CRU 2025: Presbyopia management from topicals to IOLs

Cecelia Koetting, OD, FAAO, DipABO, and Madeline Yung, MD, discussed emerging treatment and patient care options for those with presbyopia during CRU 2025. In an interview with Optometry Times, Koetting highlighted the excitement and pragmatism eye care providers are approaching presbyopia, highlighting the evolving landscape of vision correction. Key points of the presentation include:

Treatment landscape

Koetting emphasizes that no single vision correction method works universally. Just as multifocal contact lenses and progressive glasses have limitations, upcoming presbyopia drops will likely require careful patient-specific selection. There's an anticipation of developing a comprehensive guide to help navigate these new treatment options.

Patient challenges

A significant challenge lies in addressing patients who have never previously experienced vision issues. Particularly challenging are emmetropic patients or those who have had LASIK and are reluctant to return to vision aids. The discussion underscores the importance of helping patients understand presbyopia as a natural aging process.

Physiological changes

Presbyopia begins in early 40s, involving complex changes in the eye. These include:

• Lens stiffening
• Changes in zonular movement
• Pupil modifications
• Eyelid alterations

Emotional and psychological aspects

The conversation highlights the emotional journey of addressing presbyopia. Patients often struggle with:

• Acknowledging age-related changes
• Accepting new visual correction methods
• Understanding the progressive nature of the condition

Future outlook

The speaker expresses optimism about emerging treatments, particularly eye drops. There's an emphasis on:

• Continued research
• Personalized treatment approaches
• Patient education
• Adaptability in treatment selection

The ultimate goal is to provide patients with options that maintain their quality of life while addressing the natural progression of visual aging. The discussion reflects a compassionate, patient-centered approach to managing presbyopia, recognizing both the medical and emotional aspects of this universal experience.