Óptica Carreras Advanced contact lens fitting
Advanced contactology is the personalised fitting of contact lenses, designed specifically for each eye.
Using corneal topography, biomicroscopy, tear film assessment, scleral topography (profilometry) and OCT (optical coherence tomography), we obtain precise parameters that allow us to design made-to-measure lenses, optimising both visual quality and eye health.
Advanced contactology covers the fitting of every type of contact lens, including:
- Conventional and disposable soft lenses (daily, monthly, etc.), spherical and toric.
- Multifocal soft lenses for presbyopia (tired eyes).
- Soft lenses for myopia control in children and teenagers.
- Orthokeratology (Ortho-K) lenses.
- Rigid gas permeable (RGP) lenses.
- Special RGP lenses for irregular corneas.
- Hybrid lenses, combining a rigid centre with a soft edge.
- Piggy-back systems (soft lens + RGP combination).
- Scleral lenses, especially indicated in complex cases and severe dry eye.
This type of contactology covers everything from simple prescriptions to highly complex cases, including lens fitting for:
- Presbyopia (tired eyes)
- Paediatric patients
- Orthokeratology (Ortho-K)
- Special corneas: keratoconus, pellucid marginal degeneration, corneal ectasia after refractive surgery, high or irregular astigmatism, post-corneal-transplant eyes, dry eye, and more.
Orthokeratology (Ortho-K)
What is orthokeratology (Ortho-K)?
Orthokeratology is the fitting of a specialised contact lens that gently reshapes the cornea overnight, while you sleep. When the lens is removed in the morning, the patient can see clearly all day long without glasses or contact lenses.
Who is it suitable for?
It can be used from children aged 6 up to adults over 60, always after a thorough preliminary study to determine whether the eye is suitable for this treatment.
Ortho-K must only be carried out by highly specialised professionals, as it requires training, precision, experience and advanced technology.
Why is it one of the best methods for myopia control?
Numerous scientific studies show that Ortho-K slows the progression of myopia.
Does orthokeratology carry risks?
Like any healthcare treatment, it is not risk-free, but current scientific evidence shows it is a safe treatment for children and adults when fitting, hygiene and check-up protocols are properly followed.
Safety depends on:
- A rigorous preliminary study.
- Proper professional follow-up.
- Compliance with wear and care instructions.
Soft contact lenses for myopia control
There are various soft lens designs developed specifically for myopia control.
Our practice took part in the pioneering study of the first MiSight daily lenses for childhood myopia control, giving us solid clinical experience in this field.
We know the different designs on the market in depth and assess which option is best for each child, since not all eyes respond in the same way.
Studies show a reduction in myopia progression of between 29 % and 45 %, depending on the design and the patient's profile.
These lenses work by creating myopic peripheral defocus on the retina, a key mechanism in controlling eye growth.
Contact lens specialists for children and teenagers
Children's and teenagers' self-esteem and confidence are closely linked to their image and their vision.
In clinical studies, 80 % of parents say contact lenses improved their children's confidence.
Contact lenses offer greater freedom to play and do sport.
They provide a wider peripheral view than glasses, improving awareness of the surroundings.
The cost is affordable and flexible, depending on lens type, frequency of use and prescription. Some children wear them every day, others only for specific activities.
RGP contact lenses
RGP (rigid gas permeable) contact lenses are high-precision lenses designed to deliver excellent visual quality, especially in eyes with complex prescriptions or corneal irregularities.
Unlike soft lenses, RGP lenses keep their shape on the eye, which compensates for corneal irregularities and provides sharper, more stable, higher-contrast vision.
They are indicated in cases such as:
- Keratoconus and other corneal ectasias
- Eyes with poor visual quality after refractive surgery
- Corneal transplants (post-keratoplasty)
- Patients who cannot achieve good vision with soft lenses
In many cases, RGP lenses are not just another alternative, but the best — and sometimes the only — possible visual solution.
What advantages do RGP lenses offer?
- Better visual quality, especially on irregular corneas.
- Excellent corneal oxygenation thanks to their gas permeable materials.
- Greater durability than soft lenses.
- Optical stability, even with high prescriptions.
- Less deposit build-up compared with soft lenses.
Although they require an adaptation period, most patients experience such a significant visual improvement that it more than makes up for the process.
Personalised fitting: the key to success
RGP fitting cannot be standard. It requires:
- A detailed study of the cornea using corneal topography
- Anterior segment assessment with ocular biomicroscopy and OCT
- Tear film evaluation with the Keratograph's Jenvis module, which helps us choose the material
- Precise selection of lens design, diameter, curvature and material
- Close follow-up and personalised adjustments
Every RGP lens we fit is designed specifically for that eye, seeking the perfect balance between vision, comfort and eye health.
SCLERAL contact lenses
Scleral contact lenses are one of the greatest advances in modern contactology. They are large-diameter lenses that rest exclusively on the sclera (the white of the eye) and do not touch the cornea, creating a tear reservoir between the lens and the ocular surface.
This design restores vision and comfort in eyes where other lenses are no longer effective.
