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PRACTICE STRATEGIESPRACTICE STRATEGIES

Reaching Baby Boomers: 2020 and beyond Bob Pieper

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aby Boomers represent one of the largest eye andvision care markets in history, and there is literally nobetter time than the present for optometrists to reach

ut to them, according to Richard C. Edlow, chair of theOA Information and Data Committee.

Generally considered to be the generation born in theost–World War II years from 1946 to 1964, the Babyoomers are now middle aged. As a result, America’siddle-aged population is swelling to record levels, rising

rom just more than 25 million in 1990 to a projected peakf just more than 44 million in 2010, before decreasinglightly to around 38.8 million in 2020. From 2004 until014, about 10,000 Americans will turn 50 every day, addsaul M. Karpecki, O.D., whose continuing education lec-

ure, Baby Boomers: Optometry’s Future, has become aopular offering at major optometric meetings over recentears.“This is the opportunity,” Dr. Karpecki said. “This is the

ingle largest population group, the largest in terms ofuying power and the largest in terms of health care (con-umption). As the largest segment of the population, theynfluence the other population groups.”

Middle age is the period in which most people becomeresbyopic and often the period in which they first seekision care, Dr. Edlow notes. The historic near doubling ofatients requiring presbyopic correction is, in itself, enougho make Baby Boomers arguably the most important singleemographic group in vision care today. “There will be aew more years of expansion in the presbyopic population,”

ob Pieper is the senior editor for Practice Strategies. Opinions expressed

ptometrists must act now to providehe vision care middle-aged Babyoomers may still not be getting andrepare to provide the medical eye careoomers will require as they move intoheir older adult years.

Bre not necessarily those of the American Optometric Association.

529-1839/06/$ -see front matter © 2006 American Optometric Association. Alloi:10.1016/j.optm.2006.01.008

r. Edlow said. Optometrists must work to ensure Babyoomers get the presbyopic correction they need over thateriod, he said. However, in the field of eye care, the realmpact of the Baby Boomer generation may not be felt fornother 10 years as Boomers move out of the era ofresbyopia and into the era of age-related eye conditions.he “Medicare and cataract” population—those 65 andlder—will increase a remarkable 73% from 1990 to 2020,ccording to Dr. Edlow. The older adult population, alreadysubstantial 31 million in 1990, will increase to more than9 million in 2010, and then jump to more than 53 milliony 2020, according to the U.S. Census Bureau.That makes encouraging Baby Boomers to seek routine

ye care even more important, Dr. Edlow said. “The Baby

Baby Boomers are the target for this year’s AOA National Save Yourision Month observance, with “Healthy Eyes are the Essence of a Healthyife” as the theme. AOA Save Your Vision Month Member Kits, including theoster shown above, can be requested by e-mailing AOA Communicationsroup staff at publicrelations@aoa.org. For additional information callusan Thomas (ext. 263) or Julie Mahoney (ext. 176) at (800) 365-2219.

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oomer patient who comes to your office now for correc-

rights reserved.

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142 Practice Strategies

ion of presbyopia will be returning to your office in a fewears for cataract comanagement; treatment of glaucoma orge-related macular degeneration; in many cases, diabeticye disease; and other age-related eye conditions. Theational Eye Institute and Prevent Blindness America al-

eady rank the prevalence of adult vision impairment (age-elated eye disease and sight-threatening eye disease inmericans 40 and older) among their major concerns.For optometrists, from a practice management standpoint,

hat means attracting Baby Boomer patients now is partic-larly important. The American Optometric Association’sAOA’s) Caring for the Eyes of America study found thathen selecting a new eye care practitioner, 71.4% of con-

umers select an optometrist (compared with 28.6% whoelect an ophthalmologist). That means the patient whoegins seeing an optometrist today for presbyopic visionare correction will probably be returning to that optome-rist in the future for medical eye care of age-related eyeealth conditions, Dr. Edlow said.Most Baby Boomers have probably already sought cor-

ection for presbyopia, notes Matt Thornhill, author of 50hings Every Marketer Needs to Know About Babyoomers Over 50 and founder of The Boomer Project, aarketing research and consulting company focusing onaby Boomers. Three quarters of Baby Boomers are nowlder than 45, Thornhill observes. However, many of thoseaby Boomers may not be getting the best correctionvailable, according to Jeffrey L. Weaver, O.D. director ofhe AOA Clinical Care Group. Many Baby Boomer patientsay be suffering from ocular surface disease, ocular effects

f systemic conditions, or other eye-related conditions thatn optometrist can treat or correct, but that Boomers mayot recognize as treatable problems, Dr. Karpecki says. Andirtually everyone who spoke with Practice Strategies forhis article agreed that not enough Baby Boomers arendergoing the regular eye examinations they will need toelp ensure good eye health into the future.

