Blurry vision with toric contact lenses?

April 9, 2008 4:27 PM

For the past 4 months, I've been wearing toric contact lenses for my newly-developed astigmatism. My vision now slips out of focus quite often, and I find myself blinking and rubbing quite a bit to get my vision to focus - sometimes to no avail. Is this abnormal, or is this just the deal I get for being astigmatic and wanting to wear contact lens?

If it makes any difference, my current contact lenses (Acuvue Advance for Astigmatism) have a 14.5 diameter, as opposed to the 14.0 on the normal, non-astigmatic lenses I used to wear. With 14.5, I can now see the border of the contact lens around my iris. Previously at 14.0, I couldn't tell the difference. My optometrist assured me that it shouldn't make a difference in vision?

My glasses (which correct for astigmatism) don't give me the same problem.

And finally, yes, you are not an optometrist and if you are, you're probably not mine. Looking for anecdotal advice on "Yes, this is normal" or "Yes, this is what you astigmatics get".

posted by Xere to Health & Fitness (21 answers total)

By "My vision now slips out of focus quite often", I actually mean that it's been slipping out of focus for the whole 4 months. Not a recent development.
posted by Xere at 4:32 PM on April 9, 2008

The problem with astigmatism is that the orientation of corrective lenses is critical. The correct lens at the wrong orientation is the wrong lens.

With glasses that's not a problem. The lens is held in place by the frame, and the orientation doesn't change. But contacts are round and tend to rotate randomly.

What they do is to put a flat spot on one edge of the contact lens, and every time you blink, that tends to reorient it because the flat spot aligns with the edge of the eyelid. I gather it's not a totally satisfactory solution, however. That's what I've been told.
posted by Class Goat at 4:33 PM on April 9, 2008

I wear disposable toric lenses and occasionally have the same problem. I've found that for myself the issue is usually dryness.
posted by ISeemToBeAVerb at 4:36 PM on April 9, 2008

If, when you first put the lens in, the orientation is totally wrong, your vision is going to be dreadful. If it's 90 degrees out, effectively it doubles your astigmatism instead of correcting it.
posted by Class Goat at 4:42 PM on April 9, 2008

I wear disposable toric lenses in both eyes for astigmatism, but my vision does not slip out of focus and I cannot see the edges of the lenses.
posted by the littlest brussels sprout at 4:43 PM on April 9, 2008

I switched to toric lenses last year for my astigmatism as well, and I find that they "slip" now and then exactly as you describe. It usually happens when I'm tired and my eyes are dry, or when I've been wearing a pair too long (they're supposed to be thrown out every 30 days, but I'm bad about keeping track). Eye drops help with the former, and switching to a new pair helps with the latter. If neither does the trick for you, you might want to consider going back to your eye doctor to be refitted.
posted by scody at 4:45 PM on April 9, 2008

That's what happened to me on multiple tries at contacts. On my last run, the optometrist tried a couple times to have them "weight" the lens differently so it would sit correctly. But it never worked and I gave up. It would take me several blinks to fix it and it would just mess up again. Dryness seemed to be a problem in that eye too like the above poster mentioned, though I hadn't realized it had to do with the toricness of it. Ah well, just call me Nerdy McGlassesface.
posted by kookoobirdz at 4:45 PM on April 9, 2008

I have astigmatism, and wear Focus Daily disposables. I have no issues with my astigmatism because of it (no 'weighting' to teh lens or anything) although my issue may be mild.

The problems you describe, though, sound very much like the issues I have with dry eyes (the reason I switched to dailies and do actually only use them daily). I had the issue with my hard, gas permeable lenses (old skool represent!) and switching to dailies (plus an additional switch of manufacturer) sorted this out. In the meantime, I used the little capsules of artificial tears whenever my eyes were tired or feeling crappy - the bottles of the stuff isn't compatible in a lot of cases with contacts, I had little disposable pippette style deals that snapped off. They were ace.
posted by Brockles at 5:02 PM on April 9, 2008

I have Boston hard contacts and astigmatism, and haven't hand any problems like what you're describing for the past 12 years. Not sure if they fit better than yours or what, but maybe it's time for new contacts or a new optometrist.
posted by craven_morhead at 5:04 PM on April 9, 2008

Totally normal with toric lenses. Echoing dryness/wearing them into the late hours as being an aggravating factor, too . . .
posted by CommonSense at 5:40 PM on April 9, 2008

I've had that experience. I went through several sample lenses, and everything worked pretty similarly. I find it comes up especially when I'm looking down, for example when I'm reading.
posted by lore at 5:44 PM on April 9, 2008

