Please note that the comments below are representative of remarks made in the chat room, and do not necessarily reflect the views of the moderators, or the GPLI.  

• If holding lenses for lensometry is a problem, use a paper-punch to make a hole in a flat pack. Insert the lens and you'll be able to read the power fumble-free.
   
• Spinner tools are the best for polishing & repowering, but many fitters don't know about them. They make the job easy & fast.
   
• Attendee problem: fitting an Asian eye with small fissure. The power is high minus with cylinder. The lenses drop to an inferior position. The group suggested a bitoric with special attention to the edges: either CN or lenticular.
   
• Compliance with cleaning is a problem. Liquid enzyme helps, but you still have to get the patient to manually clean the lens. A corrective interview with the doctor was the consensus for the best education tool.
   
• Some interest in the ultrasonic cleaners, especially for high Dk materials, but no one had enough experience with them to make a firm recommendation.
   
• Attendee question: he uses a 30 Dk lens as his workhorse. How does he know when to use a higher Dk material? Although there was much discussion there were no clear indications given. Most thought a moderate Dk material with good design will accommodate the majority of patients.
   
• Tip for practitioners who don't like anesthetics: use a drop of Acular PF to start, then send home one vial with the patient to use q4h.
   
• For pediatric fittings where the parent will be performing application & removal: place a number of dots (up to 12) around the periphery of the lens so that they can see the lens more easily on the eye.
   
• For patients who wear off dots make one lens blue #1 and the other green or gray #1. One fitter recommends blue for left eye (bLue) and green for the right (gReen) to make it easier to remember.
   
• For a patient who complains of lens awareness on downgaze when reading: do a careful fluorescein evaluation looking for areas of bearing, especially superiorly. Re-edge the lenses. If no relief, check the tears (reading will exacerbate dry eye symptoms).
   
• For graft patients: if they need help removing the lens use the DMV remover with a hole in the center to avoid accidentally removing the graft.

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