Presbyopia: three key steps to selecting your patients

Optometrist Sarah Morgan discusses presbyopia and the importance of patient selection

Presbyopes make up a large portion of the patient base for most practices. For the optometrist, presbyopia can seem rather simple: a ‘reading add’ on the prescription and then recommending the variety of corrective options for both ophthalmic lenses and multifocal contact lenses. For the patient though, presbyopia can be much more complicated. It represents a substantial change to their vision with immediate consequences for their eyewear and contact lens needs, as well as subsequent consequences for their lifestyle. Seeing things from the perspective of the presbyope greatly helps to shape optometrist-patient discussions, making communication more effective.

Step one:

Discussing presbyopia before it occurs is ideal. Rather than discussing reading, talk about how important near vision is for everyday life. As eye care professionals and ‘vision restoration experts,’ we must guide patients through their own unique and personal experiences of presbyopia.

Step two:

Try not to prejudge a patient’s willingness or ability to pay for the preservation and restoration of their vision. Instead, have candid conversations in which you discuss the cost of your recommendations and the value of clear vision at all distances.

Step three:

If you are just beginning to offer multifocal contact lenses select patients who are enthusiastic about solving their presbyopia and who you feel are most likely to succeed with multifocal contact lenses. With more experience and confidence in the fitting process, you can offer them to all suitable patients.

Seeing presbyopia from the presbyopes perspective

Before experiencing presbyopia first-hand, an eye care practitioner may not fully appreciate the significance to the patient of deteriorating near vision. Of course, presbyopia is discussed in the early days of optometry training, but understand what patients experience – how it affects them practically and emotionally on a day-to-day basis – is somewhat beyond the explanation of a mere ‘decrease in accommodative ability of the crystalline lens’.

The current generation of presbyopes have a different self-perception than that of their parents. The lifestyle of today’s presbyope is an active one, with important work responsibilities, social and sporting activities and young families. This is partly why it is so vital to retain near vision capability.