Ben Gaddie, O.D., F.A.A.O.: There have been all sorts of unlikely bedfellows lately in our industry (and world for that matter). One of the more recent examples involves a big-box retailer’s new line of private-label contact lenses.

While news such as this can be unsettling for some, I don’t see a direct threat from private label lenses, as we use them in our practice to some degree. For most of us, it’s hard to compete on a private label lens, let alone garner 100% of our own sales or fits.

Overall, I think this is a reminder that our clinical skills and practice leadership lend us a significant advantage. Give patients a reason to see you as an expert, and retain the annual contact lens fit and annual supply. Learn to fit keratoconus patients and post surgical patients needing complex fits. Consider scleral lenses and by all means fit multifocals and treat the dry eye that goes along with the presbyopic population. Make your office the marketplace.

Milton Hom, O.D., F.A.A.O.: You’re absolutely right about specialty lenses. Many of the specialty designs are GP lenses. Have we forgotten how to read fluorescein patterns? I asked a student about fitting gas permeable lenses as an option and all I got was a look of sheer terror in their eyes. Most of the lenses requires some additional expertise, but can be highly rewarding to both the doc and the patient.

And what ever happened to GP lenses? There was a time when GP/rigid contact lenses were the mainstay of a CL practice. Years ago, Nathan Efron dressed up as the Grim Reaper and gave an international lecture on the coming demise of GPs. Soft lenses have taken over, and GPs have been moved to specialty status. In many practices, GPs are virtually extinct. I’ve heard colleagues say they do not remember the last time they fit a GP lens. And these are contact lens experts. GPs seemed to have gone the way of lined trifocals.

B.G.: Several tools have been extremely helpful in terms of fitting success for the novice and seasoned GP practitioners alike. The first is modern topography. Not only can it help pick up keratoconus and pellucid marginal degeneration, but it also can assist your GP lab in the personalized lens design for your particular patient. Couple that with an anterior segment slit lamp imaging system, and your lab has trial lens on-eye performance as well as topography for a great starting point.

M.H.: I think that one of the biggest challenges with specialty lenses is knowing when to fit what. With all the options available, it can be confusing at times. Sometimes, it’s tempting to use a more exotic, sexy design, when a run-of-the-mill one will work. When it comes to specialty fitting, remember KISS: “Keep It Simple, Stupid.”

Despite the changes in the marketplace, GPs still offer vision, safety and patient retention. OM