Article

IS THIS THE NEW NORM?

ARE UNCOMFORTABLE GP LENSES THE NEW NORM?

Initially, there is greater lens awareness with GP lenses than with traditional soft contact lenses. However, GP lenses provide remarkable uncompromised vision. Here are four proven strategies that allow GP lens wearers to optimize their contact lens comfort.

Figure 1. Assess meibomian gland function by grading the quality of the meibum produced.

  1. Lens Size Although we are unaware of any studies that have shown improved comfort with increased GP lens diameter, we have found significant improvements by doing just that. Increasing the diameter by as little as 0.2mm to 0.5mm provides remarkable opportunities for improved lens comfort. As the lens diameter increases, the lens simply moves less on the cornea; in turn, this seems to lead to less lens awareness. This is a novel strategy for new patients who require GP lenses to achieve optimal vision. Often, we now begin with lenses between 9.8mm to 10.2mm in diameter. Consider increasing the size of the lens diameter in patients who experience GP lens awareness and for those new to GP lenses.
  2. The Ocular Surface A healthy ocular surface will increase patients’ chances of being comfortable in their contact lenses. This strategy is applicable to both soft and GP lenses.
    Pay particularly close attention to the ocular surface, and rule out any signs of blepharitis, including even the most minor signs of inflammation at the margin. Consider assessing the meibomian gland structure as well as function by grading the quality of the meibum produced by the glands (Figure 1). Also, make sure to look at the ocular surface for signs of tear film compromise, such as reduced tear film breakup time, corneal and conjunctival staining, and any signs of lid wiper epitheliopathy. It is also critical to rule out any signs of palpebral irritation, including the presence of papillae.
  3. Surface Treatments Evidence suggests that advanced treatment to the surface of GP lenses will increase comfort, wettability, and deposit resistance, which will enhance the overall experience for GP lens wearers. GP lens materials are inherently hydrophobic and therefore attract mucins and protein deposits. These deposits will increase irritability as well as decrease the lubricity of the lens. One available coating is a 90% water polyethylene glycol (PEG)-based polymer mixture that is covalently bonded to the GP lens. We currently have this coating placed on all of our lenses.
  4. Contact Lens Care Most clinicians are aware of the benefits that hydrogen peroxide solutions provide to soft contact lens wearers, but they sometimes forget that this care system is also approved for GP lenses. For patients who are deposit-prone, an extra-strength peroxide-based solution could be the answer to their discomfort. These solutions effectively clean the lens surface and remove deposition irritants, which can potentially lead to more comfortable lens wear.

The Verdict

GP lenses provide remarkable opportunities for optimized vision correction for many patients. If uncomfortable GP wear is the new norm, we don’t want to be normal. CLS