Peer-to-Peer Champions on New Presbyopes

How do you handle the new presbyope who’s never worn anything but sunglasses before? To learn more about emmetropes turned presbyopes, we touched base with two Shamir Peer-to-Peer Champions—Simaan Shini, O.D., at Eye Trends in College Station, TX, and Rob Szeliga, O.D., at Spring Hill Eyecare in Spring Hill, TN.

Q. How do you explain presbyopia to them (what they are experiencing and why)?

Dr. Szeliga: “I tell them there are three guarantees in life: death, taxes, and presbyopia. And I make the gesture of extending my arms out to read so they know what presbyopia is. I tell them it usually starts around age 40, and if they are a little older, they are a late bloomer and overdue. 

“I explain the lens inside their eye doesn’t focus as well as it did when they were younger, and it requires them to hold things farther back until they outgrow their arms.”  

Dr. Shini: “Emmetropes’ refusal to accept that things are changing can be a challenge because they have always seen so much better than everyone, and they are proud of that. The best way to get them on board with progressives is to explain that this technology is not making them more dependent or aging them faster…and that the whole reason they are in my chair is that they are seeking a solution that is different than what they are already doing.

“I say, ‘Why not have the ability to just leave glasses on that make your life easier versus always going on and off with readers and looking 15 years older?’”

Q. How do you discuss and/or show their options?  

Dr. Szeliga: “If they ask, ‘Does this mean I need bifocals?,’ I reply, ‘We don’t say the B-word. We say the M-word–multifocals.’ I’ll explain they have plenty of options, but that I want to know how they use their eyes…what they do for a living and what their hobbies are.

“I’ll go over the differences between progressives—screen time/business/computer progressives, NVO (near vision only), and bifocals.” 

Dr. Shini: “For all new presbyopes, I basically draw the ‘optic’ and how a progressive works. Knowing their computer’s monitor height is crucial to make these optics as amazing as they can be.  

“The number one reason people hate progressives is not that they don’t work, but because their computer setup is preventing them from working. Logic tells the patient to look straight at monitors with glasses on, but that’s not where the help is in the lens.”

Q. How do you try to guide their choice on frames…that is, what to avoid:  

Dr. Szeliga: “If they are getting a progressive, I may recommend they don’t get something too small.” 

Dr. Shini: “My opticians do most of the detailed explaining after I plant the seed of how things work. However, if I see them having a tiny sunglass frame, for example, I’ll mention we’ll likely need to go bigger and why, but if they already have a reasonable size frame on, that’s likely what they will choose, as people are creatures of habit.”

How do you manage previous emmetropes in your practice? Tell us about it and share in the conversation on Facebook here.

Erinn Morgan