Five Tips for Increased Success with GP Lenses
BY NANCY CHAN, OD, & JOHN MARK JACKSON, OD, MS, FAAO
Corneal GP lenses remain an important part of contact lens practice. Although designs have improved significantly over time, there will always be an initial hurdle to overcome: getting patients to accept and adapt to these lenses.
Five Ways to Increase Success
Here are some of our favorite tips to achieve positive patient experiences with corneal GPs.
1. Present with enthusiasm. As the saying goes, accentuate the positive. GP lenses can provide superior vision and excellent ocular health, especially for patients who have astigmatism and irregular corneas. Initial comfort should be addressed head-on to set realistic patient expectations. That being said, more positive phrases such as “initial lens awareness” rather than “initial lens discomfort” will help to improve the initial impression that patients have with corneal GPs.
2. Use topical anesthetic. For first-time wearers, a drop of anesthetic can make a big difference in initial comfort. By eliminating corneal sensation, it reduces reflex tearing. This slows down the movement of the lens (also enhancing comfort). It also makes assessment of the fluorescein pattern and lens positioning quicker and easier. As the anesthetic wears off, the patient has time to adjust to the initial lid sensation in a controlled manner.
Topical anesthetic can also be used when the lens is dispensed for apprehensive patients.
3. Provide great vision right away. The quality of vision with GP lenses is a big motivating factor for patients. If you are comfortable with empirical fitting, it pays to use it when you can. It allows the first lens that you apply on the patient to be his own prescription, providing a visual “wow” factor. Empirical fitting also reduces chair time. Not all lenses should be fit empirically (many multifocals and lenses for irregular corneas come to mind), but it can help with the initial visual impression when you can.
Figure 1. A lid-attached GP lens.
4. Design makes a difference. Generally, a lid-attached fit (Figure 1) will be more comfortable. You can usually achieve lid attachment in normal corneas in which the upper lid covers the superior limbus. Use a relatively large diameter (such as 9.6mm to 9.8mm), but not so large that the lens bumps the bottom lid. For wider palpebral fissures, you may do better with a smaller, intrapalpebral fit.
Pay close attention to edge quality as well. A poor edge can make an otherwise great fit feel terrible. Also have the lenses plasma treated for best initial wettability.
5. Manage adaptation expectations. Instruct patients that it takes about two to four weeks to reach full-time wear, and to build wear time gradually. Skipping days in the adaptation phase can delay reaching that all-day goal. A good cleaning regimen and rewetting drops will aid comfort in the long-term, too.
Start GP Wearers Off Right
These hints should help your patients get off on the right foot with their corneal GP lenses, increasing their overall comfort and contact lens satisfaction. CLS
For references, please visit www.clspectrum.com/references.asp and click on document #219.
Dr. Chan is the current cornea and contact lens resident at Southern College of Optometry. Dr. Jackson is an associate professor at Southern College of Optometry, where he works in the Advanced Contact Lens Service, teaches courses in contact lenses, and performs clinical research. You can reach him at email@example.com.