June 27, 2012
6 min read

Meeting needs of baby boomers will help build your practice

Discuss dry eye, glaucoma, eyestrain, cataracts and supplement use.

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Baby boomers, born between 1946 and 1964, can have a large impact on the health and wealth of your optometric business. Are you paying attention to them? What do they really want? How do they really want it?

Here are five questions that every boomer should be asked during their annual visit:

  • Dry eye: Are you using artificial tears and, if so, how frequently?
  • Glaucoma: Do you have a history of glaucoma in your family?
  • Eyestrain: How many hours per day are you looking at a computer?
  • Cataract development/surgery: Have you been told you are developing cataracts or have you been recommended for cataract surgery?
  • Supplements: Are you taking any supplements for the prevention of age-related conditions?

Each of these questions can have a tremendous impact.

Dry eye

With an estimated 9 million Americans suffering from moderate to severe dry eye (Maskin and colleagues), it is a prevalent condition. Many forms are induced by hormonal changes, autoimmune diseases or the side effects of medications, so it is no surprise that a large majority of our “dry eye patients” are part of the boomer generation. Unfortunately, even with all of the direct-to-consumer information out there, most consumers still do not know that their red, irritated eyes can be related to dry eye disease. A simple question such as: “Are you using artificial tears or do you ever suffer from red or irritated eyes?” on a patient lifestyle questionnaire (or even by the staff in the exam room) is enough to initiate this important discussion.

Scot Morris

During the exam, I ask the follow-up question: “Are you using artificial tears?” I have found that artificial tears are a great option for patients with mild dry eye. If a patient tells me he or she is already using artificial tears three or four times per day, this could indicate a level 2 severity (or higher) dry eye patient, and for them I would recommend a prescription therapy, such as Restasis (cyclosporine ophthalmic emulsion 0.05%, Allergan).

This discussion and the subsequent appropriate treatment can result in a great bond between the boomer and the eye care practitioner (ECP) because the ECP was able to diagnose and effectively treat a condition that was, in some way, affecting the patient’s lifestyle, whether it is overall cosmesis or ocular comfort. In my practice, that has led to a tremendous amount of referrals.


In 2004, it was estimated that 2.2 million Americans suffered from glaucoma, but only half knew they had it (Friedman). With glaucoma being the second leading cause of blindness in the world, according to the World Health Organization, diagnosing glaucoma early in your patients is crucial. By asking about family history the ECP can easily start the conversation about not only glaucoma but the need for annual eye care to prevent this symptomless and potentially blinding disease.

With 1% of the population having glaucoma of some variety, everyone knows of someone who has glaucoma, and it makes for an easy conversation. In addition, with the advances in therapeutics, treatment has become convenient.


We cannot overlook the visual issues associated with the general aging of the boomer population’s eyes. According to the U.S. Bureau of Labor Statistics, the number of working Americans older than 65 almost doubled in the last 20 years, totaling 6.7 million in 2010. They, therefore, have become the new base of most vision care practices and, more specifically, a driving force behind your optical department’s success or failure. These consumers have a much larger expendable income than many of the later generations but are also much more cautious about their spending. The ECP can initiate the conversation about the visual needs of the workplace as well as activities and hobbies, transitioning into providing all of the solutions necessary for increased visual comfort.

Customized progressive lenses can help reduce eye fatigue while at the computer. Polarized prescription sun wear should also be addressed with every boomer. Not only can prescription sun wear provide better visual performance outside, it also protects against disease such as age-related macular degeneration and cataracts, both of which can be accelerated by UV exposure. This can create revenue opportunities for your optical department and it is also a great segue way into educating your patients on the next two questions about cataracts and supplement use.


In my experience, the boomer population is aware of cataracts and usually knows at least one person who has had cataract surgery recently. By asking if they or any one they know has been diagnosed with cataracts or has had cataract surgery, the subject of cataract prevention and, if necessary, cataract surgery can be discussed. This simple question often leads to a short discussion about what cataracts are and what is actually involved with cataract surgery. Not only does this reinforce the discussion you have already had with them about preventive eye wear, it also emphasizes the need for annual eye care to monitor cataractous lens changes.

It is important to discuss possible visual options with modern cataract surgery, including multifocal and accommodative intraocular lens implants. The ECP will inevitably receive questions about LASIK but can reassure the patient that there are more options for “complete” vision correction with these presbyopia-correcting alternatives.

Supplement use (AMD)

The last question involves supplements and provides a great transition into the discussion about AMD. Many boomers are taking multiple nutritional supplements in addition to their prescription medications. The ECP or staff should always ask what medications patients have been prescribed and what supplements they are taking. Boomers are not often asked this by their other health care providers. This is a great point during the exam to discuss how supplements can not only protect against certain forms of age-related vision changes but also how their overall health can affect their vision.

It also provides a great transition into educating them on AMD, which most boomers have heard of and have some level of unspoken fear about. Once again, reinforcement about the need for protective sun wear, UV protection in their primary eye wear (by purchasing natural UV blocking materials such as polycarbonate or high index lenses) and the need for annual eye exams to monitor for subtle changes in the macula is important.

The use of a genetic test such as Macula Risk (ArcticDx), retinal imaging or, at the very minimum, a patient education brochure or video should be used to help reinforce the need for annual eye care. It is also crucial to mention the need for dietary supplementation in some instances with products such as antioxidants and omega-3s.

Managing boomer patients

Finally, the ECP also needs to be aware that boomers live by a slightly different standard of needs, wants and expectations. Some may require a little more attention than the 20-year-old myope who just wants a contact lens prescription to order online. There will be a slightly longer discussion and patient education period necessary with the boomer patient, but these patients are typically much more loyal and willing to spend more money if, and only if, they are satisfied with the level of care they are getting. This generation wants quality care at an affordable price, but not necessarily the cheapest care around.

I have found that most people, but boomers in particular, are willing to pay for quality and for an experience, as long as their needs and wants are discussed and fulfilled. They generally are less likely to complain if you are 5 minutes behind than the younger generations, but more likely to let you know that they are unhappy with the service or the quality of the products you sell.

Our office has found that the younger generations will usually simply not say anything to you, tell all of their friends in their online social media network what a bad experience they had and never come back. However, the boomers are loyal as long as they feel a connection and that the ECP has their best interests at the forefront.

I have made it a priority to address all five of these questions as part of our office’s comprehensive lifestyle questionnaire that each patient gets at the beginning of the visit. It has led to incredible growth in our practice, even through the recent economic downturn. Our medical practice has “boomed” with patients suffering from dry eye and glaucoma, and our cataract practice is at an all-time high.

These medical visits also create many new opportunities over the course of a year to discuss eye wear needs. In addition, by taking a few extra minutes to explore their visual issues and needs we have seen an explosion in both volume and profitability in our optical department.

Boomers are a critical part of the ECP practice and will continue to be for the next few decades. Take a new look at the boomers and how you can meet their needs and they will likely help build your practice to new heights.

  • Friedman DS. Prevalence of open-angle glaucoma among adults in the United States. Arch Ophthalmol. 2004;122(4):532-538.
  • Maskin SL, Thomas P. What is dry eye syndrome? In: Reversing Dry Eye Syndrome. Yale University Press Health and Wellness Series. 2007:11.
For more information:
  • Scot Morris, OD, FAAO, can be reached at Eye Consultants of Colorado, 10791 Kitty Drive, Suite B, Conifer, CO 80433; (303) 250-0376; fax: (303) 816-7218; smorris@eccvision.com.
  • Disclosure: Dr. Morris has no relevant financial interests to disclose.