IN YOUR TRAINING, WHEN DID YOU LEARN ABOUT BRINGING up eyedrops to help patients’ vision? The answer is never. This is a whole new concept for us all. We may be well versed in refractive correction conversations. Whether discussing glasses, contact lenses, refractive surgery, or refractive lens exchanges, we have our way of describing things. Our patients are expecting it, they have usually heard of these and are expecting us to share information about vision correction. But how do eyedrops come up in the conversation?

The Knowledgeable Patient

Direct-to-consumer advertising can make it easy for us to share with our patients. Some of the work has already been done via television, radio, magazines, or social media. Patients come in with some sort of an expectation of what the drop is. Sometimes the patient specifically asks us about it, while other times they are waiting for us to bring it up. Regardless, a conversation needs to come up and be had.

During my history I always like to open the door for patients to bring up new innovations by simply asking, “Is there anything specific you want to discuss today?” If a patient does not bring up innovations during this portion of the exam, at the end of the exam I ask, “Is there anything else that we have not covered that you are wanting to discuss?” This passive method allows the patient to bring up new innovations and gives them the opportunity to open the door and ask if they are candidates.

The Unknowledgeable Patient

Most of our patients will not have heard of new innovations when they come into our office. There is something about seeing a physician that most patients assume we will bring up what is best for them. As such, they don’t pay attention to marketing or have not been around a source that makes them aware of the innovation. In these cases, we need to set the stage. Generally, I like to do this when repeating back to the patient a complaint that I have elicited during the exam. The patient may be speaking about struggles with their reading glasses, eye strain at the end of the day, or trouble with their near vision with contact lenses. I find it beneficial to simply ask, “Have you heard of the new drop that we have that can help with your near vision?”

The Explanation

I wholeheartedly subscribe to the “under promise and over deliver” train of thought. With presbyopia drops, this is no exception. I share with my patients that the FDA has approved a medication that can help patients gain improvement with their near vision for a portion of the day. I share with them that most of the patients in the study saw a meaningful improvement in their functional vision for a portion of their day, but in most cases it did not last the whole of the day.

Common Questions

Frequently the patients will ask if the drops will eliminate their need for reading glasses, and if they can go all day with good vision. In these cases, I share that the patients in the studies had variable results. I explain that many of them were able to achieve much more functional vision for portions of the day, but that I would assume they would still need their reading glasses for some of their day. Other questions revolve around side effects or if it will cause anything negative for them. In these cases, I share with them that a small percentage of patients experienced a headache that they described as mild, and that other patients had more severe issues, but the drop out rate from the study was under 2% of all patients. When asked for specifics, I simply say, “We wont know for sure how well it will work for you until we try it.”

Writing the Script

While the only product on the market at this time is cash pay, I find that most patients are willing to try at least one bottle to see what it does. My suggestion is to have your patients teach you how they use it. Across the country we are learning every day from presbyopic patients how they are using their drops. How patients are using them in place of their reading glasses, how they are using them with intense computer use during the day, how they are using them with their contact lenses, and how they are using them after surgery.

We need to ensure that the drops are safe for our patients by following and knowing the package insert, but then the joy comes by learning from experience, and finding out how each and every patient uses the drop. ■

Dr. Kading owns three practices in the Seattle area (Specialty Eye), focusing on dry eye disease, specialty lenses, and front of the eye problems. He performs research as part of the post-graduate residency that he hosts in Seattle, and lectures internationally.