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F. R. Gill, P. J. Murphy, C. Purslow; Negative Practitioner Attitudes Hinder Gas Permeable Lens Prescribing. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4859.
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Although gas permeable (GP) contact lenses provide the safest option for lens wear, prescribing rates in many parts of the world are in decline. This study investigated the effect of any practitioner bias against GP lenses on these prescribing trends.
A questionnaire was developed using focus group input and involved a short pilot study. Specific questions addressed: clinical time spent fitting GPs compared to soft contact lenses; perceived safety and comfort with GP contact lens wear and specialist equipment requirements. With ethical approval, the questionnaire was sent to 1000 randomly selected UK registered optometrists.
451 were returned from optometrists whose experience ranged from 0.5-64 years. Only 11.2% of contact lens work was devoted to GP fitting and aftercare; the remainder to soft contact lens work. GP fitting was perceived to be significantly more time consuming than general contact lens fitting (P<0.005; Wilcoxon Rank). Poor initial comfort discourages practitioners from fitting GPs compared with contact lens fitting in general (P<0.005; Wilcoxon Rank), and practitioners perceive adapted comfort to be significantly reduced in GP wear compared to general contact lens wear (P<0.005; Wilcoxon Rank). However, anterior ocular health is perceived to be significantly better in the GP wearers (P<0.005; Wilcoxon Rank). Less than 1 in 7 practitioners routinely use topical anaesthetic (TA) during GP fitting, and there was no significant difference between experienced and less-experienced practitioners (Pearson Chi Square P=0.512). Significantly more practitioners feel a topographer advantageous in GP practice compared to general contact lens practice (p<0.005; Wilcoxon Rank), but only 9.6% respondents had access to a topographer.
Although GP contact lenses account for a relatively small part of contact lens practice in the UK, practitioners recognise the benefits of superior ocular health in GP wearers compared to the soft lens wearing population. However, practitioners feel that GP lenses are more time consuming to fit, and require specialist equipment that they do not generally have. Initial discomfort discouraged GP fitting, but the use of TA at first fit is not common practice in the UK, regardless of practitioner experience. These findings indicate that negative practitioner attitudes are hindering GP lens prescribing.
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