The TOP 10 Reasons
to Inventory RGPs

BY PATRICIA M. KEECH, O.D., F.A.A.O.
OCT. 1996

Boost your RGP inventory to make fitting faster and more exact while giving your practice a competitive edge.Grow your RGP practice and your contact lens income will follow. Studies have shown that RGP wearers are more loyal, more profitable, refer more patients and may also have fewer complications. One way to serve these patients better is to begin fitting RGPs in the same manner as soft lenses: from inventory.

A colleague recently commented that fitting rigid lenses from inventory seems less than thorough, not 'custom' or 'thoughtful' enough. I've found that having all my favorite materials in inventory actually makes fitting RGPs faster and more exact. Speculating about the impact of a parameter change and then waiting a week to find out if you were right is not very scientific and can be discouraging to the patient. We wouldn't dream of fitting soft lenses this way, so why is it good enough for RGPs?

TOP 10 REASONS TO DISPENSE RGPS FROM INVENTORY

1. Eliminate Inconvenience -- We live in a 'do it today' society where patients expect instant solutions to their problems and same-day service. Avoid losing patients between the fitting visit and the dispensing visit.

2. Decrease Chair Time -- Prescribing RGPs from inventory enables you to compare two different lens designs with each trial pair. By using the two eyes independently, you gain more useful information more efficiently. For example, place a 9.0mm diameter lens on one eye and a 9.5mm diameter lens on the other to compare them side-by-side. For those marginally dry eyes nearing age 40, compare a silicone acrylate lens to a fluorosilicone acrylate lens. Often, you'll find that one lens coats immediately under the slit lamp magnification while the other does not, and you may be surprised when patients report that one lens definitely feels better.

If you need to change a parameter at the follow-up appointment, make the exchange then and there from inventory and save one appointment time. Patients are impressed by this added level of service.

3. Demonstrate the Advantages of RGPs -- Because the trial lens actually fits and provides appropriate visual correction, patients have a more realistic experience and can make informed judgments. They also soon realize that the initial discomfort is fleeting. It's no wonder more patients don't opt for rigid lenses when their sole experience is with ill-fitting lenses that they can't see through!

4. More Options Mean More Patients Served -- Our clinics maintain inventories of two or three RGP materials representing different classes and Dks. We select the best representative of each material classification for inventory in duplicate parameters. We maintain two diameters at least 0.5mm apart in 0.50-diopter increments of both power and base curve. This assortment serves the majority of patients. Because we can so often fit the patient accurately, our percentage of successful RGP fits versus soft lens fits has increased.

5. Be More Cost-effective -- If you use only your inventoried materials, parameter changes are a snap and less expensive. As your volume grows, you can negotiate better volume discounts and return privileges.

6. Keep Patients' Options Open -- Most patients will stay with RGPs if they complete the first month, so I usually ask them to commit to a 30-day trial. A few patients will fail, however, and you can refit them with soft lenses and easily return the RGPs through consignment exchange to minimize lab costs. This eliminates the fear of failure that first-time wearers sometimes harbor.

7. Become a Better Fitter -- "The skill of the rigid lens fitter increases with the size of the fitting set." This saying is true. As you immediately see the impact of design changes and observe more lenses on eyes, your judgment and your skills improve.

8. Offer Same-day Replacement -- Patients love the convenience and the perceived safety of having an immediate replacement option for their contact lenses. A patient who drops a lens down the drain doesn't want to wait a week to replace it. With their busy lifestyles, patients will tell you waiting is simply not an option. After all, would you go uncorrected for a week?

9. Give Your Practice a Competitive Edge -- As you become more comfortable with fitting from inventory, your success rate will improve. With increased confidence, you'll find that you're more interested in offering all contact lens options. Most practitioners who begin working with rigid lens inventories waste little time branching out to front surface torics, bitorics, bifocals and postsurgical designs.

