Contact Lens Design & Materials

GP Lens Use in the United States—Why So Low?

Contact Lens Design & Materials

GP Lens Use in the United States—Why So Low?

By Neil Pence, OD, FAAO

About 10 percent of contact lens prescriptions worldwide are for GP lenses, but the percentage drops to about 2 percent in the United States (Morgan et al, 2012). Although these statistics make for interesting conversation at international meetings (as well as chest-bumping by the Dutch and Kiwis and bowed heads among some U.S. practitioners), I believe this topic warrants closer examination. Given the benefits of GP contact lenses—crisp vision, healthy lens wear, and ease of handling, to name a few—why don't U.S. practitioners prescribe them more often? Let's explore some possibilities.

Is It the Lenses? The Fitters?

Comfort is an important consideration when choosing a contact lens. We know that GP lenses require some adaptation, but larger lens designs and new manufacturing techniques have significantly reduced adaption times. What's more, the need for adaptation is universal, whether a patient lives in the United States or New Zealand. Presumably, different GP designs may be available outside of the United States, but I would argue that U.S. labs produce equally innovative, high-quality lenses, so I don't think we can blame the lenses for our lagging GP numbers.

Do U.S. practitioners lack the training needed to fit GP lenses? Admittedly, as a contact lens educator in the United States I am biased, but having had the privilege of interacting with contact lens faculty from every school, I continue to be impressed by their expertise in this area. So, my answer to the latter question is a resounding no! Why, then, is our GP fitting rate so low?

Instant Gratification

I believe that the overwhelming reason why we fit so few GP lenses in the United States is because we have such a wide array of soft lenses on hand in our offices. This extensive inventory ensures that most of our patients can leave their fitting appointments wearing contact lenses in their prescriptions. In addition, having so many options at your fingertips reduces chair time and the number of visits needed. It's no wonder that practitioners reach for what they have on hand.

One consequence of repeatedly reaching for soft lenses first is that some practitioners may lose confidence in their GP fitting skills. We tend to do what we're good at, and we're good at what we tend to do most often.

Four Tactics to Increase GP Contact Lens Prescribing

What can we do to maintain our GP fitting skills and fit more GP lenses to ensure higher success rates with good candidates?

1. Emphasize the custom nature of GP contact lenses and fine-tune the conversation you have with patients about them. Be sure to emphasize the value of returning to the office to have these custom lenses fitted to their eyes.
2. Make greater use of the outstanding consultation departments at the GP labs.
3. Have your lab send several lenses for the fitting visit to increase the likelihood that your patient will be able to walk out the door with lenses at the completion of the visit.
4. Learn more about all of the excellent designs and options available. This knowledge will increase your confidence in GP lenses for all types of patients.

With so many soft lens options on hand in most offices, it is easy to lose sight of the value of GP lenses for certain patients. With only slight changes in awareness and effort, you can better serve these patients. CLS

For references, please visit and click on document #199.

Dr. Pence is the associate dean for Clinical and Patient Care Services, Indiana University School of Optometry in Bloomington, Indiana. He is also a consultant to B+L, J&J Vision Care, and Alcon. You can reach him at