By Cindy Murrill,OD,MPH
Director of Optometry
PCLI—Tacoma, WA

My optometric physician husband, Joe Pfeifer, recently had cataract surgery with multifocal IOLs. He is very happy with his vision and I thought you would be interested in some of the details.

Joe is one of the early baby boomers. He’s in his mid 50s and has a busy private practice just north of Seattle. Outgoing and gregarious, Joe’s an active guy with a type B personality and a fairly relaxed attitude toward life. But over the last several years, his hyperopia, presbyopia and dependence on corrective eyewear were increasingly frustrating.

With the early onset of cataracts, Joe became interested in multifocal lens implants. After learning more at a PCLI CE function, he made a decision for ReZoom IOLs and is delighted with his new range of vision. He now only wears cheaters for detailed vision and reading in low light.

Click here to read Joe’s case study.

Over the past 2 years, we have been making careful forays into multifocal territory. Shaun Coombs, OD and David Stanfield, OD in our Chehalis office have been cautiously leading the way. They have gained enough experience and seen enough happy patients that they are enthusiastic about this option—for properly selected candidates.

Although I have been watching the advent of multifocal IOLs with a lot of interest, I have been hesitant to fully embrace the technology in its early stages. But an increasing number of highly satisfied patients, and now Joe’s positive experience with ReZoom lenses, has encouraged me to challenge you to share this option with patients.

Click here to see the comanagement resources we have prepared for your practice.

Multifocal IOLs present exciting opportunities for comanagement. Primary care optometric physicians are well suited to counsel patients, help guide them through the decision making process, and charge for their important pre and post-operative services. Actually, that is our preference—similar to laser vision correction. Together, we have the opportunity to lead the nation in a unique and effective style of cataract care with unprecedented cooperation and communication.

• Where did LASIK patients go?
  They've aged! Across the nation, LASIK volumes are reaching a plateau. In 2006 the average age of baby boomers was 52 with many moving out of the LASIK market and into the market for refractive lens exchange.
• Multifocal IOL market
  Between 2004 and 2020 the number of people in the USA over age 65 will double. Every 7 seconds another baby boomer reaches 51 years of age and moves past the “sweet spot” for laser vision correction. Frustration with presbyopia is generating interest in multifocal IOLs.
• Cataracts in people under 65
  Approximately one-third of patients 45 to 64 years of age already have early cataract formation.
• Cataract consultation
  As baby boomers become cataract patients, it is important to discuss lens implant options with them, especially when they are motivated to reduce dependence on corrective eyewear.

Source—The 4 previous points were gleaned from a presentation given by Steven Dell, MD at Controversies in Ophthalmology, January 13, 2007, in Los Angeles.

Over the next 10 years, the impact baby boomers have on eyecare will be dramatic. This aging sector of our population is big into lifestyle. They (and I’m one of them) are unwilling to accept the aging process as a limiting factor in their active lives. For this reason, baby boomers are huge consumers of fitness, health and medical services that promise to turn back the effects of time.

As comanaging ODs and MDs have learned to cooperate and maximize each other’s skills, we face a new opportunity to expand the level of our care. I call it Lifestyle Eyecare—where we work together to tailor fit solutions that satisfy patients’ visual demands. Lifestyle eyecare will become increasingly important as the fast rising tide of boomers begin to develop cataracts. Like my husband, many of these patients will want to explore options to reduce dependency on glasses.

For cataract patients, lifestyle options include:

• Toric IOLs to correct astigmatism
• Multifocal IOLs to help reverse the effects of presbyopia
• Corneal surface treatment to correct astigmatism or fine-tune vision with IOLs

A large bubble of active, healthy, lifestyle-motivated people will soon be turning 60. I believe we are going to experience a golden age of eyecare where an increasing number of patients will present with a lot of eyecare needs. Family optometric physicians are perfectly suited to provide most of this care. And comanaging ODs and MDs are well positioned to work together to serve and delight those patients requiring additional attention.

Optometrists by nature tend to listen, build relationships with patients, and customize their care accordingly. With the burgeoning baby-boomer population, family ODs need to retain primary management of aging patients by:

• Continuing to listen to patients’ needs and desires
• Offering the full range of optometric services
• Beginning to provide lifestyle eyecare options
• Opening the door to subspecialty surgical services

Vision exams with eyeglasses Rx will not satisfy the needs of many baby boomers. Although this is the foundation on which optometry is based, primary care ODs must also offer:

• Medical eyecare—for which Medicare should be billed with appropriate E&M codes
• Advanced technology and testing—or the ability to order it from a comanagement center
• Direct referrals to the best sub specialists—accompanied with detailed pre-op information
• Post-op care—expecting excellent communication and detailed information from the surgeon

This is comanagement at its finest!

Click here to read an interesting article from Optometry Management—Comanaging Cataract Patients: The New Role of the Primary Care Optometrist.