RGP insights

Ten Steps Toward a Gas Permeable Practice

BY BY EDWARD S. BENNETT, OD, MSED
OCTOBER 1998

In a society that is growing "soft," the benefits of rigid gas permeable (RGP) lenses to both patient and practice should not be ignored. Are you prepared to offer the RGP option to your patients? Find out by asking yourself the following questions.

Find out by asking yourself the following questions:

1. Do you use the most current materials? For optimum corneal physiology, avoid using materials with a Dk of less than 20. Prescribe 50Dk or higher lens materials for hyperopia and flexible or extended wear patients.
2. Are the appropriate diagnostic sets or inventories available? At minimum, use the following RGP diagnostic sets: -3.00D, -6.00D and +3.00D (high Dk material). Non-specialty design lens sets may include base curve radii from 41.00D to 45.00D (0.25D steps) and an average diameter (9.2mm-9.4mm). If feasible, obtain a 100- to 200-lens inventory from your laboratory to give RGP patients the same conveniences soft lens patients enjoy.
3. Do you use diagnostic lenses accompanied by careful fluorescein pattern evaluation? The use of fluorescein for assessing RGP lens fit is critical for both ensuring an alignment or near alignment lens-to-cornea fitting relationship and for minimizing the potential for long-term lens induced complications. Diagnostic fitting is not as critical if the practitioner has much experience fitting RGPs, especially if a topography-based lens design program with fluorescein pattern simulation is available.
4. Do you fit specialty designs? Fitting keratoconic, bifocal and toric lenses is not particularly difficult and is a powerful practice-building tool. You can usually obtain diagnostic fitting sets for these designs from your local Contact Lens Manufacturers Association laboratory.
5. Are you apprehensive about discomfort? When RGP Lens Institute (RGPLI) advisory members were surveyed on myths about RGPs, they most commonly reported the perception of discomfort. But experienced fitters are not concerned about the initial lens awareness, and several of them say my recommended use of topical anesthetic during the fitting visit is not necessary with proper patient communication.
6. Do you take advantage of the consultative services your laboratory provides? CLMA member laboratories reported in a survey that practitioners, especially new graduates, spend little time communicating with their lab. RGP labs typically have well-trained, knowledgeable consultants on-hand to assist with lens design, materials, bifocal and other specialty design fitting sets, problem-solving, corneal topography applications, patient education materials and other services.
7. Do you supplement your RGP education with available resources? You can order educational videotapes from the RGPLI (800-344-9060), and educational CDs on RGP fitting and patient education are soon to be released.
8. Do you verify and modify your RGP lenses? A survey Bob Grohe and I sent to optometrists a few years ago indicates that approximately 50 percent of contact lens practitioners do not verify center thickness or edge quality -- arguably the most important parameters to verify. In-office lens polishing is also beneficial.
9. Do you sell solutions to your patients? Selling a few months of RGP solutions at one time will ensure that patients continue to use your recommended care system and that they return to you on a regular basis.
10. Do you use a service agreement? The use of service agreements has been steadily decreasing as a result of disposable soft lens popularity, but they remain a profitable entity for any practice that prescribes a high number of RGPs. CLS

Dr. Bennett is an associate professor of optometry at the University of Missouri-St. Louis and executive director of the RGP Lens Institute.