Astigmatism and you
April 6, 2010 9:03 AM   Subscribe

I'd like to buy contact lenses online, but the optometrist threw in a new twist. Astigmatism.

I'm confused, I've never been told I had an astigmatism in the past and, have worn normal, run of the mill, extended wear soft contact lenses for years without issue. When I asked him about it he said it wasn't possible to develop a slightly warped cornea. Is it?

I was told at the office I would need to be specially fitted for one in my right eye before having a prescription for them filled. When I try entering my prescription into the fields at some of the online retailers parts of their required information doesn't jive with the numbers I have; like axis which goes up in increments of five, but my axis numbers fall between theirs eg: 78 and 122. The other number that has me scratching my head is base curve.

Do I need to be specially fitted for a contact lens? What do I need to know about buying toric lenses online? Is it even possible to buy them online considering my prescription? If anyone who's gone though this can help me navigate this process, including any additional information I might need from my optometrist, it would be highly appreciated.
posted by squeak to Shopping (16 answers total) 2 users marked this as a favorite
I do this.

When I first got toric lenses, I got my first few from the eye doctor. I saved the boxes and ordered more online when I needed them. Once you have the exact brand, shape, size, etc. right in front of you, entering the info is easy, as the necessary fields you need to fill out are supplied. In my case, my left eye is different from my right, so I make sure to mark the cases and boxes with a marker as soon as they arrive to remember.

By the way, the toric lenses made a huge difference. I'm able to see much, much better since getting them.
posted by jeff-o-matic at 9:09 AM on April 6, 2010 [1 favorite]

You can buy them online, no problem. I strongly recommend buying them through your eye doctor until you are comfortable with the ones you get -- they can give you samples at first. After your first box or two, you can easily copy the information and order online.

As a general rule, in an emergency, you can often use a non-toric for your eye with astigmatism if you increase the prescription by 0.25, because samples are often not available for torics.
posted by jeather at 9:20 AM on April 6, 2010

Ask your optometrist exactly which contacts you should buy. They are totally unoffended by you buying them online and not through your optometrist (unless you go to like a mall-type place) and they should give you this information. Ask them what they would have you order, and then you order the same thing. I also have always gotten a sample from my optometrist before I commit to new lenses, and that case will say exactly what you should be buying (or, if you hate it, what you shouldn't be buying)
posted by brainmouse at 9:21 AM on April 6, 2010

This "not possible to develop astigmatism" thing appears to be incorrect, per WebMD. If you're super-concerned about how this happened, I would recommend seeing an ophthalmologist and getting it checked.

(I know I sure as hell developed astigmatism, but I acquired mine via surgery, which is not what your optometrist means.)
posted by fairytale of los angeles at 9:29 AM on April 6, 2010

A few thoughts on toric contact lenses (although I've never ordered them online):

I have a slight astigmatism in one eye. I had worn a toric lens in that eye up until this past summer when the eye doctor informed me that the ratio of my astigmatism power to the power of my lens was low enough that I didn't need the toric lens. (Basically I got blind enough that the aberration from the astigmatism was negligible.) The toric lenses are weighted so they orient themselves properly in your eye, and I always had trouble with them being shifty and dragging when I blinked. I think any aberration I experience without the toric lens is now offset by the fact that the lenses don't shift in my eye anymore.

I'd recommend buying a few boxes from the doctor's office first (or online if you can do that) or seeing if they can get you a trial pair. The toric lenses are quite a bit more expensive than regular lenses, so you want to make sure they don't make your vision wonky first.
posted by sararah at 9:29 AM on April 6, 2010 [1 favorite]

My husband has astigmatism, and he buys his contacts online. I only wear glasses, but two years ago, I developed astigmatism. I had been wearing glasses for sixteen years at that point, so yes, it can show up randomly like that.
posted by Ruki at 9:40 AM on April 6, 2010

My astigmatism became more of an issue as I aged, though I'm not sure it's because my general eyesight got worse or what. I will say that for several years in my early 20's, I saw an eye doctor at Lenscrafters, who never acknowledged my astigmatism. As such, I was given regular daily disposable lenses, but over time found it impossible to wear them and see properly.

