The purpose of this address is to bring to the attention of the Contact Lens practitioner certain aspects with regard to contact lens fitting in a field which tends to receive sparse acclaim and small publicity. In fairness to the manufacturers the reasons are not difficult to see. With the exception of a few, when any Ophthalmic Optician considers entering the field of Contact Lens practice he naturally chooses his stock of lenses to cater for the majority of his patients most likely to require them. Probably 80% will be myopes and a possible further 10% post-operative aphakics. Hence it is the myopic range of lenses that the part-time practitioner, in particular, will purchase. It is with this background that I was first fired with the desire to see if the contact lens net could be extended to include on level terms that forgotten section of the public, the low plus wearer and in particular the 'soft lens' low plus applicant. Let us pause for a moment to consider the type and life-style of the person we are likely to see. For the purpose of this talk I am confining myself to the + 1.50 to + 3.50 DS hypermetrope who have never had a distance prescription before and are approaching, or engulfed by, the 'mysterious forties', and those present plus spectacle wearers of the order of + 4.00 to + 8.00 DS and in the same age group. The younger hypermetropes of low plus errors can, and frequently are, very successfully fitted with traditional hard lenses. We found sfightly more men than women, seeking help in this field. Increasing numbers of young members of families are wearing contact lenses today and this highlights Father 's seclusion from the fold. Not infrequently his family are the spur to his initial inquiry. Again, in their earlier days, hypermetropes consider themselves a special breed of men and naturally tend to resist glasses at all costs and especially for distance vision. Once they think that there is a chance of an alternative to glasses as a permanency they are impatient for action and results. What should our lines of approach be and are there any special aspects to consider? Because low plus lenses are thicker and occasionally larger than those normally supplied to myopes they naturally create more of a foreign body problem and so I give the following anatomical features more detailed scrutiny. 1) The closeness of the upper eyelid to the projecting frontal process of the brows. This can sometimes give a pseudo upper lid tightness on the bulbar conjunctiva, especially when the skin fold between lid and frontal process is bulky. 2) General disposition of the upper lid, thickness of its margin and the amount of visible iris it covers. 3) The degree of apparent obviousness, that is their nearness to the surface, of the anterior ciliary arteries at the point where they bend back into the sclera, approximately 2mm. out from the limbus and the subsequent course of the anterior conjunctival vessels. 4) The degree and siting of any pinguecula type protrusions with reference to the limbus. 5) Any suspicion of ectropian tendencies. 6) Dry Blepharitic conditions, These seem to be more of a problem with the hypermatrope. I then like to satisfy myself with regard to the tear flow capabilities of the patient in question. We in a sense measure or assess the total volume or otherwise of the tear flow, and short of a culture swab, we assume that the constituents of the pre-corneal tear film are correct. I sometimes wonder if an equally important facet is the regularity of the tear flow cycle change. Dr. Kersley has drawn attention to the importance and effectivity of the blink rate and reflex. Middle aged low plus wearers I have found are often poor soft blinkers and on occasions have to be retrained in the art of blinking, to a preferable regularity greater than four second intervals. Having taken all the usual initial measurements I then proceed with lens selection bearing the following points in mind: 1) Make use of the particular manufacturer's guide for the lenses you are likely to use. Sometimes a flattening factor has to be considered and again by contrast one can fit direct on power. Flattening factors tend to be less authoritative than with minus lenses. 2) With some extended wear lenses, where one is fitting steeper than mean 'K' half the 'factor' for minus lenses is often not a bad 'starter' lens. 3) Accurate positioning and centreing of the lenses is more critical with plus lenses because of the corneal insult problem. I therefore pay great