I  will let you in on a little secret. The editors here at Review cringe every time they’re assigned a story on presbyopia. It’s not that there’s nothing to talk about. It’s just that, in most cases, it’s all been said before—yet the editor is charged with the creative challenge of packaging it in a way that is fresh and inspiring to readers like you.

Lucky for us, Nathan Bonilla-Warford, O.D., A.B.O.C., submitted something fresh and original for this month’s issue. In fact, everything about this article is new—except for the main characters/patients who are, of course, old since they are, after all, presbyopes (there was no avoiding that).

So, what is Dr. Bonilla-Warford’s novel idea? He talks about the “new” presbyope. You know, that irritating baby boomer guy who is getting old but refuses to accept or acknowledge it, even though it’s evident to anyone who saw him pull up to your door in his shiny new red sports car—the one that he just parked in the only handicapped spot in your lot. That guy.

Anyone will tell you, new presbyopes are no fun. Most of them have a mistaken idea of what presbyopia is. In fact, many think it’s a precursor to a horrible medical condition (hence, the “pre-”). Research conducted on behalf of Transitions Optical shows that some 63% of patients think it leads to blindness. So you can understand why a patient might look at you like you’re the most insensitive doctor on earth, when you casually reassure him that “this happens to everyone and is just part of getting older.”

As Dr. Bonilla-Warford points out, the challenge with presbyopes is to ascertain their stage and understanding of presbyopia, and then present options that they find tolerable. And believe it or not, in some cases, the best course of action is to change nothing. I told you this was new!

When was the last time you were advised not to prescribe a new lens to a presbyope? But, according to Dr. Bonilla-Warford, “if progressive lenses or contacts are prescribed before the patient is mentally prepared, they may go unused—or even worse, may be resented.” He compares the patient’s grief over the loss of good vision to Kübler-Ross’ stages of grief. Again, new.

Thanks Dr. Bonilla-Warford for breathing new life into presbyopia without resorting to referring to it by its new name—age-related focus dysfunction, or ARFD. The American Society of Cataract and Refractive Surgery’s product branding experts came up with that gem. I’ll give them your number.