title: Consensus on recording of gas permeable contact lens fit.
abstract: OBJECTIVE
  To develop a new schematic scheme for efficiently recording the key parameters of gas permeable contact lens (GP) fits based on current consensus.
  
  
  METHODS
  Over 100 established GP fitters and educators met to discuss the parameters proposed in educational material for evaluating GP fit and concluded on the key parameters that should be recorded. The accuracy and variability of evaluating the fluorescein pattern of GP fit was determined by having 35 experienced contact lens practitioners from across the world, grading 5 images of a range of fits and the topographer simulation of the same fits, in random, order using the proposed scheme. The accuracy of the grading was compared to objective image analysis of the fluorescein intensity of the same images.
  
  
  RESULTS
  The key information to record to adequately describe the fit of an GP was agreed as: the manufacturer, brand and lens parameters; settling time; comfort on a 5 point scale; centration; movement on blink on a ±2 scale; and the Primary Fluorescein Pattern in the central, mid-peripheral and edge regions of the lens averaged along the horizontal and vertical lens axes, on a ±2 scale. On average 50-60% of practitioners selected the median grade when subjectively rating fluorescein intensity and this was correlated to objective quantification (r=0.602, p<0.001). Objective grading suggesting horizontal median fluorescein intensity was generally symmetrical, as was the vertical meridian, but this was not the case for subjective grading. Simulated fluorescein patterns were subjectively and objectively graded as being less intense than real photographs (p<0.01).
  
  
  CONCLUSIONS
  GP fit recording can be standardised and simplified to enhance GP practice.
authors.affiliation: Ophthalmic Research Group, Life and Health Sciences, Aston University, United Kingdom. Electronic address: j.s.w.wolffsohn@aston.ac.uk.
authors.forename: James S
authors.initials: JS
authors.lastname: Wolffsohn
authors.forename: Eef
authors.initials: E
authors.lastname: van der Worp
authors.forename: John
authors.initials: J
authors.lastname: de Brabander
mesh_terms: D003261:Contact Lenses / Q000592:standards*; D003315:Cornea / Q000166:cytology*; D015590:Fluorophotometry / Q000592:standards*; D006801:Humans; D038622:Internationality; D009885:Ophthalmology / Q000592:standards*; D017755:Prosthesis Fitting / Q000592:standards*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Fitting characteristics; Fluorescein pattern observation; Lens evaluation; Record keeping; Rigid gas permeable contact lenses (RGP)