appropriate Rx.

We can generally get people to see 20/20 or close to it for distance, and 20/25 or close to it for near.  That being said, if you expect perfection, we should not even try.  There is some compromise with multifocal contact lens technology because each lens has power for distance and for near.   This means that when you are reading some of the light rays coming through your lens are going to be focused for distance (making vision somewhat defocussed).  The same is true when looking in the distance – those pesky near-vision focused light rays will cause some ‘ghosting’ or blur.

On the flip side of this discussion is a question we get asked quite a bit: how old do kids have to be to try contacts.  We generally start fitting young people at about age 13 because you have to bring a good deal of maturity to the table to wear contacts safely and responsibly.  That being said, we do make exceptions.  The young lady in the photo above was nine years old when she expressed an interest in wearing contacts.  She had recently stopped doing gymnastics because she could not perform well at the sport with her glasses on.  The blur that resulted with glasses off made it unsafe.  Dr. Mark Cannon talked to her and her parent about the importance of excellent hygiene and responsible habits.   All indications were that she was properly motivated and mature enough to wear contacts, so Dr. Mark proceeded to fit a nine year old in contacts.  Since she got her eye exam for contacts and successfully completed insertion and removal training, this young lady has left gymnastics behind and is using her contacts to pursue ballet.

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You may be wondering what is involved in an eye exam for contacts.  At Cannon EyeCare, your doctor will likely perform most of the following tests.  For a basic overview of these tests, please refer to the EyeGlass Exam service description.  The following details how these test are utilized to help with a contact lens fitting.

  • Visual acuity testing – ideally we test your vision in your current contacts; this is one of the best reasons to wear your existing lenses into the eye exam for contacts. If you have to present with your glasses instead, that will work too.
  • Cover Test – again, it’s best if we can do this test where we cover one eye, then the other, with your contact lenses on. If you have prism in your glasses, be sure to bring those as well.
  • Side Vision Test – sometimes this test is a little easier for patients who are doing their eye exam with contacts on, as the glasses frame won’t block your side vision.
  • Auto-Refractor – we will have you take your contacts out prior to this test. The info we get from auto-refraction serves as a starting point for refraction.
  • Auto-Keratometry – this quick automated test determines if your cornea is perfectly spherical or is somewhat warped (astigmatic). This info can help the optometrist perfect your glasses Rx, which may in turn lead to a toric contact lens Rx. This test also give the eye doctor some info about whether to try you in a tighter or looser fitting contact lens.
  • Air Puff Test – nobody really loves this test, but it is an important glaucoma screener that tells the doctor about the pressure inside of your eyes. We will test you with contacts off.
  • Refraction – this is the old “one-or-two test’ that optometrists are kind of famous for. There is no difference in how this test proceeds in an eye exam for contacts vs. an eyeglass exam.
  • Eye Health Exam – your eye doctor will use a slit lamp to check all of the key structures of your eyes. They will pay special attention to the lids, tear film, and the corneal health of patients who wear (or plan to wear) contact lenses.
  • Dilation – there is no real difference in this test for glasses and contact lens wearers. See the EyeGlass Exam service type for our thoughts on dilation.
  • Summary of eye exam for contacts/ conclusion. Your optometrist will review any relevant medical findings and also discuss the plan for getting your contact lens Rx finalized. Sometimes we can finalize it on the day of your initial visit and give you a printed prescription. Other patients will need trial lenses to be ordered. We always ask that patients make an effort to come back for their contact lens follow-ups promptly, as we have a brief 6-month window to get the Rx completed. If there are delays and we cannot wrap up the fitting process within six months, we are required by Washington state law to perform another eye health exam – and there is a fee for that.
  • Insurance. We are in network with the major local health insurance companies. Cannon EyeCare does not accept any 3rd party vision plans such as VSP due to unreasonable contractual stipulations.

INSURANCE WE TAKE

  • Premera Blue Cross
  • Regence Blue Shield
  • Regence Group Administrators
  • Lifewise
  • United Health
  • Group Health’s PPO plans
  • HMA: Health Management Associates
  • Bridgespan
  • Asuris
  • Out of state BC/Blue Shield (routine vision exams typically not covered)

INSURANCE WE DON’T TAKE

  • VSP: Vision Service Plan
  • EyeMed
  • Spectera
  • Davis
  • Cigna
  • Aetna
  • Medicare/Medicaid
  • Kaiser Permanente
  • First Choice Health