Contact Lens Practice Pearls

Managing the Next Generation of Presbyopes

Contact Lens Practice Pearls

Managing the Next Generation of Presbyopes

By John Mark Jackson, OD, MS, FAAO

It seems as though every article written about presbyopes discusses the characteristics of the baby boomer generation. It makes sense, as they make up the largest number of presbyopic patients. But you can't ignore a very important development: Generation X has moved into the world of multifocals and reading glasses.

Gen X Characteristics

I am fascinated by the differences in generations. Generation X usually describes people born somewhere between about 1965 and 1976, which means that as of this writing they are between about 35 to 45 years old. As are all generations, they were shaped by the events of the world as they grew up, and this affects their personalities and their interactions with you.

Independent Gen Xers grew up when women were entering the workforce in greater numbers. This was due to societal changes, a faltering economy, and increasing divorce rate. This was the era of the "latchkey" kids, who were expected to take care of themselves after school until their parent(s) got home. Gen Xers grew up self-reliant, which has carried over into their adult lives.

Tech-Savvy Gen Xers saw computer technology begin to make its way into the lives of the general public. They were the first kids to have video games and computers in their homes, and they entered college and the workforce when PCs were starting to dominate offices. They are now mid-career in an era in which smartphones and other technology are integral.

Not Big on Authority As part of their independent streak, Gen Xers tend to distrust authority. If you want them on your side, you have to engage them and help them understand why something is important or valuable to them.

Managing Gen Xers

So what does all this have to do with contact lenses? Although these are stereotypes, they do tend to influence how I interact with patients. As they begin their presbyopic years, contact lens wearers are faced with the typical choices: reading glasses, monovision, or multifocal lenses. How do they respond to these choices?

First, remember that Gen Xers aren't going to respond well to authority without understanding why you are making a recommendation. Help them understand their choices rather than simply telling them which option you think is best (though still make the recommendation).

Their independent nature seems to make them unhappy with the idea of reading glasses. Although not wanting to "look old" is important to them, I think the loss of independence is what really bothers them. Interestingly, most Gen Xers don't complain to me that their "arms are too short"…they instead complain about difficulty using computers and smartphones.

Their tech-savvy nature seems to make them especially interested in multifocals. They don't like the idea of monovision, but they are usually fascinated with how you can get distance, intermediate, and near all in one lens. In the past I would try to delay multifocals as long as possible, but I have learned that Gen Xers seem to fare better when you get them started early. I suggest multifocals when they still can do their near tasks but have visual fatigue near the end of the work day. CLS

Dr. Jackson is an associate professor at Southern College of Optometry where he works in the Advanced Contact Lens Service, teaches courses in contact lenses, and performs clinical research. You can reach him at