For a patient with a tight gas-permeable lens, which modification would best relieve the fit?

In the context of managing a tight gas-permeable lens fit, reducing the size of the optic zone is a strategy that can effectively relieve pressure and improve comfort for the patient. A tight lens fit often leads to discomfort due to excessive bearing on the central cornea or the periphery, resulting in inadequate tear exchange and potential corneal distortion.

By decreasing the size of the optic zone, the lens can become less aggressive in its fit on the corneal surface. This allows the lens to sit more freely, potentially increasing the movement of the lens with each blink and enhancing tear exchange beneath the lens. Improved tear exchange can alleviate any buildup of debris and increase overall comfort, helping to mitigate issues associated with a tight fit.

This approach is particularly useful when the lens design is otherwise appropriate, but slight adjustments can make a significant difference in patient comfort and lens performance. The other modifications, while potentially useful in specific situations, may not directly address the tightness of the fit as effectively as reducing the optic zone size.