The presbyopes are coming, and so are new drops to treat them
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The earlier we prepare patients for presbyopia — and reassure them that there are new treatment options on the horizon — the better.
With millennials now becoming presbyopic, the size of the population affected is set to explode. Consider the numbers: 1.8 billion people globally have presbyopia, including around 128 million in the U.S. alone (Fricke at al.; American Optometric Association; Zebardast et al.; U.S. Census Bureau). Research shows that as many as 30.9 million patients do not visit an eye care provider when they start to struggle, opting for readers instead (Vision Council). A survey showed that 96% of patients aged 40 to 55 years report being somewhat affected by presbyopia symptoms, 46% said they are extremely affected, and 90% are frustrated or irritated with presbyopia (Allergan survey of 797 patients; Allergan survey of 1,339 patients).
With several pharmaceutical options working their way through the pipeline, we as eye care providers have an incredible opportunity to help our patients.
In my clinic, I make it a point to tell my patients about any advancements on the horizon that may be applicable and of interest to them. I have been discussing the forthcoming presbyopia-correcting drops, and the response has been extremely positive across the board — men, women, young, old — everyone says, “Wow!” I also document what we discussed so that I can continue the conversation at the return visit.
Synergies among solutions
Future pharmaceutical options for presbyopia will not replace glasses, contact lenses or refractive procedures, but will be synergistic. Like with multifocal contact lenses, for example, we can enhance that solution with glasses; patients use both. I see future pharmaceutical options as being additive and beneficial to the current options that we have today.
Considering the size of the anti-aging market, $44,124 million in the U.S. in 2020, we know these drops will play a role in terms of patients' desire to remain looking and feeling youthful (Market Data Forecast, Business Wire). Simply, many people just do not see themselves wearing glasses for near vision.
I am looking forward to new pharmaceuticals that can help our patients have freedom from glasses or contacts if they wish and being able to choose which solutions to use in what situations. Of course, my specific conversations with patients are customized to that individual.
Aging can be universally frightening to people, so I even talk with patients in their 30s to reassure them that there are options. Although they are not symptomatic now, I let them know that when they do start to have trouble with their vision and it affects their ability to do their favorite hobbies — read, work on the computer or even just look at their phone — there are options for them. I want patients to let me know when they notice a change in their vision.
Don’t say “aging”
When I discuss presbyopia, I explain that it is a natural process that we all experience; I typically do not use the word aging. As someone who became presbyopic before age 40 years, I will say that it is a whole lot easier to talk to my patients now than it was 20 years ago.
I hope that because of presbyopia drops becoming available, we will have the opportunity to perform more eye exams and ultimately diagnose and treat a variety of diseases earlier, and even prevent them. Increased public awareness around the need for eye exams could have huge public health consequences.
Determining the best patient for the drops or how to incorporate them into a treatment plan will be individualized, specific and personalized, depending on the patients' desires. Do they want to use the drop when going out to dinner or playing a sport? What exactly is it that they want to do? I see some patients saying they want to use it every day, for work, all the time. Others will use it occasionally, maybe only on the weekends or for social functions. The fun part comes when we work with our patients to meet their needs.
References:
- American Optometric Association. Care of the Patient with Presbyopia. Accessed March 16, 2021.
- Business Wire. Global Anti-aging Market (2021 to 2026) — Growth, Trends, COVID-19 Impact, and Forecasts — ResearchAndMarkets.com. Accessed May 1, 2021.
- Data on file, Allergan; Full Quantitative Summary. Survey of 797 patients aged 40-55 years.
- Data on file, Allergan; Full Quantitative Summary. Survey of 1,339 patients aged 40-55 years.
- Fricke TR, et al. Ophthalmol. 2018;doi:10.1016/j.ophtha.2018.04.013.
- Market Data Forecast. North America Anti-Aging Market Research Report – Segmented by Demographics Products Type, Services, Devices Type, Country (United States, Canada & Rest of the North America) — Industry Analysis, Size, Share, Growth, Trends, Forecast. 2020 to 2025. Accessed April 10, 2021.
- U.S. Census Bureau. Table 9. Projections of the Population by Sex and Age for the United States: 2015 to 2060 (NP2014-T9). Washington: Population Division. 2014.
- Vision Council website. Vision Watch — The Vision Council Member Benefit Report September2016. Accessed May 2, 2021.
- Zebardast N, et al. Am J Ophthalmol. 2017;doi:10.1016/j.ajo.2016.11.004.
For more information:
Melissa Barnett, OD, FAAO, FSLS, FBCLA, is a principal optometrist at the University of California, Davis Eye Center in Sacramento and Davis, Calif. She is an internationally recognized key opinion leader, specializing in ocular eye disease and specialty contact lenses. She can be reached at DrBarnett@UCDavis.edu.
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