By Melody Huang, OD
Sept. 18, 2019
Presbyopia is the eventual fate of all of us. Unlike many other conditions, presbyopia isn’t a question of if, but when. If you live long enough, you will become presbyopic. The good news, as ODs know, is there are more options than ever to continue functioning seamlessly regardless of the loss of natural ability to see up close.
The challenge is communicating that information to patients. Here are the key questions and conversations I have with my presbyopic patients.
As a freelance optometrist, I see a multitude of presbyopic patients. Across all of the practices where I work, about 40 percent of patients I examine are presbyopes. I present my presbyopic patients with all possible solutions. If they are interested in glasses, I discuss the benefits of progressives versus reading glasses. If they are interested in contacts, I discuss the pros and cons of multifocals versus monovision versus reading glasses over contacts.
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I find that patients respond well when they have options and can be involved in making the decision. The last thing you want is for your patient to be upset because you didn’t tell them about another option they have! I let the patient know they can come back and try yet another option if the one they leave with doesn’t work out.
How Do I Start the Presbyopia Conversation?
To start my conversation with presbyopic patients, I ask a few key questions:
• Do you find yourself holding your phone or books further out in order to see clearly?
• Do you struggle to see the menu in a dimly lit restaurant?
• Do you get headaches or eye fatigue when you use the computer after a short period of time?
• If the patient is nearsighted: Do you find yourself taking off your glasses to read more frequently?
These types of questions encourage the patient to think about their vision on a day-to-day basis, and help you uncover their needs. After figuring out your patient’s needs, you can easily segue into a conversation about presbyopia. Here’s a sample dialogue you can use:
“Your symptoms are the result of presbyopia, which is a gradual loss of near focusing ability due to age. This change is totally normal. The good news is, we can alleviate your symptoms by prescribing you glasses or contact lenses.”
What’s the Best Way to Respond to Common Presbyopia Questions?
Here is how I handle common questions from patients after I explain to them that they have presbyopia:
Patient: “Is there anything I can do to stop this change from happening?”
Me: “Over the age of 40, our eyes start to lose the ability to focus up close. There is no way to prevent presbyopia from happening, or at least, the cure hasn’t been discovered yet! In the meantime, we can get you glasses or contact lenses that will prevent your eyes from straining when you read.”
Patient: “What happens if I don’t wear the glasses?”
Me: “Not wearing your glasses won’t necessarily cause your prescription to progress faster. However, you will be straining your eyes, which can cause symptoms like headaches, tiredness, dry eyes, double vision and blurry vision.”
Patient: “Will my vision keep getting worse for the rest of my life?”
Me: “Don’t worry, it’s completely normal for your near vision to change with age. These changes typically stabilize after age 60.”
How Do You Tell Them About the Products That Can Help Them?
A good place to start is to ask key questions:
• What type of work do you do?
• Any particular hobbies?
• When do you struggle the most with your vision?
• Do you prefer to keep your glasses on for convenience, or only wear them when you need to?
• For contacts: Do you plan on wearing the contacts everyday, at work, or only for recreational use?
Once you know how the patient plans on using the glasses or contacts, you can make lens recommendations that fit with their lifestyle.
I try to accompany the patient to the optical when possible, especially if they are a newly diagnosed presbyope. I let the optician know the options I have discussed with the patient, and that the patient is new to these lens options.
For example, if the patient is not familiar with progressives, the optician should know that. The optician can then further explain how progressives work and help the patient choose an appropriate frame for their glasses.
Patient education can go a long way in increasing patient satisfaction. After all, if your patient buys progressives, and has no idea how to use them, they may not be very happy you recommended them!
Melody Huang, OD, is a freelance optometrist and writer practicing in Los Angeles, Calif. To contact her: firstname.lastname@example.org