Managing presbyopia successfully is about managing patients’ expectations, which leads to gaining patients’ trust. How we educate, set realistic goals, and communicate with empathy can transform their experience and ultimate satisfaction with us.
Delivering the Diagnosis
My advice to the optometrist is to be prepared to address the emotional aspect of the problem. This will come in the form of patient questions like, “Why can’t I read anymore? My vision was always perfect!” By providing a lighthearted and reassuring response, such as, “Your eyes are naturally evolving, as you have more birthdays,” you can lessen the blow. I have found that normalizing presbyopia helps reassure patients that it is to be expected for everyone.
Reviewing the Options
Glasses are a familiar option for patients, but many presbyopic patients are confused and frustrated that single vision lenses are no longer working for all ranges of vision. Instead of always starting with progressive lenses, I find success in prescribing a “baby” progressive or antifatigue lens design to provide a gentle introduction to progressive technology before a full progressive lens becomes essential. Once a larger range of vision is needed, I find that presenting progressive lenses as a versatile tool in the toolkit, rather than as a one-size-fits-all solution, helps patients appreciate their options and avoid disappointment. With higher add powers, it is important to discuss the real estate of the progressive lens to ensure patients understand the technology and how it works. To set the patient up for success, I have found it’s crucial to talk about the fact that progressive lenses are often best complemented with a pair specialized for computer work or extended reading.
For contact lenses, many presbyopic patients love the freedom multifocal lenses offer, but it’s important to explain: “While contact lenses provide a great balance, they’re not always as sharp as glasses for every situation. Think of them as a B+ for clarity compared to the A+ you get with glasses.” It’s also worth noting to the patient that adjustments may be needed, but the convenience contact lenses provide often outweighs the trade-offs. This transparency ensures they are excited about the freedom contact lenses offer, while understanding their limitations.
Regarding surgical advancements, it’s important to clarify that laser-assisted in situ keratomileusis (LASIK) doesn’t address the full spectrum of presbyopic correction: “LASIK can correct your distance vision, but once presbyopia sets in, you’ll still need reading glasses. It’s a paradigm shift, especially for those who’ve relied on their near vision naturally for years.” By framing surgery as one part of the solution, rather than as a cure-all, patients can make informed decisions and avoid disappointment.
It's All About the Presentation
It is crucial to explain that no option will provide the level of vision the patient had before presbyopia. They all have their pros and cons. But when presented as part of a comprehensive toolbox, patients feel empowered. Acknowledging trade-offs while celebrating customizable solutions helps patients embrace presbyopia care. With empathy, education, and even a bit of humor, we can show them that life with presbyopia can still be clear, comfortable, and full of possibilities. OM