Last year, I began seeing a different eye doctor at a more reputable office, and mentioned how I wished I could wear contacts again but could never see very well with them. She mentioned that it was very likely because of my astigmatism, and gave me samples of three different types of toric lenses for astigmatism to try out. I seriously could not believe how much better my vision was with these lenses and how much more comfortable I felt. (I settled on the CIBA Air Optix for Astigmatism lenses, btw.)

After I decided that the Air Optix were the most comfortable of the samples, I was given the option to order them through the office or get a prescription (I did order it through the office, but also have a copy of my Rx for emergency ordering). Any time you get a new contacts or eyeglasses prescription, you should be able to ask for a copy of your prescription. In addition, with pretty much any disposable lens (even the monthlies) you should be given at least a week or two's worth of samples. Every eye doctor I have been to has done this, regardless of whether I eventually purchase my lenses there or not. Contact lens companies are more than happy to supply doctors with samples of their product to encourage patients to buy them.
posted by tastybrains at 9:49 AM on April 6, 2010

Just to reinforce test fitting, I have astigmatism and despite multiple tries with different doctors, have never found a toric lens that's even remotely comfortable. I continue to use "regular" contacts with no problem. I seem to be the exception rather than the rule, but you should obviously be sure what you end up ordering is something you're comfortable wearing.
posted by jalexei at 9:53 AM on April 6, 2010

It is possible to develop astigmatism, sure. Or it's possible that previous doctors didn't think yours was serious enough to warrant treatment. I've had slight astigmatism for most of my life but only worn toric lenses for the last three years or so. It can also get better - at my last visit my doc mentioned that mine had decreased, and that sometimes astigmatism can go completely away on its own.

It does take some trial and error to find toric lenses that are comfortable - but tell your doctor if the ones they assign you originally don't work for you. I kept my mouth shut for a year because I figured all toric lenses must be uncomfortable, but when I finally mentioned it to the doctor he was horrified that I'd put up with it and let me try some other ones (Acuvue) that work for me perfectly.
posted by something something at 9:58 AM on April 6, 2010

Toric lenses have a vertical alignment that has to be kept correct for the astigmatism correction to function (i.e. they have to be the in the right rotation on the surface of the eye). They do this by being a tiny bit thicker at the bottom than at the top, so when you blink and your upper eyelid comes down, it runs smoothly over the thinner edge and pushes the thicker edge as far away as possible before popping over it to close the eye. This keeps the lens in the right alignment.

The differing thickness is tiny, and is meant to be almost un-noticeable by the wearer. In my experience this is true for one model of torics only (B&L for me, but there's no way anyone could recommend a brand, it just completely depends on your eyes) - the others felt gritty and didn't rotate properly. Even so I find they pop out of alignment about once a day, and you have to blink repeatedly for about 3 seconds to realign them (you don't lose sight whilst doing this, just detail, so it's no big deal for driving and so on.)

That said, some people I know have never found the process to work smoothly. I tried every brand of torics available in the UK to find that only one worked - but they do work *flawlessly* and after 18 years of 4" myopia it's like having new eyes.

Can't recommend it enough, but you'll need to be prepared to try a load of samples.
posted by cromagnon at 12:02 PM on April 6, 2010

Adding to the pile on I also have astigmatism (developed since I was an adult and at different rates in each eye) and buy my lenses online without a single problem. Copying from the box is the best way to get the correct lenses. If the website doesn't take the information in the right format then you need a better website, the form should be customised to the type of lenses you're buying. Also, different lenses work for different people so it's worth going through the rigmarole of trying them out with your optometrist and wearing them for a boxes worth before buying a whole bunch.