Who are scleral lenses for?
Scleral lenses are especially indicated in:
- Advanced keratoconus.
- Pellucid marginal degeneration.
- Corneal ectasia after refractive surgery.
- Corneal transplants (post-keratoplasty).
- Severe irregular astigmatism.
- Moderate and severe dry eye.
- Patients intolerant to other contact lenses.
- Patients with ocular surface disease, and more.
In many of these cases, scleral lenses are not just another option, but the lens of choice when other fittings fail to provide adequate vision or comfort.
Why are scleral lenses so comfortable?
Because they do not rest on the cornea, they:
- Avoid rubbing on a sensitive or irregular surface.
- Protect the cornea from eyelid friction.
- Maintain a constant tear reservoir that hydrates and nourishes the ocular surface.
For this reason, even patients with severe dry eye or eye pain can experience a high level of comfort from the very first days of wear.
Made-to-measure fitting with SCLERAL PROFILOMETRY (Eye Surface Profiler)
The key to success with scleral lenses is an absolutely personalised fitting.
Thanks to our recently incorporated scleral profilometer, we can analyse with great precision the true shape of the sclera, which is neither perfectly regular nor symmetrical.
This allows us to:
- Design fully made-to-measure lenses, adapted to each eye.
- Optimise the scleral landing zone, improving comfort.
- Reduce pressure points and complications.
- Increase lens stability.
- Improve long-term eye health.
Scleral profilometry is a qualitative leap in precision, especially in complex cases where standard fittings are not enough.
Advanced technology for complex cases
For scleral lens fitting we use:
- Three-dimensional corneal topography.
- Anterior segment OCT to assess the landing zone and tear reservoir.
- High-precision scleral profilometry with the ESP.
- Photography and video systems for follow-up.
All this allows us to monitor the fit over time, make fine adjustments and guarantee stable, safe results.
Advantages of scleral lenses
- Excellent visual quality on irregular corneas.
- High comfort, even for sensitive eyes.
- Protection of the ocular surface.
- Significant improvement in vision and quality of life.
- Completely personalised design.
For many patients, scleral lenses are a genuine turning point — not only visually, but also in daily comfort and wellbeing.
Experience, technology and follow-up
Scleral lens fitting is one of the most complex procedures in contactology. It requires advanced training, specific technology and clinical experience.
Our approach is based on:
- A thorough initial study.
- An individualised design for each lens.
- Close follow-up with progressive adjustments.
- Absolute priority on eye health.
Are scleral lenses right for you?
Every eye is unique and every case needs an individual assessment.
We carry out a personalised study to determine whether scleral lenses are the best option for you, or whether another type of lens better suits your ocular condition and visual needs.
Our goal is always the same: to recover the best possible vision, with maximum comfort and safety.
What is keratoconus?
Keratoconus is a progressive disease of the cornea that causes it to thin and bulge, producing irregular astigmatism and blurred vision.
- It usually affects both eyes, although one is typically more advanced.
- It generally appears in puberty.
- It progresses slowly and usually stabilises around age 40–45.
- It does not cause blindness, but it can seriously affect visual quality.
Treatment requires a high level of specialisation, advanced technology and clinical experience.
What causes keratoconus?
Although the exact cause is unknown, it is associated with:
- Enzymatic changes that weaken the corneal tissue.
- Hormonal influence (puberty, pregnancy).
- Frequent eye rubbing, especially with allergies, which can release cytokines that stimulate corneal tissue breakdown.
- A genetic component (6–10 % of cases have a family history).
How do we help these patients?
The role of the specialised contact lens optometrist is key.
The goal is to fit special lenses that achieve the best possible vision while always protecting eye health. We use:
- Three-dimensional corneal topography.
- Anterior segment OCT.
- Photography and video systems to monitor the fit.
Depending on the case, we can fit:
- Special soft lenses.
- RGP lenses.
- Hybrid lenses.
- Piggy-back systems.
- Scleral lenses, which rest on the sclera without touching the cornea, providing great comfort even in severe cases.
Contact lenses for high astigmatism
With high or irregular astigmatism, individualised — not standard — lenses are essential.
Thanks to corneal topography, we design fully made-to-measure lenses, improving:
- Eye health.
- Visual quality.
- Stability and comfort.
In many cases, this is the only viable option for patients with complex prescriptions.
Multifocal contact lenses
Multifocal contact lenses combine several powers in a single lens, allowing clear vision at distance, near and intermediate range (computer).
They are an excellent solution for presbyopia (tired eyes), when the eye can no longer focus — especially for active people who want visual freedom.
With age, the eye becomes more delicate and needs higher-quality materials, resistant to dehydration and compatible with reduced tear production.
Which is the best option for me?
There are soft and gas permeable progressive contact lenses, always personalised.
We carry out an individualised study taking into account:
- The characteristics of your eyes.
- Your work environment.
- Your daily and sporting activities.
- Your lifestyle.
We will recommend the option best suited to you, always with the latest-generation materials and a focus on comfort, health and durability.
