I wrote my first GP column for Contact Lens Spectrum in 1993. Now, almost 150 columns later, I decided earlier this year to make this one my last. When I first started this journey in 1993, GP lenses still played a very prominent role in the industry; but, it was at the Scottish Contact Lens Society meeting in 1994 when I first heard Professor Nathan Efron predict that GP lenses would be gone by the year 2000 (he later revised this to 2010 and eventually admitted that he was incorrect) (Efron, 1994, 2010, 2013). However, contact lens specialists and manufacturers worldwide at that time already knew that GP lenses were not going to just go away. In fact, in the United States, there appears to be a slight upward trend (Nichols, 2018).

It’s exciting to see the future directions of this modality. The following are five core areas that represent the present and the future of GP contact lenses.

GPs: Today and Tomorrow

1. Scleral Lenses Without doubt, scleral lenses have benefited the GP lens business as well as dry eye and irregular cornea patients who could not otherwise tolerate contact lens wear. Many individuals who have moderate-to-severe keratoconus and would previously have been referred for some form of corneal transplant can be successfully treated with scleral lenses (Koppen et al, 2018). With online resources, webinars, workshops, and laboratory consultants, it is not difficult to become proficient in scleral lens fitting. You won’t regret it once you see the look on patients’ faces.
2. Orthokeratology Time will dictate the growth of orthokeratology, but the myopia control awareness explosion will occur. Myopic patients can benefit from eyecare practitioners who provide them with device-free vision correction during the day while potentially preventing the complications of high myopia later in life.
3. Multifocals Having been some form of rigid lens wearer for more than 51 years—the last 23 in multifocals—I’ve been spoiled by the quality of vision that I’ve always achieved. With most designs having excellent center-distance optics and empirical ordering, soft lens wearers desiring good vision at all distances, notably at distance, deserve to experience the comparison, especially if their vision is blurred through soft lenses. You’ll be surprised by how patients react when the lenses are first dispensed.
4. Moderate-to-High Astigmatism The hallmark benefits of GP lenses are ocular health and vision. The latter benefit is evident when correcting astigmatism with either a spherical or bitoric design. Again, these designs can be empirically fit via the laboratory online calculators or with calculators/nomograms such as Mandell-Moore, GP Toric and Spherical, and Newman’s Guide (all available at www.gpli.info ) and via eyedock.com .
5. Irregular Corneas It is well known that both corneal and scleral GP lenses can improve the vision and quality of life for patients who have any form of irregular cornea.

Give Patients the Best Vision

Contact lenses are—and will continue to be—an integral component of eyecare practice. However, patients deserve more than the simple option of receiving lenses from an available inventory. GP lenses allow you to build your practice from very satisfied patients and the resultant referrals; but, more importantly, they allow practitioners to increase their professional satisfaction as a direct result of knowing that they have improved the quality of life of their patients. CLS

For references, please visit www.clspectrum.com/references and click on document #275.