Custom-made contact lenses

A bespoke contact lens is a lens made specifically for your eye, rather than coming from a standard stock. Your optician or optometrist will take detailed measurements of your eye, such as the curvature of the cornea (keratometry), the diameter of the iris, the size of the pupil and, of course, your prescription. Based on this data, the lens is individually manufactured by the manufacturer.

Custom-made lenses are mainly prescribed when standard lenses do not fit properly or do not provide sufficient correction. This may be the case with a highly irregular cornea, following eye surgery, with very high prescriptions, or with unusual eye shapes. In cases of keratoconus – a condition in which the cornea gradually becomes thinner and takes on a conical shape – custom-made lenses are often the only option for achieving clear vision.

The process of having a lens made to measure takes longer than with standard lenses – often several weeks – and usually requires several follow-up appointments to optimise the fit and comfort. The optician can have the lens adjusted as necessary until the fit is right.

When are custom-made lenses prescribed?

Custom-made lenses are intended for situations where standard lenses are not suitable. This may be the case with a very steep or, conversely, very flat curvature of the cornea, with high cylindrical power (astigmatism), with presbyopia combined with other conditions, or following refractive surgery such as LASIK. A custom-made lens may also be required in cases of corneal scarring or following a transplant.

Types of custom-made lenses

There are various types of custom-made lenses. Soft custom-made lenses are made from materials such as silicone hydrogel and may, for example, have a larger diameter or a specific toric geometry. Custom-made rigid gas-permeable (RGP) lenses are often prescribed for irregular corneas, as they create a smoother optical surface and thus provide sharper correction. Scleral lenses are large rigid lenses that rest on the white of the eye and span the cornea; they are used to treat severe dry eye, keratoconus or other corneal conditions.

The fitting process

Fitting a bespoke lens begins with a comprehensive eye examination. The optician or optometrist measures the curvature of your cornea using a keratometer or topographer, determines the diameter and assesses the tear film. Sometimes trial lenses are used to test the fit before the final lens is ordered. Following delivery, follow-up appointments are scheduled to check that the lens moves correctly, is neither too tight nor too loose, and that your vision is clear and comfortable.

Care and lifespan

Custom-made lenses require the same careful maintenance as standard lenses, depending on the material. Soft custom-made lenses should be cleaned with an all-in-one solution or a peroxide system, whilst rigid gas-permeable (RGP) lenses should be cleaned with a special RGP solution. Their lifespan depends on the type: custom-made soft lenses are often replaced monthly or every three months, whilst rigid gas-permeable lenses can last for one to two years if properly maintained. Always follow the replacement schedule recommended by your optician.

Costs and reimbursement

Custom-made lenses are more expensive than standard lenses, as they are made to order. The price varies considerably depending on the type and manufacturer. In the Netherlands, basic health insurance only covers contact lenses for certain medical conditions, such as keratoconus or aphakia; supplementary insurance may contribute towards the cost. Ask your optician or health insurer about the options available.