A prospective patient walks into a dispensary. This person has not previously required any type of vision correction. But he explains to the optician that he has noticed a change in his ability to read at close distances and would like some advice on what kind of vision correction he needs. What did one optician recently suggest to this emerging presbyope? Ready-made reading glasses from a drugstore.

Those with expertise in the area of treating former emmetropes who are becoming presbyopic would chorus a resounding response: "Wrong Answer." Most agree that this patient is the perfect candidate for traditional progressives or progressive reading lenses. Sending them to the drug store for readers is basically throwing away what could be a highly profitable sale-and the satisfaction of your patient and customer.

"Since the average age of my patients is 46, I see this type of person all day every day," says Texas Smith, O.D., in private practice in Citrus Heights, Calif. "If people only need a reader, I will always give them a variable power (progressive) reader because of the variety of close ranges they need to see-from 8 inches to 6 or 8 feet. It's a real practice builder."

Some optometrists, however, choose to direct these patients toward standard progressives. "I find that patients want the ability to see at both distance and near points without taking their glasses on and off," says David B. Seibel, O.D. FAAO, who is in private practice at Visions Care Consultants in St. Louis. "We really try to keep it simple and prescribe standard progressives."

Whatever direction you choose as right for your patients and your dispensary, one thing is for sure: This market will grow.

The Candidates

Many feel that vision correction for this type of patient will become even more widespread within the next two years for two major reasons: First, there will be a vast number of baby boomers swinging full force into presbyopia; and second, many people who have had LASIK and are entering their 40s will need this specific type of vision correction.

"We will see a growth in this market as the people who have had LASIK done become presbyopic," says Dave Ziegler, O.D., located in West Dallas, Wisc.

"This type of patient," continues Ziegler, "who is just getting to you because they have become presbyopic after having laser surgery, has a lot of options." Ready-made readers are one of those options, he notes. And a standard progressive lens, which gives the ability to see close up and out to distance, is another option. The third choice is progressive readers: "You put them on mainly for close vision but they also have variable powers in them," he says. "They don't give distance vision, however."

Additionally, the prevalence of computers both in the workplace and at home has created a need for the former emmetrope or laser surgery patient to see at varying distances.

"Nowadays with everybody using computers it's difficult for this patient to only use reading glasses," says Smith, "because he really needs to see different distances. The variable power readers take care of that."

Presenting the Options

Asking patients about their computer usage and vision needs-as well as their basic lifestyle-will help in dispensing the appropriate progressive lens product for them.

"The first thing is finding out what their needs are," says Ziegler. "If they sit at a computer all day, a single-vision reader may work. But if they move around all day using different focal points, then they will want a progressive. Or if they are a switchboard operator, who needs to see close up, they may want to use progressive reading lenses."

One of the keys for dispensers with this patient is talking about their need for various focal lengths. Experts say that reading glasses will give a focal length of up to 14 to 18 inches. But they also point out that the shelf at the grocery store-where patients may be looking at labels-may be 30 inches away from the face.

In single-vision reading glasses, this person would have to get real close or back away from the object they are looking at. And most say that this is where progressives can come into play.

"I go over the notable advantages of progressives with the patients while they are in the exam room and make a prescription on a pad which they then take out to the dispensary," says Seibel.

"For opticians it's important to move into a lifestyle questionnaire. Ask patients what they do and how much they work on computers and make a recommendation. You are the authority and people will respect that if you give them valid information."

To make the progressives sale, dispensers can talk about different distances that the patient needs to see and the fact that reading glasses may not be the right thing to suit their needs. With today's varying lifestyles, people need to see at many varying lengths all day long-looking at cell phones, dashboards, and computer screens, or reading fine print. And most people want the help with their close vision.

"We did some research on fitting pre-presbyopes with progressives," says Ziegler. "We put people in these lenses and found that one-third of them wanted to stay in the progressive after they tried it, even though they were not yet presbyopic. There's a desire for help with their close vision even when they don't need it because of presbyopia."

The pricing of progressive reading lenses can also be appealing to these patients. According to Smith, they run in the $90 to $110 range, "About half of what bifocals cost."

Once they have come into the dispensary, there are many reasonable options to present to them; however, part of the challenge is to get them there in the first place. Most dispensers say they currently do not market to this patient. And some feel they don't need to.

"A lot of people hit the drugstores first when they are an emerging presbyope," says. Smith. "But they mostly won't do that for beyond a plus 1.50 correction. At this point they will opt to go to the optometrist. They may do readers for the first pair, but they won't do it for the second pair."

And as the field of former emmetropes who are now emerging presbyopes grows in leaps and bounds, and the laser surgery market creates a new customer for PALs and progressive readers, the entire progressives area will become an even more profitable segment for optical dispensers.

"There is absolutely no question that there could be a huge growth in the variable power reader in the future as the rate of LASIK grows," says Smith. "I probably prescribe already about five pair of those a day." EB