You also need to go back regularly and keep your prescription updated simply because astigmatism lenses are improving all the time. Anyone who says they can't wear torics but hasn't tried in the last twelve to eighteen months is totally out of date and should go back and try again. My last set worked really well and I'm still impressed with how the newer version feels, it's worth staying current with this stuff.
posted by shelleycat at 2:29 PM on April 6, 2010

Air Optix for Astigmatism

Just jumping in to say I wear these too are they are the most comfortable lenses I've worn in a long time if ever, and I've been wearing contacts for more than a couple of decades. I got them from the "1-800" place, no problem at all.
posted by fuse theorem at 5:52 PM on April 6, 2010

It's absolutely possible to develop astigmatism. I did :( How bad is yours? If it's minor, you can usually slightly over-correct the myopia and be fine.

It takes a while to find the right toric lenses. You might go through a lot of trial pairs at the doctor's office. It's kindof a pain in the arse but once you find a kind that works, you can usually stick with those forever.
posted by radioamy at 7:35 PM on April 6, 2010

Response by poster: shelleycat, I'm not sure this is a problem with the retailers, but in how manufacturers make the lenses. If it was for eyeglasses I can enter the prescription exactly, but for the contacts I've looked across various sites the axis number is a ballpark figure eg: the eye that has the astigmatism is -200 -75 78. So with something like the Air Optix I can choose 75 or 80 as the axis number. With what's been said here it looks like a test fitting (or two or three) is how you determine where in that ballpark you should be.

radioamy, I was told it was "slight"* and I would need a toric lens by the optometrist as I was passed off to another person in their contact lens department who began to peddle their wares and, was pressuring me into one particular option despite telling them I wasn't interested from the outset. I didn't help that I was in the midst of a migraine induced brain fog and, completely overwhelmed in understanding what the options were. I got my prescription and, bailed. Once I'm better armed I'll ask around about whether I can get away with wearing regular contact lenses or, whether a toric lens is essential.

Thanks for the help everyone.

*nothing like the SO's astigmatism, when I try on his glasses I feel like Alice in Wonderland, everything is oddly stretched and distorted
posted by squeak at 7:20 AM on April 7, 2010

I'm not sure this is a problem with the retailers, but in how manufacturers make the lenses.

What I mean is the retailers should change their site to match the details given for each lens. The place I use, you click the type of lens you want and get a customised ordering page which exactly matches what's on that specific box. And that page is different for different lens types where what's on the box is different. If the site you're using doesn't do that I'd be looking for somewhere more accommodating. Trying to go from a glasses prescription to a contact lenses one doesn't work though (glasses go in smaller increments, which is probably where your problem is coming from), so you'll need to have the actual contact lenses first.

To some extent astigmatism is a try it and see thing, some people can live with it and some can't. So definitely hustle them for trial lenses, you shouldn't be paying for anything until you've worn at least one pair for a while to see if it makes a difference for you or not. Personally I get it corrected in my dominant eye and not in the other one even though the actual astigmatism is similar in both now (the non-dominant one is much more short sighted). Contacts can be a good way to figure this out actually because they're used for a short time and can be swapped around easily, whereas once you get lenses made for glasses it's harder to change them.
posted by shelleycat at 3:31 PM on April 7, 2010

Response by poster: What I mean is the retailers should change their site to match the details given for each lens.

The sites I've been looking at do this. The confusion was on my part partly because being ill-informed by the office I went to with their we'll specially fit a lens to you then when I went to sites like Clearly Contacts I could never get the axis number (which tells them where the astigmatism is on the eye along a 180 degree arc*) to jive with my prescription. Massive confusion. Turns out toric lenses are made with an axis number in either a 5 or 10 degree increments depending on who makes them so that number will always have to be rounded up or down.

It's all good, its making a lot more sense to me than it did a few days ago. I just wish there was a Toric Lenses For Dummies page out there somewhere ...

*I've been doing some reading - heh
posted by squeak at 9:26 AM on April 8, 2010

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