Presbyopia is no longer a concern that starts in the mid-40s. With increasing screen time from phones, tablets, and computers, patients in their late 30s and early 40s are experiencing near-vision challenges sooner—and eyecare professionals need to adapt their communication and care strategies.

EB connected with Drew Provost, OD, clinic director and founder of Great Hills Eye Care, with 3 locations in Texas, to learn how he’s reframing patient communication as presbyopia increasingly affects patients earlier in life.

Reframing the Conversation

Traditional messaging, such as “Your eyes are getting older,” doesn’t resonate with today’s younger presbyopes. Instead, frame presbyopia as a lifestyle consideration. Talk about digital eye strain or focusing fatigue, tying visual changes to the demands of modern device use rather than aging alone. “Now, the conversation is a lot more, ‘We’re using our eyes in a different manner. Our environment has changed. The need for near vision is higher because of digital device usage, and these are some things we need to do to help,’” says Dr. Provost.

Although the second step is vision correction from the ECP, the first is instilling better habits in patients. “A prevention mindset,” he calls it. “I tell patients, ‘Be really intentional about your environment,’” suggesting to patients they should try to hold the phone further away, take breaks, and manage their overall screen time.

Starting this conversation early, even before patients notice symptoms, is proactive, rather than reactive, input from the ECP that can build trust. Patients who are coming in for their yearly exam might not realize they’re experiencing symptoms of digital eye strain. “But you know that they are because everyone is,” he says. “By giving them these tips, they like that you took that extra 5 seconds to give them some education.”

The Contact Lens Continuum

Dr. Provost shared the concept of the contact lens continuum, a gradual path that leads patients from single-vision lenses to multifocals as their needs evolve. The goal is to reduce dropout by reassuring patients that comfort and performance will progress gradually, not abruptly.

When the conversation about eye strain and fatigue comes up, ECPs can let patients know that “the contact lens industry has put a lot of resources, research, and effort into developing lenses that specifically address that [they] are now facing and will continue to face,” he says. This declaration lets younger presbyopes know that this is a common issue and leads into the continuum concept: Treatment begins with a single-vision lens, and “as your vision changes over the next few years, we can adapt to a very similar-feeling lens with different optics,” Dr. Provost assures patients.

“The idea is you want the patient to feel comfortable and to understand that they are not going to fall off a cliff,” he says. “It’s a gradual change.”

Patient Education

Dr. Provost pointed to 3 main misconceptions patients have about multifocal contact lenses: (1) vision won’t be clear enough, (2) vision should match their glasses exactly, and (3) multifocals are too expensive. Clear education, expectation setting, and in-office demonstrations can demystify multifocals and improve adoption.

• Show, don’t just tell: “Keep it simple; don’t reinvent the wheel,” he says. Use manufacturer diagrams or in-office tools to illustrate how multifocal optics work.

• Hands-on trials: Let patients try lenses during their appointment to experience vision improvement firsthand. “It’s about experiencing it,” he says. “‘Hey, let’s just let the lens settle in for a minute while we talk about your eye health.’ After about 5 minutes, ‘Hey, how are things looking? Good? Well, we’ve just proven we’re off to a great start.’”

• Tailor to lifestyle: Consider a patient’s screen usage and recreational activities when prescribing lenses. “If they’re at the computer Monday through Friday, we have excellent task-specific glasses for that,” Dr. Provost says. “Then they wear multifocals 2 or 3 times a week, when they’re going to watch their kids play sports or going out to dinner.” Not every patient needs to wear multifocals full-time; partial-week use can balance performance and cost.

A patient of Dr. Provost, a 46-year-old heavy computer user, was frustrated with eye strain and hesitant about multifocals. “His previous doctor said, ‘Hey, I don’t think multifocals are a good option for you.’” Dr. Provost’s approach? “I say, ‘Knowing what we know about your daily computer usage and how important that is for your job, let’s develop a solution that’s very specific for that and get you perfect vision for those 40 hours of the week.” He assessed the patient’s visual environment and prescribed lenses optimized for computer work. Multifocals allowed the patient freedom from his glasses for weekend activities. The result was clear, comfortable vision during high-intensity near work and a patient who was feeling empowered rather than restricted.