In this episode of Presbyopia Playbook, Mark Schaeffer, OD, FAAO, is joined by Harmin Chima, OD, FAAO to discuss how prescribing presbyopia drops as a treatment option does not have a negative impact on optical sales.
Dr. Chima is Vice President of Professional Services at West Point Optical Group, a franchisee of Pearle Vision, in the Cleveland, Ohio area.
Presbyopia drops fast facts:
- Presbyopia is an age-related condition marked by the gradual inability to focus on close objects.1
- Over time, the eye lens and ciliary muscles stiffen, resulting in loss of elasticity and causing refractive error.2,3
- Typical onset occurs between 40 to 50 years old and affects an estimated 1.8 billion people worldwide.4
- Treatment options include glasses, contact lenses, laser procedures, intraocular implants, and pharmaceutical drops.5
- Current FDA-approved presbyopia drops:
- VUITY (pilocarpine HCl 1.25%, AbbVie)6
- Note: brand name has been discontinued
- QLOSI (pilocarpine HCl 0.4%, Orasis Pharmaceuticals)7
- VIZZ (aceclidine 1.44%, LENZ Therapeutics)8
- YUVEZZI (Carbachol 2.75% and brimonidine tartrate ophthalmic solution 2.75%/0.1%, Tenpoint Therapeutics)9
- VUITY (pilocarpine HCl 1.25%, AbbVie)6
- Current FDA-approved presbyopia drops:
- Presbyopia drops create a “pinhole effect” by constricting the pupil to increase the depth of field without compromising distance vision.10
Presbyopia drops are not an “or”
Drs. Schaeffer and Chima suggest that presbyopia drops are a necessary part of the conversation when offering treatment options to candidate patients in the exam lane. It should be an "and" proposition, not an "or."
“It’s presenting it almost like a menu,” Dr. Schaeffer said, noting that it’s the optometrist’s responsibility as the expert in the room to educate the patient and guide conversation around the best treatment options.
Problems with presbyopia are exacerbated by increased screen time and consumption of digital media that have become a regular part of daily life. Not only do patients report issues from digital eye strain, but they also take to social media to share their experiences and also seek out information—or misinformation.11
Dr. Chima said that patients want independence and are sometimes resistant to adopt correction when they didn’t previously need it. If a patient has some psychological resistance to correction, providers can present the options in an educated and informed manner.
Ultimately, both patient and provider want to see the best outcomes, which often incorporates a combination of therapies for different situations. When given the flexibility of choice, Dr. Schaeffer said that patients are more likely to purchase glasses or contacts as well.
“It's so important that we set realistic expectations for our patients, so they understand these drops are not a complete replacement for glasses, but rather an additional option to have in their toolkit.”
Prescription miotics have no negative impact on optical sales
In December 2025, Dr. Chima and his group conducted the Presbyopia Pathway Implementation Pilot (PPIP) study to assess the efficacy and adverse effects of QLOSI in their patients.12
Dr. Chima shared their findings in a poster presentation at the AOA’s 2026 Optometry’s Meeting.13 Notably, the PPIP also looked at the effect that prescribing the drops would have on existing revenue streams and key performance indicators.12
Key findings from the PPIP study12
- A total of 111 patients were evaluated across multiple West Point Optical Group locations.
- After receiving prescription drops, all evaluated KPIs exceeded baselines:
- New patients represented 34% of study participants (4.0 percentage-point increase over baseline).
- New medical diagnoses were identified in 24.5% of patients (6.2 percentage-point increase over baseline).
- New optical purchases sold to 71.6% of study participants (2.8 percentage-point increase over baseline).
- Ultra-widefield imaging was utilized in 85.6% of patients (16.4 percentage-point increase over baseline).
- 70% of participants reported a satisfaction rating of 7 or higher.
Messaging matters
In a retail setting, Dr. Chima says that patients often come in with the perceived notion that "this doctor is here to sell me glasses and contacts and that is their primary objective" when the reality is to prioritize patient care and provide them with the best options possible.
The goal is to establish trust with each patient and give them the full scope of options so they are more likely to make a decision based on the provider’s recommendations. Dr. Schaeffer says that providing options gives patients the confidence to choose one rather than having to make a “yes or no” decision.
“If we're boosting optical sales, it's worth every minute of the investment you're putting into that patient.”
Final thoughts
Drs. Schaeffer and Chima conclude that presbyopia drops are here to stay, joining the other optical treatments that have been a mainstay of optometric practices. Having thorough conversations with patients is important to ensure they are informed of all the options rather than turning to advice from social media or non-experts.
It’s important to continue learning about new technologies and treatments to incorporate into the exam lane to be able to provide the best care.
This article was written by Mariel Mohns, MS, based on the recorded conversation between Drs. Schaeffer and Chima.