10. Your Contact Lens Practice Will Grow -- Isn't that the idea after all?

COST VS. VALUE

Of course, to fit from inventory, you'll need a lot of lenses. Some practitioners blanch at the cost, but thinking 'cost' alone is short-sighted. Your RGP inventory is an investment that will reap many benefits.

You should be able to negotiate favorable terms from the labs. Because our office prescribes such a large volume of rigid lenses, we worked out a consignment agreement with our lab. Other practitioners have negotiated terms in which the consignment is purchased over time. In other words, as long as they maintain purchases at a predetermined level, a portion of the price is forgiven in each billing cycle. At the very least, you should be able to obtain a favorable volume discount when purchasing your inventory.

Make sure you have the option of returning any lenses that don't meet specification tolerances or that need parameter changes after dispensing. Your inventory agreement should also allow for the very few patients who drop out. You may want to inquire if your inventory can be included on the lab's guaranteed fit programs (remember, you'll be ordering to refill inventory with each dispensing). Be sure your lab knows that this inventory represents a long-term commitment, not just a one-time sale.

MINIMUM REQUIREMENTS FOR A WORKABLE INVENTORY

Have at least two different materials in stock. I recommend a lower Dk and a higher Dk. Limit the power range. We have found that -l.00D to -6.00D in half-diopter steps works well. Keep some trial lenses in plus power for your hyperopic patients. Rather than hold these in inventory, we trial fit with a reasonably close plus-powered lens and then special order. Choose two or three diameters at least 0.4mm to 0.5mm apart, such as 8.5mm, 9.0mm and 9.5mm or 8.8mm and 9.2mm. Base curves should be in 0.1mm steps: 7.40mm to 8.20mm or so will serve most of your patients. We inventory our low Dk lenses in gray and our high Dk lenses in light blue to reduce the possibility of confusing the two. Use the equation in Figure 1 to calculate your basic RGP inventory requirements.

STORING YOUR INVENTORY

When we first started inventorying lenses in our office, we tried both wet and dry storage. Dry lenses maintain a lower level of microbial contamination and we found that when we wet-stored the lenses in flat packs, the solution would evaporate and warp the lenses between uses. Now we store lenses dry, cleaning and rewetting them vigorously before each use. Our procedure is very straightforward. After a lens has been used for trial purposes (not dispensed) we clean it thoroughly with a heavy duty solution such as the laboratory cleaners available from button manufacturers. We then reinspect it and store it in inventory. The next time we need it, we use a milder surfactant, the same type dispensed to patients for home use. After cleaning the lens, we rub it in wetting solution and rinse. We repeat the rub-and-rinse step at least five times. While this sounds like a lot of bother, it really takes very little time and ensures comfortable, clean, safe lenses.

A BETTER-THAN-AVERAGE RETURN

Inventory fitting of rigid lenses is a win-win-win situation: patients love the convenience, we save chair time, and the lab knows that 99 percent of the time, the lens it ships to us isn't coming back. By eliminating the guesswork from empirical fitting, we've dramatically reduced the number of new wearers dropping out or converting to soft lenses. Our return rate is so low it's become insignificant, and when we do return a lens, the lab knows there's honestly a problem. Our RGP contact lens practice has grown, and so has our patient loyalty and satisfaction. When you think of all the advantages of our inventory investment, it seems to offer a better-than-average return. CLS

BENEFITS OF AN RGP INVENTORY

• Avoid losing patients between the fitting visit and the dispensing visit.
• Compare two different lens designs with each trial pair.
• For marginally dry eyes, compare a silicone acrylate lens to a fluorosilicone acrylate lens.
• Reduce chair time by dispensing parameter changes the same day.
• Impress patients with this added level of service.
• Give new RGP patients a more realistic experience with appropriate visual correction.
• Improve your judgment and skills when you see the impact of design changes immediately.
• Through consignment exchange, you can offer the rare, unsuccessful patient an option to convert to soft lenses.
• Offer same-day replacement.
• Improve your success rate.