The Complete Guide to Contact Lenses: Types, Care, and When to See Your Doctor

Contact lenses are one of the most successful medical devices ever developed — worn by approximately 45 million Americans, they provide clear vision without the frame and lens limitations of glasses. But they're also medical devices that require proper fitting, appropriate selection, and consistent care to be safe and comfortable.

Whether you're considering contacts for the first time or have been wearing them for years, this guide covers everything you need to know.

Soft lenses are made from hydrogel or silicone hydrogel materials and conform to the shape of the eye. They're the most commonly prescribed type and are comfortable for most wearers from the first day.

Daily disposables: Worn once and discarded. No cleaning, no storage, no solution required. The healthiest option for most wearers — each day starts with a fresh, sterile lens. Particularly recommended for occasional wearers, allergy sufferers, and patients prone to deposits.

Two-week disposables: Replaced every two weeks. Require daily cleaning and proper storage. More economical than dailies for full-time wearers.

Monthly disposables: Replaced monthly. The most economical soft lens option for full-time wearers, but require the most diligent cleaning and care.

Extended wear lenses: Approved for overnight wear for up to 30 consecutive nights. Carry higher risk of corneal complications than daily wear lenses — discuss carefully with your eye doctor before choosing this option.

Silicone hydrogel lenses transmit significantly more oxygen to the cornea than standard hydrogel lenses. The cornea has no blood vessels — it gets its oxygen directly from the atmosphere through the tear film. Oxygen deprivation (hypoxia) is a leading cause of contact lens complications, including abnormal blood vessel growth into the cornea.

For most patients, silicone hydrogel lenses are the preferred choice. However, some patients find them less comfortable than standard hydrogel lenses, particularly those with dry eye — the higher oxygen permeability comes with lower water content, which can feel drier.

Astigmatism occurs when the cornea or lens is shaped more like a football than a sphere, causing blurry vision at all distances. Standard spherical contact lenses don't correct astigmatism — toric lenses are specifically designed to do so.

Toric lenses have different powers in different meridians and must stay properly oriented on the eye to provide clear vision. Modern toric lenses use ballasting and other stabilization mechanisms to maintain correct orientation, and most patients adapt to them quickly.

Toric lenses are available in daily, two-week, and monthly replacement schedules.

After age 40, the lens inside the eye gradually loses its ability to change focus for near distances — a condition called presbyopia. Multifocal contact lenses address this by incorporating multiple focal zones into a single lens, allowing clear vision at distance, intermediate, and near distances.

Multifocal lenses require a fitting process that involves some trial and adjustment — the brain needs to learn to use the different zones, and the power balance between distance and near correction needs to be optimized. Most patients achieve good results with patience and a skilled fitter.

RGP lenses are made from firm, oxygen-permeable materials. They provide sharper vision than soft lenses for many prescriptions, particularly high astigmatism, and are more durable and deposit-resistant. The tradeoff is a longer adaptation period — RGP lenses take 1–2 weeks to become comfortable, compared to the immediate comfort of soft lenses.

RGP lenses are often the best choice for patients with irregular corneas, high prescriptions, or conditions like keratoconus.

Scleral lenses are large-diameter rigid lenses that vault over the entire cornea and rest on the sclera (the white of the eye). They create a fluid reservoir between the lens and the cornea that provides continuous lubrication — making them an excellent option for patients with severe dry eye, irregular corneas, or conditions like keratoconus and corneal scarring.

Scleral lenses require specialized fitting and are more involved to insert and remove than standard lenses, but for patients who can't wear conventional lenses comfortably, they can be transformative.

Dry eye is the most common reason people stop wearing contact lenses. The lens sits on the tear film and can disrupt its stability, leading to dryness, discomfort, and blurry vision — particularly in the afternoon and evening.

If you experience contact lens-related dryness, several strategies can help:

Switch to daily disposables: Fresh lenses every day means no protein and lipid deposits that accumulate on reusable lenses and contribute to dryness.

Try a different material: Some patients do better with standard hydrogel lenses (higher water content) despite their lower oxygen permeability; others do better with silicone hydrogel. Trial and error with your optometrist's guidance is often necessary.

Use preservative-free rewetting drops: Drops specifically formulated for use with contact lenses can provide relief during wear. Avoid drops with preservatives, which can accumulate on the lens.

Treat the underlying dry eye: If your dry eye is significant, no contact lens will be comfortable until the underlying condition is addressed. This may mean meibomian gland treatment, anti-inflammatory therapy, or other dry eye interventions before returning to contact lens wear.

Consider scleral lenses: For patients with moderate to severe dry eye, scleral lenses — with their built-in fluid reservoir — can provide comfortable vision when nothing else works.

In Las Vegas's desert climate, contact lens-related dryness is particularly common. The low humidity and air conditioning create challenging conditions for tear film stability. If you're struggling with dry, uncomfortable lenses in Las Vegas, it's worth a dedicated dry eye evaluation before giving up on contacts entirely.

Contact lenses are safe when used correctly. Most serious complications — corneal infections, ulcers, and permanent vision loss — are preventable with proper habits.

Sleeping in contact lenses dramatically increases the risk of corneal infection. The cornea needs oxygen, and a closed eye with a contact lens creates a hypoxic environment that promotes bacterial growth. Even one night of sleeping in lenses significantly elevates infection risk.

If you fall asleep accidentally with lenses in, remove them as soon as you wake up and give your eyes a day of rest before wearing lenses again.

Wearing lenses beyond their replacement schedule allows protein, lipid, and calcium deposits to accumulate on the lens surface. These deposits reduce oxygen transmission, harbor bacteria, and cause inflammation. A monthly lens worn for six weeks is not the same as a fresh monthly lens — it's a deposit-laden surface that increases your infection risk.

Tap water, distilled water, and even sterile saline are not appropriate for contact lens care. Water can harbor Acanthamoeba — a microscopic organism that causes a devastating corneal infection that is extremely difficult to treat. Always use fresh contact lens solution.

This rule applies to showering and swimming as well. Remove lenses before any water exposure, or wear waterproof goggles.

This seems obvious but is frequently skipped. Bacteria from your hands are a primary source of contact lens contamination. Wash with soap and water and dry thoroughly before inserting or removing lenses.

Contact lens cases harbor biofilm — a bacterial community that resists cleaning. Replace your case at least every three months, or with every new bottle of solution. Rinse with fresh solution (not water) and allow to air dry face-down on a clean tissue.

A red, painful eye in a contact lens wearer is an emergency until proven otherwise. Remove your lenses immediately and call your eye doctor. Corneal infections can progress rapidly — hours matter. Do not put your lenses back in until you've been evaluated.

Beyond your annual contact lens exam, see your eye doctor promptly if you experience:

• Redness that doesn't resolve after removing your lenses
• Pain or significant discomfort
• Sudden blurry vision
• Increased light sensitivity
• Discharge from the eye
• A feeling that something is in your eye that doesn't resolve

Annual contact lens exams are required for prescription renewal — and they're important even if your vision seems unchanged. Your eye doctor checks the health of your cornea, evaluates the fit of your lenses, and can catch early signs of complications before they become serious.

Whether you're new to contact lenses or looking to update your prescription or try a different lens type, we'd be happy to help. Dr. Payne takes the time to find the right lens for your eyes, prescription, and lifestyle — not just the most convenient option.

Schedule a contact lens exam at our Summerlin office. We see patients of all ages and experience levels.