Patient Questions

Yes. Plenty of people wear specialty lenses comfortably into their 70s and beyond.

• Keratoconus usually changes most from the teens through the 30s and tends to slow or stabilize with age. If it is progressing, cross-linking can now halt it.
• Lens options are much better than they used to be. Scleral lenses are large and stable, and many older wearers find them easier to handle than small rigid lenses.
• If hands become less steady, insertion stands, lighted plungers and a trained family member make a big difference.
• Cataract surgery later in life takes careful planning with keratoconus, and you may still wear a specialty lens afterward.

Keep up with regular exams, and if you ever have sudden pain, significant redness, light sensitivity or a drop in vision while wearing lenses, take them out and get seen the same day.

Plungers usually aren't sold in regular stores, but they're easy to get. The office that fit your lenses almost always has them and can show you how to use one, which is the best place to start. They're also sold online as "DMV remover" or "scleral lens remover."

Make sure you get the right type: a small solid plunger for rigid gas permeable (RGP) lenses, or a larger vented one for scleral lenses. For sclerals, place the plunger near the lower edge of the lens, not the center, then tilt it to break the suction.

Removing lenses shouldn't hurt. If removal is painful, or your eye is red, sore, light-sensitive or blurry afterward, have your eye doctor look at it soon.

That flinch is a protective blink reflex, and it almost always fades with practice.

• Practice without a lens first. With clean hands, touch the white of your eye (not the center) with a fingertip wet with saline, a few times a day.
• Break it into steps: hold your lids open for 10 seconds, then bring a lens close without touching, then the full insertion. Stop before you feel overwhelmed.
• Hold your lids firmly at the lashes, top lid with one hand and bottom with the other, so a blink can't win.
• Look straight ahead, not at the lens coming in, and breathe out slowly as you insert.
• Ask your fitter for extra training visits and about insertion tools that keep fingers farther from the eye.

How you do at the first visit doesn't predict how you'll do in a month.

For many people, yes. Multifocal contacts are a balance, so most wearers don't get exactly the sharpness of progressives at every distance. Distance and phone range are often very good, and the hardest task is fine print in dim light.

• Book a contact lens exam, not just a glasses exam, with an optometrist who fits multifocals. Trial lenses let you try them right away.
• Expect one or two follow-up visits; fitters often fine-tune the power between the two eyes.
• Daily disposable multifocals are convenient: a fresh lens each day and nothing to clean.
• Ask about monovision too, where one eye is set for distance and the other for near. Some people prefer it.

Wear them for a few full days before an important event, including in a dim restaurant, so nothing surprises you.

Yes, with a few precautions. The main water concern with contacts is microorganisms in tap water, lakes, pools and hot tubs. Raindrops while hiking are a much lower risk than swimming.

• Daily disposables are ideal for trips: a fresh, sterile lens each day and no case to keep clean in a wet tent.
• A brimmed hat and wraparound sunglasses keep rain, wind and debris out of your eyes.
• Keep your hands clean and dry for removal, and never rinse lenses or a case with stream or rain water.
• Bring preservative-free rewetting drops, a spare pair of lenses and your glasses as a backup.
• Don't sleep in lenses unless they're approved for overnight wear.

If an eye becomes painful, very red, light-sensitive or blurry and doesn't clear when you take the lens out, switch to glasses and get it checked as soon as you can.

At a high prescription, the frame you choose matters as much as the lens.

• Pick smaller, rounder or oval frames with a narrower lens. Large or wide frames make the edges thick.
• Make sure the frame fits so your pupils sit near the center of each lens. Accurate measurements matter more the higher your prescription.
• Choose high-index lenses (1.67 or 1.74) with an aspheric design and anti-reflective coating.
• Full-rim acetate frames hide edge thickness better than rimless or thin wire frames, and the edges can be polished.

At a high prescription, a yearly dilated eye exam is also a good idea, because higher myopia comes with a higher risk of retinal problems.

Differences of 0.25 to 0.50 between two exams are common. Part of a refraction depends on your answers ("which is clearer, 1 or 2?"), and doctors also make judgment calls. Some prescribe the full amount for the sharpest distance vision; others reduce it slightly for comfort, especially if you do a lot of close work or it's a big change from your old glasses.

Wearing either prescription won't damage your eyes. A slightly weaker one means a little less sharpness far away; a slightly stronger one can feel more tiring up close.

It's fair to ask why a doctor chose a particular power. Give new glasses a couple of weeks, and go back for a recheck if you have double vision, headaches or ongoing strain.

Glasses won't treat an eye condition, but they can make light sensitivity much more comfortable.

• Sunglasses that block 100% of UV (labeled UV400) are the most useful. A darker tint or polarized lenses help with glare, and larger or wraparound frames block light from the sides.
• Photochromic lenses that darken outdoors are handy, but they darken slowly and barely change in a car, so most people still want real sunglasses.
• Blue-light glasses aren't needed for eye health. Lowering screen brightness often helps more.
• If you need a prescription, prescription sunglasses mean you don't have to choose between seeing clearly and being comfortable.

New or worsening light sensitivity with redness, pain or blur can signal a flare of an eye condition, so call your eye doctor promptly rather than just reaching for darker glasses.

On plated frames, polishing removes the plating along with the scratch, so a real fix means refinishing or re-plating, not buffing.

• For a luxury brand, start with an authorized retailer or the brand's boutique. Many brands offer after-sales refinishing for authentic eyewear; bring your authenticity card or receipt, and expect it to take a few weeks.
• Independent re-plating shops exist, but the color and finish may not match exactly, and outside work can affect resale value.
• If the frames have prescription lenses, have the lenses removed before refinishing and have an optician check the fit afterward.

Light wear on gold frames is normal, and many owners simply enjoy the patina.

They're related but not the same. High myopia is defined by the prescription number, about -6.00 or stronger. Pathologic myopia describes changes seen in the back of the eye: stretching and thinning of the retina and the layer beneath it around the macula, sometimes with thin patches, small cracks or an outward bulge of the eye wall. It's about the eye's length and shape, which is why it can be found even when a prescription has been stable for years.

The practical step is watching your central vision. If straight lines start looking wavy or bent, or you notice a new blurry or dark spot in the middle of your vision, get seen within a day or two. That can be a treatable complication, and early treatment protects vision. Regular retinal imaging is the right plan.

Rewetting drops won't hurt, but they won't do much for itching or real redness. The most important step is to take your contacts out and wear glasses until your eyes feel normal again.

• Itching points toward allergies, which are common when traveling. A cold compress helps, and try not to rub.
• A pharmacist can recommend an over-the-counter allergy eye drop. Use it with your lenses out.
• Skip redness-relief drops. They only mask redness and aren't meant for contact lens wearers.
• Start with a fresh pair of lenses once your eyes are back to normal.

Get seen promptly for real pain, light sensitivity, blurry vision, discharge, a white spot on the eye, or if it isn't clearly better within about a day with the lenses out. Contact lens wearers can get corneal infections that need treatment quickly.

It depends on how you like to live with glasses.

• Distance target: you see far (driving, TV) without glasses and use readers or progressives for close-up.
• Near target, staying a little nearsighted: you can read and use your phone without glasses but wear glasses to drive. Many lifelong nearsighted people who like taking their glasses off to read choose this.

Either way, halos from the cataract should improve, because the cloudy lens is removed.

• What exact target are you aiming for in each eye, and will both eyes match?
• Do I have astigmatism a toric lens would correct, and what does that cost?
• How will I manage between the two surgeries, when my eyes won't match?

With a mild cataract, surgery is rarely urgent, so it's fine to take time to get your questions answered first.