Benefits & Basics...A GUIDE TO GP CONTACTS
This guide to dispensing GP oxygen permeable contact lenses will help you add this modality to your practice
By Barbara Kogan Anan, OD

As soon as you or your staff member applies a gas permeable contact lens on a patient's eye, he or she almost always says, "Wow, I can see so much better!" GP's ability to provide such clear visual acuity can restore soft contact lens dropouts to successful-wearer status because they automatically correct most astigmatism and have excellent optical quality.

Other potential wearers range from children to seniors. In both international studies and clinical settings, GPs have been shown to slow the progression of myopia in young people. And, on the other end of the age spectrum, bifocal and bitoric designs offer excellent visual acuity and comfort to presbyopes and those with irregular corneas.

There are other benefits as well.

Ocular health. Excellent ocular health is a significant benefit of wearing GPs. The material has the ability to provide two-to-three times more oxygen than soft contact lens materials. Additionally, they allow for good tear exchange, removal of debris from its small diameter, and less deposits with its good surface wettability characteristics.

Ease of use. These contact lenses last considerably longer than soft lens materials and subsequently have a lower long-term patient cost. GPs are easy to insert and remove and have simple and quick cleaning and disinfection care systems.

Multiple-sale profits. All GP wearers need plano sunglasses to use with their contact lenses and current backup glasses to wear when not using their contact lenses. In addition, low-plus computer glasses, for use over contact lenses, can further enhance patients' vision functioning at near and intermediate distances and when looking in the distance after computer work. The opportunities combine to enhance your practice's profitability.

A helpful reference card is available from the RGP Lens Institute for fitting GP lenses

LAB EXPERTISE

Each GP contact lens is custom designed. "With approximately 75 percent of the Contact Lens Manufacturers Association's (CLMA) labs being small and independent, its consultants can easily assist you by telephone to custom design the best lens," according to Jan Daniels, CLMA's vice president and president/owner of a Portland, Ore., lab.

"Getting to know your lab gives you all the confidence in the world," she says. "Most lab staffs remain with the same lab for 20 to 25 years, so you get the same somebody when you call with any question about GP contact lenses."

Another benefit of CLMA labs is that many are local or regional, so "you can visit the lab to understand how the GP contact lens is manufactured and you, technicians, and patients have access to the lab as well," Daniels points out. This can be for pick up of an emergency contact lens replacement or polishing a lens. The relationship, she says, "is a lot of TLC, and it assists you with learning about different materials so you can gain more knowledge about your preferences."

EDUCATIONAL RESOURCES

In 1985 the CLMA formed the Rigid Gas Permeable Lens Institute (RGPLI) as its educational arm for students and practitioners to learn about the importance and clinical applications of RGP contact lenses. The Institute has a practitioner's Website, www.rgpli.org, which has a guide to all available lenses and materials from its CLMA member labs.

	A weekly educational symposium runs at RGPLI.com
	The CLSA's Website offers useful GP information

By connecting to the RGPLI Website the second Tuesday of each month from 9 p.m. to 10:30 p.m. Eastern time, you can join in on an informative, 90-minute, CLMA-sponsored symposium. "Knowledgeable practitioners and consultants who are nominated by their lab to the RGPLI's Advisory Committee, serve as the symposium faculty," says executive director Ed Bennett, OD.

Topics include: GP fitting for young myopes, astigmats, and those who need bifocal contact lenses; problem solving; and practice management.

Among the many other RGPLI resources Bennett describes as especially beneficial are: The Institute's RGP Lens Management Guide, fluorescein pattern card, the problem solving and bifocal videos, and reception room brochures. They include "RGP Care and Handling," "You Can't Find a Better Lens," and RGP fits for "Your Active Lifestyle."

These resources, as well as labs, can help you learn how to work with patients when it comes to discussing and fitting RP lenses. Bennett also stresses the importance of telling patients there will be some initial lens awareness. This will be helped by the application of a topical anesthetic at the fit visit only.

"The first few minutes after lens application are critical, and this will help the patient remove the potential hurdle of excessive awareness," he says. The drops, he adds, are "more for reassuring the practitioner than the patient."

A KNOWLEDGEABLE GP TEAM

Quality contact lens staff is an integral component in developing a successful GP contact lens aspect in your practice. Technicians are often the first exposure a potential, first-time, or returning patient has with your office, whether a first-time contact lens wearer, a contact lens dropout from previous dryness and irritation, or an individual seeking information about surgical and non-surgical vision correction options. Educating your staff in communicating both on the telephone and in the reception room GP's benefits and appropriate patient language are vital.

Advance Comfort Formula Starter Kit from Boston, a division of Bausch & Lomb

Skills. These technicians should be skilled beyond lensometry, keratometry, and topography. When applicable, they should be able to use a radiuscope and 7x magnifier. This enables the staff to completely verify the following aspects of a new GP contact lens from the lab or a GP lens a patient is wearing: Prescription, base curve, diameter, and edge and lens quality. With the additional skills of polishing and modification, your staff is often able to provide or assist you with in-office tweaking of a GP contact lens. This knowledge is a valuable resource when a patient is returning for a contact lens follow-up evaluation.

Lab relationships. Technicians also should develop a working relationship with the CLMA-member lab they work with so they can speak with the consultant they know and who is familiar with the practice. This applies to the initial GP lens order, as well as any lab modification or exchange.

Tracking log. To help your staff, a tracking lab log is beneficial, especially for more advanced designs, such as bitoric and bifocal GPs which sometimes require additional lab production time. The log will increase in-office efficiency and enable the technician to apprise both you and the patient of the GP arrival status.

Patient education. Initial insertion and removal (I&R) classes should be organized to include information about solution care regimens and appropriate hygiene. Staff should make sure these are part of both the initial class and every follow-up office visit to ensure a proper care regimen is being followed for these durable contact lenses.

	Visions Ultra Thin GP contact lenses by X-Cel Contacts, a Walman Company

Between-visit care. Frequently, when a patient has a GP question between office visits, it is common for him or her to request your contact lens technician who has instilled confidence in the patient. The combination of the doctor-technician and individualized care is a major factor in maintaining the patient's complete confidence in your care.

FINDING STAFF

One source of knowledgeable GP staff is the 1,000-member Contact Lens Society of America (CLSA). For initial membership, a minimum of two years of contact lens fitting experience is required and/or two years of college or advanced education above high school specific in the field of ophthalmics.

Following completion of the National Contact Lens Examiners exam, writing two case histories, and completing advanced and professional development allows this contact lens fitter to sit for the fellowship practical before the CLSA's 12-member committee.

"After successfully completing this 12 to 18 month process, he or she is granted fellowship and becomes an elite fitter," according to executive director Tina Schott.

To date, some 200 CLSA members have achieved Fellow status.

Since the CLSA was founded in 1955, basic, continuing and advanced continuing education have been significant components for its membership through manuals, workshops, videos, and conferences. And, looking forward, experts agree that education will be increasingly important in the contact lens arena.

For More Information

To learn more about RGPLI or to order literature, contact Pam Witham in Lincoln, Neb., at 800-344-9060; fax, 402-465-4187; or e-mail rgppam@aol.com.

For information about CLSA, go to its Website at www.clsa.org, or call the organization's office in Reston, Va., at 703-437-5100.