By Linda Conlin, ABOC, NCLEC


Currently, there are 128 million presbyopes in the U.S. While the majority are over age 45, eyecare professionals are seeing younger presbyopic patients, beginning at about age 37. With the digital age, visual demands are changing. According to Comparitech data, the average American spends more than seven hours a day using digital devices, with younger groups and some workers estimated at 10 hours a day. The variety of digital devices we use also require different viewing distances. Smartphones are typically viewed at 13 inches, tablets at 16 inches, computer screens at 25 inches, up to 10 feet for large screen TVs, and yes, we still read print, at about 15 inches. Considering that we frequently switch between these mediums, that’s a high accommodative demand, and the strain is showing in younger patients, the millennials.

Tip: Introduce the topic of presbyopia during prior annual visits, when patients are in their later 30s. This presents ECPs with an opportunity to introduce new optical products into the eyewear consultation and selection process when the patient needs an intermediate and near prescription.

Presbyopia doesn’t happen overnight. Like most optical conditions, it creeps up over time, and as it slowly progresses, most folks develop coping strategies. We will see emerging presbyopes in two general categories, emmetropes and ametropes, and their psychological approach to the need for intermediate and near correction differs. Myopes who can accommodate a little longer than some or take their glasses off to read can manage longer without reading correction. Emmetropes tend to use over-the-counter readers, referring to them as “cheaters” because they “don’t really need glasses.” Resistance to presbyopic progression is futile, however, and there comes a point when coping strategies fail, and the need for reading assistance is accepted. Even the smug myopes reach a point at which their myopia improves but with a cost to their near acuity.

Ametropes may make the transition into multifocals more easily because they have been wearing glasses and understand that they are a tool to provide clear, comfortable vision. Emmetropes have always had good vision and tend to resist the need for correction. In both cases, progressive lenses incorporate vision correction at multiple viewing distances into one pair of glasses, creating an opportunity to bypass lined multifocals entirely for a generation whose aesthetic is younger and more casual, even at work. They provide a solution now and for life.

Tip: Millennials, whether ametropic or emmetropic, want customized solutions to problems. Start by listening to the patient explain the problem, even if you think you know what they need, then offer the lens solution for their individual needs.

Even when your patients acknowledge their need for vision correction, barriers to the best solution may remain. Most commonly, these barriers include price, the perception that the need for near correction is a sign of aging, progressive lenses can be complicated to explain, and they know people who have had difficulty with progressive lenses. Be prepared to address these objections.

Answer the price barrier by explaining this is a customized solution for their individual needs, and be knowledgeable about insurance benefits that may be used toward the cost of a progressive lens. As for presbyopia as a sign of aging, explain that this is a natural occurrence that happens to everyone. Avoid technical details when explaining progressive lenses and demonstrate that the lenses look just like the glasses or “cheaters” they have been wearing. As for those who had difficulty with progressive lenses in the past, point out that designs continue to improve to eliminate issues with swim or finding the “right spot” for viewing at each distance, and the newer, better lenses will exceed their expectations for a better experience.

Tip: Listen to the patient at the dispense. If they are having difficulty, take steps to resolve it. Most often, an adjustment is all that is needed. Avoid the seven deadly words, “You’ll have to get used to them.” Solve the problem!

Successful progressive wear requires the right prescription, the right fit and the right lens. Millennials, the emerging presbyopic market, want their products, services and experiences to be presented as one of a kind, geared to their unique needs. Digitally surfaced lenses double down on that “made to order” concept, resulting in more precise visual acuity. Become familiar with a variety of progressive designs and the benefits of each. Pre-adjust frames at the fitting and before dispensing. Reassure the patient that this is a solution to their problem, and teach them to learn to use the lenses in the same way they would learn to use a new tool—or digital device.