Washington Eye Physicians & Surgeons

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As seen in The Post-Gazette

By Adam Geller, The Associated Press

NEW YORK -- It got to where Ray Bergey kept one pair of reading glasses alongside the television remote, another on his bedside reading table, still another in the car, and at least one more at the office. Pairs piled up as he repeatedly upgraded lenses to keep pace with increasingly blurry near vision.

"My world was going from one set of readers to the next," says Bergey, who is 47 and a real estate agent in Virginia Beach, Va."Part of my own psychology was, hey, how bad is this going to get?"

Bergey put aside frustrations with his vision last year when he opted for conductive keratoplasty, a new type of outpatient eye surgery marketed as offering baby boomers a chance to turn back the clock. The eye care business is convinced there are plenty of other consumers like him out there.

It used to be that as people got older, and their near, or reading, vision blurred, they had little choice but to make peace with reading glasses. But that was before millions of baby boomers began reaching their 40s and 50s and found glasses an imposition on their active lifestyles.

Their pursuit of clearer vision -- even if it costs thousands of dollars -- is shaping up as one of the next big market opportunities in optical care.

The market is driven by the inevitable. As people move into their 40s, the lens inside the eyes turn increasingly brittle, hampering the ability to focus on objects up close. The condition is known as presbyopia -- from the Greek for"old" and"eye" -- and there's nothing new about it.

But the aging of the boomer generation means there are lot more people dealing with presbyopia. And just as they've helped fuel demand for BOTOX®Cosmetic treatments, baldness drugs and other products designed to combat the symptoms of middle-age, boomers with disposable income are showing increased interest in new ways of treating their aging eyes.

"There's a huge potential market out there," said David Harmon, president of Market Scope, a market research firm focused on the ophthalmology profession.

"Baby boomers now have a different outlook on life (than their parents) and they're not as satisfied with someone saying you're just older, you need to wear reading glasses. That used to be a good solution, but it doesn't have the appeal it once had," Harmon said.

Boomer patients have been asking more questions of doctors in recent months, since the Food and Drug Administration's approval of conductive keratoplasty for treatment of presbyopia.

The technique is still largely unknown to the public. But interest in CK -- in which tiny probes are used to apply radio waves to the eye in order to reshape the cornea -- is spreading despite the fact that it is not covered by insurance and costs the average patient around $1,500.

"It's so you can go out with your friends and see the menu without dragging out the reading glasses. ... You can see the hors d'oeuvres on the tray, you can see the label on the wine bottle," said Dr. Glenn Strauss, an ophthalmologist in Tyler, Texas who estimates he has performed 800 CK procedures.

Even as word of CK spreads, the vision care profession is paying close attention to development of new types of artificial lens that can be implanted in the eye.

The makers of these lenses have been pitching them specifically to older people with cataracts. But the FDA is moving toward approval of the so-called intraocular lens, or IOLs, for treatment of presbyopia.

"New Hope for Presbyopes," crows the cover headline on the May issue of EyeNet, the journal of the American Academy of Ophthalmology, a story focused on the replacement lenses.

Some physicians have begun using implants like the Crystalens® in patients who don't have cataracts but are looking for an answer to presbyopia. That is despite the fact that implant of the Crystalens®costs about $5,000 an eye and it is usually a two-eye procedure.

"It's very early in the learning curve," said Dr. Neil Martin of Chevy Chase, Md., who has performed about 20 Crystalens® implants over the past 4 months, all but one on patients with cataracts.

But as physicians learn more about the new treatments for presbyopia and word spreads among consumers, demand is likely to rise for a variety of procedures matched to different age groups and needs, Martin and others in the field say.

Some physicians see CK -- whose benefits diminish after about 5 years -- and the new IOLS as two parts of a continuum. Younger boomers may start with CK treatment, then later in life opt for a more permanent but costly lens implant, they say.

Neither procedure is a silver bullet for blurring vision, eye care professionals say.

CK takes just minutes and is nearly painless, but some in the field have doubts about the temporary nature of the improvements it offers. Because the procedure is usually performed on just one eye, some physicians say the resulting improvements are great for reading, but may not be effective for more demanding activities that require rapid changes in vision, like playing tennis.

Lens implants can offer permanent, wide-ranging improvements in vision. But in addition to the cost, they are far more invasive procedures, and it is unclear how non-cataract patients, who still have relatively healthy eyes, will feel about having the lens they were born with removed.

"Everything that's out there right now kind of involves some trade-offs," Harmon said.

But for boomers like Larry Rublee of Olney, Md., who have had one of the new procedures done, the results erase any doubts.

Rublee, who is 57, decided to have Crystalens®implanted in both eyes this spring to lay the groundwork for his retirement a few years from now. He plans to sell his home then, and make his life on the water.

"Retiring onto a sailboat with all the wind, I thought it'd be nice to not have to wear glasses," he said."And at this stage of my life, I can afford to do it out of pocket."







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