Joel Hunter, MD Refractive Surgeon, Hunter Vision Updated 12/19/19 1:09 PM
A lot of people with astigmatism choose to wear contact lenses on a regular basis instead of eyeglasses. That's because contact lenses provide a more natural field of view without thick frames getting in the way of their peripheral vision. And for the fashionable folks, there's no need to compromise one's style while wearing contacts. There are a lot of reasons people choose contacts over glasses. One of those reasons is to change their eye color. Today’s question: can you fix astigmatism with colored contacts?
I've been asked a lot about this question; so I decided to write about it knowing that there are a lot of people out who may want to know more about switching to colored contacts for good. For starters, it’s important to point out that any contact lens should have a prescription from the doctor. It's a rule that everyone should follow, but sometimes gets overlooked by patients seeking colored contacts.
So, before we get to the details, always seek your eye doctor's advice first should you decide to wear colored contact lenses. There are many retailers selling colored contacts without asking for a prescription and buyers (who are just looking to change their eye color) don’t have a reason to ask, “are we observing the proper protocol here?” Yet, while we can all agree how awesome it is to amber or light blue eyes, the last thing you'd want to happen is to develop poorer vision. Even worse results are possible, like pink eye (conjunctivitis) a severe corneal infection. In the end, the shortcut is too risky to be worth it.
What are colored contact lenses for astigmatism?
At one time, contacts could be vision-correcting or strictly for cosmetic purposes. The latter is popular among teens and college students. As an aside, there is interesting market research describing how this trend is related to social media and entertainment. Several studies, such as a 2004 research study by Australian optometrists, have found that those who wear cosmetic tinted lenses experienced lower visual performance during and after wearing the contacts. Singaporean researchers also published a study on cosmetic contact lens-related infections.
In general, vision-correcting contacts are known as prescription contact lenses because they can correct farsightedness (or hyperopia), nearsightedness (or myopia) and, on topic for today, astigmatism. Cosmetic contacts (also known as plano color contact lenses) are those that are worn without need for vision correction.
Today, many brands have contacts that are both cosmetic and vision-correcting. In addition, the variation in color has grown quite a bit. Patients are not limited to hazelnut or brown alone, but can also choose fun colors like sapphire or turquoise. There are also two, three, and even four-tone variations that incorporate different shades into one contact lens. Manufacturers market these as contacts that make one's eyes sparkle and, for lack of a better word, eye-catching because the colors seem to change while the contacts are worn.
While the cost of colored contacts when compared to regular type is also much higher, many wearers feel that changing their eye color is worth the price of each pair of lenses. And the truth is, if someone feels that way, they’re right.
For those with astigmatism, colored contacts are soft toric lenses. They are considered appropriate for those with astigmatism because of the custom fit that they provide considering for a cornea has two curvatures instead of one. When worn, they are most likely to get crisp and clearer vision. Take note that for this to be achieved and provide the wearer with better comfort, an eye doctor often has to fit the lens over several visits so that the customized fit is perfect for each eye, both in comfort and visual acuity. There's no one-size-fits-all standard when it comes to contact lenses.
However, if the contacts keep on misaligning due to excessive eye movement or blinking often, a gas permeable colored contact lens can be tested. This type of contact doesn’t have issues with rotational stability that cause problems with soft toric contact lenses. Rigid gas permeable lenses also take time to fit properly, but if the right fit is found to be comfortable, they’re hard to beat for quality of vision.
So, are colored contacts safe?
That depends on what colored contact lenses you use and your daily care. One easy step is to look and see if the contacts are approved by the Food and Drug Administration (FDA). And as long as they are properly prescribed by your eye doctor and you religiously follow hygienic practices, then you can feel confident wearing them. A study commissioned in 2013 by a leading contact lens manufacturer found this (maybe unsurprisingly) to be true. The study looked at cosmetic tinted lenses and included over 800 patients. It found that when cosmetic lenses are properly prescribed by an eye doctor, and used by experienced wearers who follow proper care procedures, these contact lenses are safe to use.
Can colored contacts correct astigmatism? How does it work?
With astigmatism, the cornea is not smooth or evenly curved, so light doesn’t focus properly on the retina. This is a case of corneal astigmatism. There’s also lenticular astigmatism, which is the same problem except it is the lens instead of the cornea that is irregular. In either case, light isn’t getting focused clearly, and that’s why there’s always a blur when looking at objects.
It is rare to have astigmatism as the only problem. Usually, nearsightedness or farsightedness is also a part of the problem. For all three of these, astigmatism, nearsightedness, and farsightedness, it’s genetics at play more than any other factor. There’s a pervasive urban legend that reading in low light or sitting too close to the TV or working long hours in front of the computer causes these problems. The American Academy of Ophthalmology (AAO) hasn’t found this to be true. In my experience, I believe they’re correct. Even if I wasn’t an eye doctor, I’d struggle to find a reason for the AAO hide the truth on this issue.
As mentioned previously, toric contact lenses are prescribed by eye doctors for astigmatism patients. The American Optometric Association (AOA) lists toric soft contact lenses as an alternative to eyeglasses for astigmatism. The downside is that the hydrogel or silicone hydrogel component in the lens that makes it soft often cause the contacts to move while worn. This can cause intermittent blur when the refractive power of the lens changes with every blink. This alone is a good reason to find an optometrist who is great at fitting contacts. I happen to know one name: Justine Siergey. I’m not even saying that because she works at Hunter Vision. I honestly sent patients to her even back when she worked for our competition. She’s that good.
