Page 16 - Envision-05-2022
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Cover Story

         T HE P R E SB Y OP I A OP P OR T UNI T Y

                                                                               associated with surgical interventions
                                                                               and difficult to fit with glasses
                                         EDUCATION & MANAGEMENT                as well. If both the natural and
                                         It is important to take a proactive     pseudo-emmetropes understand  and
                                         approach and begin a discussion about   accept that there is currently no
                                         presbyopia based on the expected      perfect solution for them, then
                                         onset of the condition. The biggest    the present-day solution with a
                                         unmet need, and a massive opportunity    multifocal contact lens in one eye,
                                         for the eyecare industry, is the      along  with presbyopia-correcting
                                         “emmetropes”, not just the natural ones   pharmaceutical agents, works nicely
                                         but  also  those  without  any  refractive     for them.
                                         errors, because they have had
                                         refractive surgery or wear contact    2. The hyperope, when compared
                                         lenses or glasses for distance, who are   to the emmetrope and myope, is the
                                                                               easiest group, especially the mild-to-
                                         now experiencing presbyopia.
          “    The biggest unmet         There exist similarities yet distinct      moderate latent ones who present
                                                                               in their mid- to late-30s with blur
                                         differences between the different
                                                                               at near and without symptoms
            need, and a massive
              opportunity  for the       categories of refractive errors and       at distance. As an added bonus,
                                         presbyopic treatment options. Knowing
                                                                               placing  anything  on  them  will
                eyecare industry,        which innovations are available and     improve their distance vision, which
                                                                               they  love.  Depending  on whether
                                         which are in the pipeline can guide
             is the  “emmetropes”,       the conversation about the best       or not they want glasses, the
               not just the natural      individualized options for the patient,   discussion can easily turn to contact
             ones but also those         especially if you take into account their     lenses, surgical options and soon-to-
                                                                               be-introduced pharmaceuticals. The
                                         questions and concerns and adjust,
            without any refractive       establish and manage their expectations.  only proviso is lens handling, as the
             errors, because they        1. The natural emmetrope is a         presbyopia increases and hyperopes
                                                                               will always need an auxiliary pair of
             have had  refractive         challenging category. If not already   glasses.

                  surgery or wear         wearing reading glasses, they are
                                          often seen when coming in for their  3. Myopes are an interesting lot and
               contact  lenses or         first eye exam while in the midst of   require a lot of hand-holding to
             glasses for distance,        presbyopia. They have no idea what   successfully navigate their presbyopia.
                                                                               They present ECPs with a different
                                          is happening to them because they
                    who are now           have never required any type of      set of challenges, depending on what
                                     “    Their biggest concern is, “I can’t see   lifestyle and the treatment option
                    experiencing          refractive correction or worn/placed   their current treatment modality is,
                     presbyopia.          anything on their nose/face/eyes.    what they want to fit their current
                                          up close.” Education and adjusting/
                                          setting their expectations are key to   selected. The most difficult challenge
                                                                               is explaining to myopes why they
                                          managing their journey as their eyes   can’t see up close with their distance
                                          progressively change over the coming     correction but can see up close when
                                          decades.                             they  take  off their glasses/contact
                                                                               lenses. The idea is often too abstract
                                           Despite laying out their different    for them to comprehend.
                                          options, including the new
                                          technologies coming through the  Myopes who just want to transition
                                          pipeline, they are often the hardest  into progressive add (PAL) lenses and

                                          to convince that their vision will not  have no interest in refractive surgery
                                          return  to  a  pre-presbyopia  state.   or contact lenses, need to be educated
                                          They are usually averse to the risks   that there will always be a compromise

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