This newsletter will feature highlights from our outstanding April webinar entitled “Topography-Guided Troubleshooting for Orthokeratology” from Advisory Board member Dr. Anita Gulmiri.

For anyone desiring to learn the basics on fitting and troubleshooting – as well as how to implement orthokeratology into your practice - this is a great resource. To review/watch the complete presentation: CLICK HERE .

The resources spotlight will, likewise, focus on the numerous resources and programs available online pertaining to orthokeratology and myopia management. 


"Topography-Guided Troubleshooting
for Orthokeratology"

=====Anita Gulmiri, OD, FAAO

Dr. Gulmiri had the following clinical pearls:

1)   The use of corneal topography is essential for fitting, monitoring, and troubleshooting orthokeratology patients.

2)   Likewise, hyper Dk lens materials are necessary due to the overnight retainer wear involved.

3)   The lens design typically consists of a base curve, a reverse curve, 1 – 2 alignment curves, and a peripheral curve which contribute to a rapid reduction in myopia and – quite often – meeting the ultimate goal of slight hyperopia with only one pair of lenses.

4)   FDA approval is present for up to 6D of myopia and 1.75D of astigmatism for the CRT lenses and -1.00 to -5.00D and up to 1.50D of astigmatism for the Vision Shaping Treatment (VST) lenses.

5)   The base curve is selected to be flatter than the flat K reading by the amount of the spherical refractive error plus an additional 0.50 – 1D to account for daytime regression (i.e., if the K values are 43/43.50 @ 090, and refraction is -2.00 – 0.50 x 180, you would select a BCR equal to 2 + 0.75D or 2.75 flatter than 43 or 40.25D).

6)   These lenses can typically be fit empirically and some have online calculators to arrive at the recommended lens design parameters.

7)   The optical or treatment zone averages around 6mm but in higher amounts of myopia a smaller zone is recommended.

8)   Ideal candidates include topography readings between 42 – 46D, low amounts of WTR astigmatism, symmetrical astigmatism, and no topographical corneal irregularities.

9)   The difference map (i.e., comparing baseline visit to findings after overnight lens wear) is very important to assess. The ideal map after lens wear consists of a “bulls-eye” with central flattening (i.e., blue or blue-green in appearance) and mid-peripheral steepening (i.e., red appearance).

10)          A superior decentered or flat-fitting lens will result in a topography map with a superior flattened region with an inferior arcuate steep pattern (i.e., “Smiley Face”). Increasing the sagittal depth as recommended by the manufacturer will often solve the problem.

11)          An inferior decentering lens will often result in the opposite problem (i.e., “frowney face”) which can often be solved by flattening the lens/decreasing sagittal depth as recommended by the manufacturer. Likewise, if the topography pattern shows incomplete flattening/treatment centrally, decreasing sagittal depth is recommended.

12)           Toric designs are available for astigmatic patients in which the lens is decentering, poor midperipheral alignment exists, or an incomplete treatment ring is shown via topography. Often this is with patients who have greater than 1.50D of corneal astigmatism, limbus-to-limbus astigmatism, or a greater than 30 micron elevation difference over a 8mm chord of the central-mid-peripheral cornea.

Resource Spotlight:

Orthokeratology and Myopia Management

To accompany Dr. Gulmiri’s webinar you can find a number of myopia management resources under “Education By Lens Type” on the home page. This would include the following:

1.    8 archived webinars on orthokeratology in the last 3 years alone available on the home page under “Education By Lens Type” followed by “Corneal Reshaping”. This includes reimbursement paradigms, how to integrate myopia control into your practice, and design, fitting, and problem-solving webinars.

2.    Consumer Brochures. The GPLI has two consumer brochures on this topic. Go to “Resources” followed by “Order Printed Materials”.
=====a.    Myopia Management”. Authored by myopia research ==========icon and GPLI Advisory Board member, Dr. Jeff ==========Walline, this is an excellent resource for patients ==========desiring to learn about the applications of ==========orthokeratology, peripheral plus power soft lenses, ==========and low dose atropine in the slowing of myopia ==========progression.
=====b.    See with Your Contact Lenses Even When You are Not ==========Wearing Them”. This describes the benefits of ==========orthokeratology in slowing myopia and also allowing ==========for visual freedom during the day.



The GPLI maintains a database of U.S. eye care professionals who prescribe and fit GP lenses. This list is used daily by personnel visiting our consumer education website: Driven by zip codes, patients can obtain a list of GP Specialists (up to 25 listings) within a 100 mile radius of their zip code.

Do you need to refer a patient? Utilizing the new zip code where your patient is relocating or visiting, find a specialist to refer them.

Join 2,791 GP Specialists that are already listed in our database throughout the United States. You need to specialize in 4 of the 5 areas of expertise to enhance your listing. They are:

General GP Contact Lenses
Bifocal/Multifocal Contact Lenses
Contact Lenses for Irregular Corneas
Corneal Reshaping / Orthokeratology
Scleral Lens Designs

CLICK HERE to go to the page for input.


2021 GPLI Monthly Webinar Series

May 18, 2021

Management of the Scleral Lens Ocular Surface Disease Patient Beyond the Fit

Presented by
Karen G. Carrasquillo OD, PhD, FAAO, FSLS, FBCLA
8:00 PM Central


June 15: Heidi Miller OD, FAAO, FSLS:
Pediatric Specialty Contact Lens Applications

July 20: Jeff Walline OD, PhD, FAAO: 
Myopia Management Update

July 27: STUDENT WEBINAR: Dawn Lam, MS, OD, FAAO and Erin Rueff, OD, PhD, FAAO
Troubleshooting Corneal GP Lenses

August 17: Stephanie L. Woo OD, FAAO, FSLS:
Contact Lens Management of Keratoconus

September 21: Renee Reeder OD, FAAO, FSLS: Custom Soft Lens Update for Healthy and Irregular Cornea Patients

October 19: Jason Jedlicka OD, FAAO, FSLS:
Software Applications for Specialty Lens Designs

November 16: Greg DeNaeyer OD, FAAO, FSLS: Beyond the Basics: Advanced scleral lens design

December 21: Maria K. Walker OD, MS, FAAO, FSLS: GP Material Update


Orders shipped to the USA only - 200 of each complimentary including shipping

1)   GP Lens Management Guide (download only)

2)   Fluorescein Pattern Identification Card

3)   Correcting Presbyopia Tips Card

4)   Contact Lens Clinical Pocket Guide

5)   In-Office Disinfection of Multi-Patient Use Diagnostic Contact Lenses

6)   See with Your Contacts Even When You’re Not Wearing Them (Orthokeratology Patient Brochure which can be downloaded as well)

7)   Look as Young as You Feel (Multifocal Patient Brochure which can be downloaded as well)

8)   Scleral Lenses are Big News (Scleral Consumer Brochure which can be downloaded as well)

9)   Caring for Your GP Lenses (Care and Handling Patient Brochure which can be downloaded as well)

10)   Myopia Management (Myopia Patient Brochure for which the references can be downloaded from this site)

11)  Reading Verification Card (features both passages on one size of varying acuity and different types of print – newspaper, etc. – on the other side)

12) Scleral Lens Care Tips, Application and Removal Card

Edward S. Bennett, OD, MSEd, FAAO, FSLS
Professor Emeritus, University of Missouri St Louis College of Optometry
President and Executive Director

The Gas Permeable Lens Institute is dedicated to providing eyecare professionals with unbiased educational and practice-building resources highlighting GP and custom manufactured soft contact lenses.

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