By Sara Bonizio

Eyecare professionals have long known that understanding the vision and lifestyle needs of presbyopic patients, combined with “wants” related to aesthetics, comfort and convenience, will strengthen the eyewear consultation process and bolster multi-pair sales. With a new generation—the oldest Millennials—poised to enter the multifocal market, ECPs will be well-served to plan for the emergence of a discerning, tech-dependent consumer who will likely eschew the aging effect of wearing a traditional bifocal, drawing the line at… the line. “I may have no control over my eyes getting older, but I refuse to look like my grandparents,” is a refrain ECPs often hear from emerging presbyopes. That begs the question, how will your practice meet their needs as their vision begins changing? The answer, in short, is offering multiple lens choices to help these patients “pass the test” of the vision challenges facing them in their 40s and beyond.

Within the next three years, the oldest members of the Millennial generation will hit 40, the age where the “long arms” of presbyopia begin to emerge like tentacles of an octopus. This condition is a natural part of the aging process and (assuming no surgery is performed) presents ECPs with a near-universal opportunity to introduce new optical products into the eyewear consultation and selection process. Patients with refractive error are already accustomed to depending on vision correction, but those who have enjoyed a plano OU Rx and now have an add may struggle with the idea of needing and using glasses when they never did before.

If ECPs have introduced the topic of presbyopia during prior annual visits, when patients are in their late 30s, a smoother transition is likelier; bonus points if your staff has successfully consulted younger patients to use single-vision computer glasses with blue-defense anti-glare coating to alleviate digital eye strain. With symptoms usually becoming more pronounced as the aging eye’s focusing ability decreases, having already introduced the concept of a visual aid at intermediate distance may render the patient more likely to incorporate near vision accommodation later via computer progressives once near focusing ability becomes impaired. Think of it (but perhaps don’t vocalize it) as Thirty: The New 40! –an opening for the ECP to ease the pre-presbyope into the practice of using occupational eyewear (a valuable second- or third-pair sale).

While there is no true all-in-one eyewear solution for presbyopes, progressives are typically seen as the closest option, incorporating vision correction at multiple viewing distances into one pair of glasses for continual wear, without the lines that many consider a telltale sign of aging. As PAL designs become more sophisticated, many complaints about “swim” have subsided, and successful adaptation can occur more quickly than ever before, creating an opportunity to bypass lined multifocals entirely for a generation whose aesthetic is younger and more casual, even at work.

No, not “Come here often?” I’m thinking of: “You wouldn’t have just one pair of shoes, why would you have only one pair of glasses?” In the optical world, it’s the time-honored analogy that has helped close multi-pair sales for decades, co-opting a wardrobe-building mindset to validate the brown tortoiseshell frame purchase and the classic black; a mature metal for work, a funkier acetate for play. However, rooting the multiple mindset solely in fashion is only part of the story.

Ask a patient how many digital screens they use daily; the answer will likely be “smartphone, TV, computer and/or tablet,” for an average of nine hours-plus daily. In today’s increasingly device-dependent world, this complementary premise might resonate: “You don’t have just one screen to work and consume media, so why would you only have one set of lenses for all of your different work, play and leisure activities, both digital and off-screen?”

Emerging presbyopes have new vision needs that ECPs should start preparing them for well in advance of the day when their arms mysteriously grow several inches. And for those past middle age who are used to wearing the multifocals of yesteryear (and compensating for their inherent limitations): ECPs can demonstrate the advantages of digitally-surfaced lenses for these patients to graduate into, which will minimize distortion.

No matter the viewing distance, when outdoors, patients of all ages need UV protection and decreased barriers to donning appropriate eyewear. With proper education by your staff, they’ll already be versed in the comfort and convenience offered by polarized sunwear and photochromics, and open to incorporating premium sun versions of the lens designs new to their expanding multi-pair collection.

Your practice’s die-hard contact lens wearers are of course also candidates for multiple pairs as presbyopes, especially sunwear; even if they successfully transition into multifocal contacts, they need glasses as backup in case of infection, irritation or other conditions precluding wear, so don’t rule out offering premium lenses.

As new eyewear designs continue to entice accessorizers with optical expressions of trends, Transitions’ brand ambassador program has successfully raised awareness of the eye health benefits and convenience of built-in shades, paired with fashion-forward frames. The program is promoted by prominent influencers inside and outside of the optical industry, and accompanied by a Snapchat “Transitions filter” released in 2018 allowing users to virtually experiment with photochromic looks. Although the Transitions program is designed to promote premium lenses to a more youthful demographic, Millennials, even older ones may be receptive to this type of social media marketing.

Educating presbyopes about their changing vision needs and reinforcing the need for multiple pairs at multiple intervals is key, from online interactions (post information on your practice’s website, blog and social media, and send pertinent links directly to patients via email and text—videos are especially popular with Millennials) to the doctor’s exam and throughout the visit. With many practices featuring numerous computer workstations, staff who are themselves presbyopic should be given ample incentive to try different pairs including computer progressives at the company discount, to be able to endorse their value from personal experience.

Encourage staff to utilize visual aids, such as side-by-side comparisons of lens designs (app-based simulators are particularly adept at demonstrating the difference between basic and premium lenses, bifocals and progressives, etc.). However, be aware that these can work almost too well, so be mindful of how you present each option. Many practices opt for a “good-better-best” categorization, vs. “bad-OK-premium,” since over-emphasizing the limitations and distortions of “old tech”—only to have patients settle for it due to budget constraints—may predispose them to walk out of your practice anxiously anticipating discomfort.

Most practices offer multi-pair specials; take it one step further by tailoring packages for presbyopes consisting of progressives, computer glasses, a couple of single-vision options and consider a grace period (i.e., 30 days) where the patient can come back and add another pair into the mix at the discounted rate. Also ensure you have unique stock readers on hand to offer at the end of the sale as backup (and easy add-on revenue), e.g., lighted options for travel, reading in bed, on planes or in other dim conditions.

All presbyopia solutions involve some degree of compromise; no currently available corrective lenses can completely restore the focusing flexibility the patient had before (though surgery can come close), and there is no true all-in-one eyewear solution yet. Adjustable-focus eyewear that allows wearers to manually or electronically switch between different viewing distance prescriptions remains promising, although no such “Rx on-demand” products are currently being marketed.

ECPs should aim to meet patients’ needs with an array of complementary eyewear offerings tailored to their specific workplace, home and leisure environments; and if communication about changing needs begins before presbyopia hits, your staff can segue more seamlessly into meeting the demands of vision correction after age 40 with multiple pairs that accommodate increasingly digital lifestyles and accent their Chuck Taylors.


Today, with websites offering seemingly endless options to tailor purchases to one’s discerning tastes, patients are well-acquainted with the “build your own” concept, made possible with a series of radio button selections.

At this year’s Vision Monday Global Leadership Summit, presenter Jason Dorsey noted that products, services and experiences marketed to Millennials need to be presented as one of a kind, “as unique as they are,” but cautioned against using terms like individualized or customized, considered dated concepts of the prior generation.

Digitally-surfaced lenses double down on that “made to order” M.O., optimizing the OD’s prescription so that the intended vision correction is what is actually fabricated, based on the frame’s parameters; the patient is measured for position of wear and the surfacing process corrects higher-grade aberrations, resulting in more precise visual acuity. With patients’ growing dependence on digital screens, blue-defense anti-glare coating should be offered on all pairs.


Contributing editor Sara Bonizio is the marketing director for Metro Optics, a New York-based optical retailer.