Several studies have also shown a high success rate with toric contact lenses. Medical researchers found out that toric contact lenses contribute to improved vision among patients in low-to-moderate cases of astigmatism. Another study among 30 patients found the same.
So, toric lenses can help astigmatic patients, and it doesn’t matter if they are clear or tinted for an eye color-changing effect. Just to be clear, the astigmatism correction is brought about by the special toric design; the color is irrelevant. Whatever color you choose, as long as the lens is approved by the FDA and prescribed by your doctor, the contacts may help. The part of the contacts that covers the pupil does not have any color so you can see things as they are and not with the tint of blue, green, or brown.
What choices do I have with colored contact lenses for my astigmatism?
There are plenty of options available. In terms of tint, colored contacts come in visibility, enhancement, and opaque variants. Visibility tinted contact lenses (sometimes called Lite Tint or VISITINT) are designed for wearers who prefer a more natural effect. That's because these lenses often come in very light blue or green but have very little effect on changing your eye color. It's closer to transparent, because the color just exists to guide you better when placing the contacts on your eyes. It’s hard to see contacts that are completely clear with zero tint.
Enhancement tinted lenses, on the other hand, are a level higher when it comes to darkness compared to visibility tinted lenses. Also known as medium tints in some optical shops, these contacts are better for people with green or blue eyes. They aren’t that helpful for those with dark eyes. With dark brown eyes, the tint is lost and doesn’t produce a lot of color-changing effect.
Finally, opaque contacts are non-transparent variants that contain a solid layer of color around the iris with a clear, transparent center (for you to see clearly). It's perfect for users with naturally dark eyes because they mask the underlying darker color. The natural brown of the iris isn’t seen because the opaque contact blocks it. The color can be whatever the wearer chooses.
Your eye doctor may also refer you to a manufacturer that creates customized prescription colored contact lenses. They can design a specific eye color for you. As you can imagine, this is more expensive.
How to get colored contacts for astigmatism
As I mentioned above, all contact lenses require a prescription and proper fitting by an optometrist or ophthalmologist. Why do you need a prescription? Mostly because it’s safer that way. But also because the FDA categorizes contact lenses as prescription medical devices and therefore, they cannot be sold over-the-counter without patients presenting a prescription. I’ve even heard stories of sting operations where vendors were recorded selling colored contacts without a prescription. But I’m not sure if that’s true or just a campfire story told by eye doctors.
Requiring a prescription protects consumers from obtaining contact lenses from illegal vendors and prevents the risk of injury caused by counterfeit products. The AOA reports, however, that 53 percent of consumers in 2014 have purchased cosmetic contacts without a prescription. Clearly, more information in the public sphere would be helpful. Hopefully, this article will contribute to that.
So, what about ordering online? You guessed it! You still have to present a prescription. The Fairness to Contact Lens Consumers Act (FCLCA) requires sellers to ask and verify prescriptions before selling contact lenses. So even if you purchase online, the step of seeing an eye doctor remains necessary.
Are there risks associated with wearing colored contacts for astigmatism?
Wearing contact lenses, whether they are cosmetic, prescription, colored or transparent, comes with risk. It’s necessary to write that in any article like this. I’m glad that it’s necessary, but also find it a little confusing. There is risk in just about any active or inactive pursuit possible. Even eyeglasses have risks.
A common risk among those who wear colored contact lenses is movement of the lens when they blink. Imagine finding yourself in an important client meeting only to draw the other person's attention because he thinks you have two different-colored eyes (or a case of heterochromia iridium if you want to be more scientific).
Allergic reaction is another risk. Some develop eye irritation from the components of the contact lens solution or the contact lens itself. Patients may suffer from redness of the eye, pain, and worse vision.
The size of your pupil will also adjust to different lighting conditions with your contacts. That’s normal. Other risks may develop, however, especially if someone isn't used to wearing contacts. These include corneal infection, corneal abrasion (or scratches), pink eye, or decreased vision.
If you notice any of these, it is highly recommended to seek the advice of your eye doctor and to avoid self-medicating as this can lead to even more dangerous consequences.
Since we talk about LASIK a lot on this website, I’ll mention here that there’s an option that prevents the need for contacts altogether. If your main goal is to fix your vision and forget about contacts, then it’s worth checking out LASIK. It can fix astigmatism, too.
How much does LASIK cost for astigmatism?
One of the common questions I get is the cost for LASIK in cases of astigmatism. Honestly, LASIK costs vary depending on your condition, your region, your clinic or hospital, the laser technology used in the procedure, your doctor's expertise and qualifications, and a host of other factors.
Plus, some doctors have hidden costs that you'd only find out upon receiving your hospital bill. These include medications and disposable medical supplies, royalty fees for the laser equipment manufacturer, overhead cost for the surgery clinic or hospital, pre-operation consultancy fee, eye examination fee, and the list goes on.
The best way to figure out how much LASIK would cost for you is to set up a free consultation. Find a place that will let you ask all the questions you want to ask. If that place happens to be Hunter Vision, then we can help you find good answers about LASIK or colored contact lenses, depending on what works best for you right now.
Author: Joel Hunter, MD is an Ophthalmologist, Refractive Surgeon, and the Founder of Hunter Vision, a LASIK Orlando Clinic in Florida. A recognized and respected specialist in vision correction who has performed a countless number of refractive surgeries, Joel gives lectures across the country and trains fellow doctors in the newest LASIK surgery techniques.