GP Lenses: a Primary Option
BY BRAD GIEDD, OD, MS, FAAO
In writing my final column for 2008, I spent a good deal of time contemplating what topic would bring good GP closure to the year. Is there some hot topic I haven't touched upon that might shed some new light on a current lens design or fitting technique? Is there a case I've seen that might offer some enlightenment to GP fitters that I've overlooked until now?
In the absence of an epiphany, I decided that the best way I could accomplish my mission of advocating increased use of GP lenses in mainstream practice would be to share some personal GP enlightenment stories, the morals of which have more to do with attitude and conviction than with some technological breakthrough.
A Lens Fitting Revisited
The teenage son of a patient who is a successful GP multifocal wearer came in for his annual examination. This young man was entering those awkward teenage years, and appearance had suddenly become critically important and had led him to request contact lenses. I remembered having fit him with contact lenses a few years before at the request of his mother, but he was ultimately unsuccessful at that time due to lens handling and application issues.
This time around though, life, and perhaps a new outlook on the opposite gender, had definitely motivated him and it was his idea to try contact lenses again. We proceeded with the fitting and started him with a mainstream, planned-replacement, low-toric soft contact lens and a multipurpose solution. I applied the initial lenses, checked the fit, demonstrated the vision to him, and off I went to the next patient believing that the next time I'd see that young man, he'd be a happy, successful lens wearer.
It didn't exactly work out that way. He returned 10 days later, with his mom but not his lenses. He'd experienced the same problems and just wasn't getting the hang of applying those floppy soft lenses to his eyes.
And at that moment it struck me. Why hadn't I considered GPs, especially this time around? After all, I am an advocate. I even wear them myself and have since I was a teenager. This was a GP wearer waiting to happen! After a brief explanation of GP benefits (Mom sure didn't need much convincing), I refit him with GPs. He adapted easily and mastered lens handling relatively quickly. He also appreciated slightly better vision with the GP lenses.
Ending Soft Lens Frustration
Several days later I was working with a presbyopic patient who had failed with monovision and was experiencing problems with soft multifocal lenses. Every attempt at fine-tuning his vision corrected one problem but induced another. This patient had a long history of soft contact lens wear dating back to long before he was a patient of our practice.
I recounted this patient's recent poor experiences with soft lenses and presented GP multifocals as a better option. This was the proactive approach that for some reason I'd let "soften." Two weeks later at his follow-up visit, the patient could hardly thank me enough. He'd found an arrangement that gave him excellent computer vision and the ability to do near work without constantly relying on reading glasses and without compromise to his distance vision.
Recommend GPs First
If you are truly an advocate of GP lenses and you believe the positive things that you tell your patients about them, then you need to be willing to present GPs as a first option. In my experience this is not how most of you practice, so I challenge you to make a conscious effort to include GPs when you consider your initial lens selections. Resist the urge to simply default to soft lenses. You will find that there are many more opportunities to fit GP lenses than you thought possible, and you and your patients will be better for it. CLS
Dr. Giedd entered private practice with the Eye Associates of Winter Park in 2000, where he specializes in fitting specialty contact lenses and also performs contact lens-related clinical research.