How should initial fit inform soft contact lens prescribing

Nikolay Boychev, Deborah S. Laughton, Gulshan Bharwani, Hafsa Ghuman, James S. Wolffsohn*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Purpose: To investigate how initial HEMA and silicone-hydrogel (SiHy) contact lens fit on insertion, which informs prescribing decisions, reflect end of day fit. Methods: Thirty participants (aged 22.9. ±. 4.9 years) were fitted contralaterally with HEMA and SiHy contact lenses. Corneal topography and tear break-up time were assessed pre-lens wear. Centration, lag, post-blink movement during up-gaze and push-up recovery speed were recorded after 5,10,20. min and 8. h of contact lens wear by a digital slit-lamp biomicroscope camera, along with reported comfort. Lens fit metrics were analysed using bespoke software. Results: Comfort and centration were similar with the HEMA and SiHy lenses (p > 0.05), but comfort decreased with time (p <. 0.01) whereas centration remained stable (F = 0.036, p = 0.991). Movement-on-blink and lag were greater with the HEMA than the SiHy lens (p <. 0.01), but movement-on-blink decreased with time after insertion (F = 22.423, p <. 0.001) whereas lag remained stable (F = 1.967, p = 0.129). Push-up recovery speed was similar with the HEMA and the SiHy lens 5-20. min after insertion (p > 0.05), but was slower with SiHy after 8. h wear (p = 0.016). Lens movement on blink and push-up recovery speed was predictive of the movement after 8. h of wear after 10-20. min SiHy wear, but after 5 to 20. min of HEMA lens wear. Conclusions: A HEMA or SiHy contact lens with poor movement on blink/push-up after at least 10. min after insertion should be rejected.

Original languageEnglish
Pages (from-to)227-233
Number of pages7
JournalContact Lens and Anterior Eye
Issue number3
Early online date19 Nov 2015
Publication statusPublished - Jun 2016

Bibliographical note

© 2015, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International


  • contact lenses
  • HEMA
  • prescribing
  • settling time
  • silicone hydrogel


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