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    ODs: Rulers of the Land of Presbyopia


    The views expressed here belong to the author. They do not necessarily represent the views of Optometry Times or UBM Medica.

    You may have noticed that surgical correction of presbyopia is a hot topic.

    This is not surprising because there are a lot a demanding presbyopes. U.S. Census Bureau figures suggest that 112 million Americans had presbyopia in 2006, with increasing prevalence over the last decade.1

    Related: Managing presbyopia with surgery

    I practice in a contact lens world 50 percent of the time and in a surgery world 50 percent of the time. We often perform cataract surgery with near vision correction, using monovision or presbyopia-correcting intraocular lenses (IOLs). These folks are typically happy despite having mild residual refractive error.

    Yes, I just said these patients are happy with residual refractive error. Something magically happens between that patient getting glasses that she “just cannot wear, at all” and getting cataract surgery.

    Let’s follow that patient’s path.

    Related: Minimally invasive surgical solutions for presbyopia

    A patient’s journey

    This is the same patient who decided to try progressive lenses at age 47 after you told her at age 43 she would benefit from progressive lenses. She had second, third, and fourth thoughts when she was presented with the price (that is so much lower than presbyopia-correcting IOLs).

    She had to talk to her spouse and her friends and return twice to the office to see the frame and make sure you can’t see the bifocal line when they are made. And the logo on the frame? That will be gone? Yes, that will be gone, and no, you can’t see the lines.

    Then we have to go over her vision and medical benefits before she committed to the progressive spectacles. She spent 20 minutes on whether or not to get an antireflection coating (always) or a separate pair of computer glasses (required if you are an engineer) or sunglasses (required if you are not a hermit).

    She calls daily for 10 days to see if her glasses are ready. When you send her a text and an email, then make two phone calls to tell her the glasses are ready, she shows up three days later when it finally stops raining to pick them up.

    She makes the face that says, “I do not like these glasses.”

    Tracy Schroeder Swartz, OD, MS, FAAO
    Tracy Schroeder Swartz currently practices at Madison Eye Care Center in Madison, Alabama. She serves as Education Chair for the ...

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    • [email protected]
      I always thought how can the same optics in MF's CL's work so poorly yet when incorporated in an IOL they are perfect. SMH.

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