Features: Contact Lenses


Contact Sports

Contact Sports

Creative Contact Lens Fits For Athletes

by Nancy Del Pizzo

With 85 percent of Americans participating in sports or exercise—according to the 2001 Economy & Leisure Study by the Sporting Goods Manufacturers Association—it’s likely that many eyecare patients are active in at least one sport. Whether those patients are $10 million-a-year golf stars, 40-year-old league tennis players or 14-year-old swimming phenoms, they all have one thing in common: A desire to perform their sport at their best. Contact lenses can provide a visual edge for sports performance by offering optimal visual acuity, dynamic visual acuity, eye-hand coordination and depth perception. But one lens doesn’t fit all.

While it’s true disposable contact lenses meet the needs of many active patients, they are not the only option and not always the best option. Practitioners who are committed to identifying patients’ lifestyles and are educated and current about available contact lens options have developed a loyal contact lens patient base and a steady stream of referrals. Below, they share some of their creative fitting techniques for various athletes:

Active Considerations
Most practitioners have a preferred set of contact lenses they generally depend on for active patients. Daily disposables fall into this category, because they require little cleaning and can be worn for the activity and thrown out later.
Other types of lenses for athletes include those in larger diameters. “I tend to fit larger diameter lenses for sports use than I do for everyday use,” says Christopher Clark, OD, of Seattle Sports Vision in Seattle, Wash. “I also tend to prescribe more frequent replacement schedules for my athletes.”
“A larger diameter lens tends to get less debris under it—making it more useful for sports like cycling, baseball and soccer,”adds Ridgefield, Conn.-based Alan Berman, OD. “I may also fit a lens tighter than normal for the athlete to achieve stability, which is extremely important in rapid eye movement sports.”
 Another fitting technique Dr. Berman uses with athletes is to fit a thicker lens. “Some sports require steady fixation, like a pitcher in baseball. As a result, the eyes tend to blink less and dry out. A thicker lens and regular lubrication with drops can alleviate that problem.”

Some of these techniques lend themselves to multiple pair sales. For example, while tight-fitting lenses may be the better option for an athlete, they can cause edema or poor corneal physiology over time, notes Dr. Berman. In that case, he may prescribe the tighter lens only for use during the sport and another pair for everyday use.

Fitting By Sport
But when it comes to specific sports, practitioners may adapt their general fitting techniques to fine-tune the contact lens fit. For example, Dr. Clark says “golf is a game where depth perception is critical, especially in the short game [putting and chipping].” And arguably, many patients who golf happen to be over age 40 and/or are presbyopic. To provide these patients with the best depth perception, he typically fits them with contact lenses in their full distance corrections and suggests reading glasses for scorekeeping.

Some practitioners use monovision or a modified monovision for presbyopic golfers. But, generally, the more the patient cares about performance, the less likely mono-vision is as a good choice. “With monovision, the patient will have less depth perception and less judgment. I’d be more likely to use a multifocal lens to provide binocularity,” says Michael Goldsmid, OD of Arena Eyeworks Optometry in San Diego, Calif.

If, however, the patient is already wearing monovision on a daily basis, Dr. Goldsmid may recommend remaining in monovision for golf, but adding a pair of sunglasses fitted with a prescription lens in one eye to provide distance vision over the eye that’s wearing the near vision contact lens. “Then, the patient gets full distance vision but can lift up the sunglasses to read the scorecard,” he says.
Sometimes a practitioner will adapt a contact lens prescription for the skill of the patient. “If a presbyopic patient has a putting problem on the golf course, we might over plus the contact lenses, so the patient can follow the ball better. The patient has to understand that the ball will look fuzzy in the distance,” says Miami Dolphins team doctor Robert Davis, OD, based in Pembroke Pines, Fla. Dr. Davis explains to patients what they can expect before applying lenses, then uses free trial lenses to let them experiment.

Other sports get the same specialized treatment. For example, a daily disposable lens is usually the best option for swimmers. “Water can contaminate a contact lens. Even if the patient who swims doesn’t wear disposable lenses as a regular daily use lens, we recommend them for swimming,” says Dr. Davis. “They’re fantastic for swimmers who have to deal with chlorine and the risk of acanthamoeba keratitis,” adds Dr. Goldsmid. “Disposable lenses are so easy to care for, can be thrown away after use and are available in single-vision and progressive designs, so we can now fit them on more patients.”

For tennis players, practitioners say they’ve tried specialized products, such as ProSoft, that are designed to enhance the yellow in a tennis ball for increased contrast sensitivity. And, for sports such as hockey where patients complain of lenses drying out, lower water content lenses seem to help, notes Dr. Clark.

Focus On UV
Practitioners say they will usually look for a contact lens with ultraviolet (UV) light protection when fitting an active patient. While sunglasses with UV protection shield more of the eye and the face from the harmful effects of the sun, some athletes won’t wear them. “They might find them cumbersome or [annoying] because they fly off their faces. So, I always try to use a contact lens with a UV filter to offer some protection,” says Dr. Goldsmid.

Recommending sunglasses, though, is preferred even when using a contact lens with UV protection. “Contacts are great for protecting the eye’s lens and retina,” says Dr. Clark. “But extended UV exposure is still a problem for the conjunctiva. I don’t like to rely on the UV filtering capabilities of contacts, so I instruct my patients to wear a quality pair of sunglasses when outdoors.”

The newest contact lens option, 30-day continuous wear lenses, may seem contrary to the current practice of fitting frequent replacement benefits for athletes. Still, practitioners who make it a point to really get to know their active patients’ needs are finding sports use applications for these longer wearing lenses. “The 30-day lenses are the closest thing to not wearing a contact lens at all,” says Dr. Goldsmid. “For athletes who complain about dryness, comfort issues or the annoyance of applying drops, these lenses can work well.”

Whatever sport a patient participates in, an experienced OD can find the right CL to fit both the activity and the enthuisiast.