ptimal refractive correctionroviding the best vision possible for presbyopic Babyoomers “generally will mean progressive lenses,” notesr. Weaver. It also means making sure lenses—both spec-

acle and contact lenses—meet the visual needs of theatient at work and play. They should also provide theltraviolet protection patients need and increasingly want,r. Weaver said. However, explosive growth in the popu-

arity of over-the-counter reading glasses over recent yearsuggests many Baby Boomers are not enjoying the benefitf optimal refractive correction, notes Ed DeRosa, execu-ive vice president of progressive lens maker Signet Armor-ite. “It’s huge,” said DeRosa, “I just talked to a companyhat will sell $100 million in readers this year.”

Progressive lenses should have natural appeal for Babyoomers, who are known for their interest in new technol-gy—as well as looking good and being comfortable, ac-ording to lens industry spokespersons. Most progressive

ens manufacturers today utilize new technology to smooth

he change in correction across the lens surface, relegate anylur to areas outside the central visual field, and avoid theppearance of traditional multifocals while generally mak-ng their lenses more comfortable to wear. However, edu-ating Baby Boomers on the benefits of progressive lensesas been difficult, some industry spokespersons say. Ulti-ately, AOA Clinical Care Director Dr. Weaver agrees, itill be up to optometrists to get Baby Boomer patients into

heir offices where they can evaluate patient needs andxplain the benefits of proper correction. “Optometristsust provide education while the patient is in the chair,” Dr.eaver said. He adds, patient history should cover not justpatient’s job title but “how they use their eyes during the

ourse of a day.”Many Baby Boomers may initially try out a pair of readershen they encounter vision problems in middle age, ac-nowledges Rod Tahran, O.D., director of professionalelations for Essilor of America. “However, ultimately, theynd up coming in (to the optometrist’s office) for prescrip-ion eyewear that can really meet their needs,” Dr. Tahranaid. One reason, Dr. Tahran suggests: the increasing use ofechnology. “Virtually everyone, today, uses computers inome shape or fashion. With the range of technology to-ay—up close with cell phones, intermediate with Black-erries and computers, and distance with televisions, mov-

es, and other forms of technology—people must haveenses that can provide the range of vision they need. Thatakes a pair of lightweight, antireflection-coated, progres-

ive addition lenses virtually essential,” he notes.“Optometrists must also meet Baby Boomer’s needs in the

rea of refractive surgery comanagement,” Dr. Karpeckidds. “Many patients with presbyopia become contact lensntolerant, and there are numerous procedures that mightenefit presbyopic Baby Boomers. Among those proceduresre conductive keratoplasty (CK), or even accommodatingr multifocal IOL options (in appropriate patients).”

Tired eyes”he popularity of over-the-counter dry eye remedies serves

o show how common “tired eyes” are and how manyeople are actively seeking a remedy. “If there is oneondition you are going to target in the Baby Boomeropulation, it is dry eye and ocular surface diseases,” saidr. Karpecki. Although generally associated with the retire-ent-age population, dry eye actually begins to occur when

eople are middle aged, and it is common among people inheir 40s. Dry eye has been linked to any number ofisposing factors, many of which are commonly associatedith those in middle age, including:

❖ Medications (including high blood pressure medica-tions)

❖ Hormonal changes associated with menopause❖ Environmental factors (such as computer use)❖ Rheumatoid arthritis, lupus, and diabetes (which, like

dry eye itself, may often be associated more with the

elderly, although they often begin in middle age)

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Practice Strategies 143

Often, patients will not really recognize dry eye as areatable eye condition when they experience it, viewing itimply as an unpleasant sensation, or new discomfort inearing contact lenses, Dr. Karpecki notes. “They may

imply begin complaining that their eyes feel ‘tired’ orheavy.’ They will notice that they are not able to comfort-bly wear their contact lenses as they did in the past,” Dr.arpecki said.They also will probably not know to see an optometristho can look for the causes of the condition and prescribe

yclosporine or anti-inflammatory agents if over-the-ounter remedies are not sufficient.Lid diseases, such as blepharitis and meibomianitis, like-ise, are often associated with older adulthood but actuallyegin in middle age. They may not be recognized byatients as a treatable eye-related condition. Instead, theyay simply complain that their eyes feel tired or heavy or

hat they experience a foreign body sensation. As a result,hey may not think to see an optometrist who can find theause of the problem. In most cases, diseases of the eye lidill not be visibly apparent. Diagnosis requires careful

nspection around and under the lid by an eye care practi-ioner, Dr. Weaver notes.

