My wife and I like to do the New York Times crossword together every Saturday—the hardest, and most fun, puzzle of the week (Sunday’s is too big and boring). It’s a weekly ritual we both look forward to, one of the few moments in the hectic lives of new parents when we get to take a break from talking about diapers and day care and actually use our brains. Anyway, we love the crossword.
Trouble is, I can’t see the damn thing anymore.
I’ve been presbyopic for the last few years. Until recently, I took it in stride. Having worn contact lenses since I was 20, I was motivated to stay in the modality. So I got multifocal contacts a few years ago and honestly loved them—for a while. I saw great at distance and just fine at near. Then the inevitable happened: my presbyopia progressed. Reading menus at restaurants got a little harder. I had to maneuver my cell phone a bit to find the sweet spot for viewing. But all in all, I got by.
Until a few months ago when the crossword became unworkable. I would bob and weave like a prizefighter to try to get it in focus, but just couldn’t. Maybe the point size of the text is too small or the viewing distance I need for sharing the page with my wife is too awkward for realistic expectations of success (always a thorny issue between doctor and patient). My OD was very generous with time and trial lenses in trying to find a new prescription for me, to no avail; I just had to chalk this one up as a loss.
So, as I wondered who might be a viable candidate for an eye drop to treat presbyopia, well, one name came to mind pretty quickly. It’s too early to tell if these drugs will even be approved, let alone perform in practice as anticipated, but I can definitely see the wisdom of an insightful point made by Mile Brujic, OD, in this month’s cover story. Dr. Brujic points out that low-add patients are more successful with multifocal contact lenses than high-add ones, “so if we can take advanced presbyopic patients and improve their vision to a level where they really just need a low add, then we can increase their chances of becoming more successful” with multifocal lenses. The same goes for LASIK candidates, notes Chris Freeman, OD.
Wholly new product categories are rare, and I’m as intrigued as everyone we interviewed about the prospect of another option to pursue for such a universal ailment as presbyopia. Maybe these eye drops won’t storm into the market and completely overtake the tried-and-true methods; they’re still vulnerable to patient noncompliance, an all-too-common check against enthusiasm. But I can see them finding success in cases like mine, where existing modalities fall short and the patient is highly motivated to keep trying.
Don’t write off older options in the rush to embrace new ones. If I could administer an eye drop every Saturday morning and be able to enjoy my crossword time with my wife in peace, I’d pay out of pocket for that privilege—and still keep paying for my contact lenses.