I agree that this is likely an eye dryness problem (as I understand it, toric lenses are actually weighted (thicker on the bottom) so that they orient themselves on the correct axis - so either your eye is too dry to allow the lens to float as it should, or the axis on your prescription is wrong). Every brand of toric lenses I tried turned my eyeballs into cornflakes until I tried Biomedics toric (and I still can't wear them as long as I could wear non-toric lenses, but I can certainly do 12 hours easily enough). I suggest you get the axis checked, and/or try some different lens brands (your eye doc should be able to give you free samples of most kinds) until you find ones that work. Also, use a solution that provides extra moisture.
posted by biscotti at 5:48 PM on April 9, 2008

I have an old pair of toric dailies and they work fine. I recently tried disposables, and they won't stay centered. It took a few tries with the dailies to get the right angle, and then another try to get a steeper pair to counteract the drying, but now they work fine.
posted by atchafalaya at 5:50 PM on April 9, 2008

What you describe is precisely why I could never wear contacts. It wasn't even tolerable first thing in the morning with fresh brand new contacts - it got worse as the day went on.

I strongly recommend lasik as a solution.
posted by arabelladragon at 5:51 PM on April 9, 2008

I wear torics sometimes but not very often because of this issue. I find that there is an optimal level of wetness/dryness which is neither too wet not too dry that makes they stay in place. If I keep blinking and fiddling with them they keep moving but if I get them just so and then keep my eyes open for a while they seem to dry out a bit and then they seem to stay in place. So stop blinking so much is my advice.
posted by GuyZero at 5:58 PM on April 9, 2008

I think the Acuvue toric lenses are just prone to shifting. I used to wear those same lenses for astigmatism in one of my eyes and had the same problem. I could always feel the lens shifting around and the vision in my left eye would go all wonky. My optometrist switched me to O2 Optix toric lenses and I haven't had any problems since. They're also tons more comfortable than the Acuvues.
posted by strangecargo at 7:20 PM on April 9, 2008

This is a problem with toric lenses, but it's not "normal" in the sense that "you should suck it up and put up with it." Dryness may exacerbate the symptoms, but the problem is that the contacts aren't sitting right on your eyes. You need to go back to the eye doc to either get a slightly different rx or try a different brand. I remember going through a few different pairs of trial lenses before I found the right toric lenses. It was a pain, but I settled on Preference Toric and wore those for a long time.

As to what craven_morhead said about hard contacts (or possibly he means gas permeables), you do have sharper vision and no shifting, but on the flipside they make your eyes extreeemmeeely sensitive to dust, etc, which is intollerable to many.
posted by radioamy at 7:41 PM on April 9, 2008

Yup, that's why I went back to glasses 15 years ago. It happened all the time. My doctor said that because of the astigmatism, my vision would never be fully corrected with contact lenses, but I also have a crazy, oblique astigmatism that I think is a tad rarer than normal (and I am farsighted and at a good +7.00 in that eye). I found the cutest frames and shelled out the cash for the polycarbonate, high index blah blah blah to make them lightweight and reflection-free.

Good luck!
posted by cachondeo45 at 8:55 PM on April 9, 2008

According to what my optometrist told me last week the torics are usually a bit bigger than the non-torics. So that part is OK at least.

I was at the optometrist because my previous prescription was crap and I was getting problems just like you're describing, plus a lot of dryness and discomfort (I've had a dry eye problem for several years). That dryness causes the loss of focus, the lenses get gunky and covered in crap plus they stick and get dragged around when your eye moves. In my case the problem was completely solved by a change in lenses and in storage fluid despite my history of dryness issues. So don't give up because this isn't normal or necessary for you to put up with.

Note that the contact lens fluid can be as important as the lenses themselves, so talk to your optometrist about both. Also note that there are some new lenses around now that weren't a year or two ago (silicone hydragel I think they were called) and these days normal astigmatism can be completely corrected with hassle free lens wearing. I've been wearing lenses for twelve years and the astigmatism ones just keep getting better and better, it really is worth persisting.
posted by shelleycat at 12:42 AM on April 10, 2008

Radioamy, I am talking about gas permeables. I haven't had a ton of trouble with dust and grit, but it's occasionally an issue.
posted by craven_morhead at 8:21 AM on April 10, 2008

I used to wear gas perms because they were better for astigmatism, but now I wear toric lenses. Is the little slit in them what make them stay in position? Just curious, really. Anyhoo, I have the same issues with mine, but mostly when I've been wearing them longer than I should (they're 30 day disposables.)
posted by pyjammy at 9:31 AM on April 10, 2008