Lid disease is often the result of insufficient hygiene,r. Weaver notes. However, most patients probably willot be aware of the relationship of good hygiene and eyeid disease. There has been relatively little public educa-ion regarding lid disease, Dr. Weaver notes. In mostases, optometrists can simply counsel patients regardinghe importance of proper cleaning of the eyelids as wells the area around the eye. When a systemic conditionuch as Sjogren’s Syndrome (the onset of which com-only occurs among people in their late 40s—most often

n women) is found to be the cause, a pharmaceutical cane prescribed.Again, patient education will be the key in reachingaby Boomers with dry eye and ocular surface disease,r. Karpecki notes. He recommends a special question-aire covering dry eye symptoms be provided by staff toll middle-aged patients entering a practice for an ap-ointment.

iabetes-related eye conditionsiabetes is another condition that is more commonly associ-

ted with older adults than those in middle age. However, overecent years, diabetes has become an epidemic reaching virtu-lly all segments of the population, including Baby Boomers.any patients with diabetes apparently remain unaware that

nnual dilated eye examinations are crucial to determine ifedical procedures are warranted to stop the development of

iabetes-related retinal conditions. Also, few know the diseaseay produce changes in refractive error, Dr. Weaver notes.The American Diabetes Association recommends annual

omprehensive eye examinations for all patients with theisease. The federally funded Early Treatment Diabeticetinopathy Study (ETDRS) confirmed the effectiveness of

nnual eye examinations in treating diabetes-related condi- n

ions of the retina. However, education will still be neededn several fronts. Those who experience vision problemssuch as blurred or fluctuating vision) that may be related toiabetes must be encouraged to see an optometrist. (Manyatients first learn that they have diabetes when they seekorrection for such problems.) Patients with diabetes need toe educated that regular eye examinations must be part ofheir regular health care regimens. Health care providers—uch as general practice medical doctors—must be educatedhat regular eye examinations are crucial for patients withiabetes and that optometrists can provide those examina-ions.

Dr. Karpecki recommends that optometrists meet withocal medical doctors to discuss the services they canrovide for patients with diabetes. (He has scheduled aeeting with doctors at the hospital next to the medical

omplex housing his office, even though he is not on stafft the hospital.) He also recommends sending letters toocal medical doctors regarding eye care for patients withiabetes. Medical doctors often do not realize optome-rists are able to provide the necessary examinations.Often they are happy to refer patients,” he said.

eaching Baby Boomersociologists have long noted that the Baby Boomers tend toedefine the various stages of life—youth, middle age, olderdulthood—as they move through those stages. Marketingesearch indicates Baby Boomers, even in middle age,ttempt to hang on to their youth while managing theesponsibilities of jobs and children. One study foundoomers consider people age 50 to be “young” with old age

Types of Baby BoomersBaby Boomers are far from homogenous. AmericanDemographics, the Dow Jones journal of market re-search, has identified at least 3 types:Power players—Baby Boomers in their 50s who arereaping the rewards of successful careers.Fun seekers—Baby Boomers who, in their 50s, arecontinuing a lifelong search for a good time. While intheir 40s, many found their ability to enjoy life limitedby the responsibilities of career and family. As theymove into their 50s, they again want to have more fun.Matriarchs—Independent Baby Boomer women whocan enjoy their freedom in their 50s. With theirchildren grown, Baby Boomer women will begin tospend time on themselves again, American Demo-graphics predicts. The magazine believes those BabyBoomer women will have a profound affect on spend-ing trends in the coming years. Businesses that havenot paid sufficient attention to older women in the pastwill need to change their strategies, the magazinesuggests.

ot beginning until 70. The emphasis on youth and activity

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144 Practice Strategies

mong Baby Boomers obviously creates an increased de-and for recreation and lifestyle eyewear—including UV

rotection—that may not have been found in previousenerations. However, it also means optometrists mustnow how to relate information regarding eye and visionare appropriately. Don’t frame eye problems in terms ofge, marketer Thornhill advises. Instead, frame issues inerms of eye health. “Don’t say your eyes are getting old,alk about keeping your eyes vital or keeping your eyesealthy.”Don’t just provide facts; provide them in the context of a

tory with emotional appeal, Thornhill adds. “That isn’t to i

ay you shouldn’t provide your patients with information.ut don’t just say that ‘X’ percent of people get thisondition. Talk about maintaining your eyes so that you canee your grandchildren.” That is because, in at least oneespect, Baby Boomers are like all generations, according tohornhill. “Marketers have long known that people makeecisions based on 3 factors: rationality, the heart, and theut,” Thornhill said. The older people get the more theyend to make decisions based on “gut” reaction. As Boomersge, they will tend to make decisions, including decisionsn eye and vision care based not on lengthy analysis but “if

t just sounds right to you.”