The Presbyopic Patient: Who They Are and What They Want

Presbyopia patients have a variety of lifestyles and visual needs. However, Ralph Chu, MD, founder and director of Chu Vision Institute in Bloomington, MN, and Selina McGee, OD, founder of Precision Vision Edmond in Edmond, OK, see a number of similarities among the patients walking into their office for presbyopia treatment.

 Here, Dr. Chu and Dr. McGee discuss further who their presbyopia patients are, and what’s important to them.

 1. Who is your presbyopia patient?  

Ralph Chu, MD: Our typical presbyopic patient is in their mid-40s to early-50s who have typically had good vision for most of their lives. Some of them are natural plano patients, and others have achieved plano vision through vision correction surgery. Some present anxious and scared that their eyes are starting to “break down,” while others have heard of this aging process and just want to confirm that their eyes are healthy and simply aging.

 These patients have enjoyed freedom from glasses and now are confronted with the aging process where they are no longer able to see as well as they used to up close. They describe situations where their “arms are too short” or that it’s getting really frustrating trying to see in low-lighting conditions, such as in a restaurant or at parties. They also express frustration doing practical tasks around the house in dimly lit situations like handywork. Many try their own DIY solutions from something as simple as over-the-counter cheaters to other interesting workarounds to help them see better up close.

 Selina McGee, OD: My presbyopic patients are a wide range of individuals with varying degrees of symptoms. Some may only be tired at the end of the day, while others explore self-help in the form of increasing the font size on their phone or increasing their lighting. Still others have a full-blown 911 emergency of “I can’t see!” When probed though, all have admitted to trying some form of workaround to help them with near activities.

 2. What do your presbyopia patients want from you, their doctor? 

Dr. Chu: I think the main thing that our patients are looking for when they seek opinions about their presbyopia is reassurance that their eyes are not abnormal or breaking down. They’re also asking if there is a way to fix their eyes so they don’t have to wear cheaters. We spend time educating the patients about the anatomy of their eyes and the aging process. We use the term “presbyopia” regularly so there is a consistent message across the practice, and we also educate the patients about their treatment options, including medical and surgical options.

 Dr. McGee: As Dr. Chu mentioned, they want reassurance. They want to know that presbyopia doesn’t continue to worsen for the rest of their life. They want to know what presbyopia is and what it means for them: Is the condition inevitable? Why is it happening, and is there something they or I can do to stop it? Ultimately, they want education about presbyopia, and they want to hear how I can help them with their frustration.

 3. What frustrates you the most about presbyopia for your patients? 

Dr. Chu: As a surgeon, one of the most frustrating things about presbyopia is that currently there are no great surgical options that help bridge the gap early between cheaters and surgical correction. A plano presbyope’s primary concern is the safety of any surgical intervention versus efficacy of the procedure. So, while lens-based solutions exist, adoption is still small. We remain optimistic and excited about what the future holds to fill this current need. 

 Dr. McGee: It’s a lifestyle change, and lifestyle changes are really hard. If you’ve ever changed your diet or incorporated an exercise program into your routine, you know how hard lifestyle changes can be. This is a lifestyle change the patient didn’t ask for, and it certainly doesn’t enhance anything—except the emotion of feeling old. 

 It’s often their first brush with aging, and with that comes a whole range of emotions. They are thrust into situations that they’ve take for granted their whole life, such as ease of working and enjoying their hobbies. Now, something as simple as putting on mascara, shaving, seasoning their food—and being able to even read a menu, for that matter—can be difficult to near impossible. Visual demands in many workplaces can be an enormous burden for patients to navigate. From computer work to reading serial numbers for electricians or plumbers, this can make for a less productive and tiring workday. I help them with all the amazing technology we have, but even so, patients are still sometimes frustrated with what’s available and ask for more options.

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