Ingram’s Executive Health Feature: Vision

The personal and professional challenges of eye care

By Dennis Boone

     Some points of personal and professional development to consider:

     • The average age of a business owner is just shy of 51, while the average age of a Fortune 500 CEO is about a year older.
     • The average age of onset for cases of presbyopia—the point where you probably need reading glasses—is about 41.   

    So if you’re in either of the first two groups, and you’re not using said spectacles, you’re probably squinting right now.

    There’s almost no getting around the fact that most people, at the age of ascending to the ranks of leadership within their organizations, can’t read like the used to. It’s as natural a consequence of aging as gray hair, wrinkles, and that odd crackling sounds coming out of your joints in the morning.

    Easy enough to deal with by visiting your eye doctor, perhaps, but for those in   leadership roles, it’s important to consider that everyone on your staff this morning is a day older than they were 24 hours ago, and the same metaphorical water is dripping on the same rock with the people who make your company tick. Compounding the aging factor are increasingly competitive venues for all of our eyes, from printed materials to computer screens, mobile apps to after-hours entertainment.

    But if you’re going to address the challenges posed therein, it helps to understand the root causes—because what’s going on here entails more than the inconvenience of misplacing another pair of reading glasses.

    “These are normal physiological changes, caused by several factors, in particular the hardening of our own natural lens in the eye,” says Stephen Silverstein, of Silverstein Eye Centers. “But every increased year puts us all at risk for glaucoma and macular degeneration. It’s really important that you start to have regular eye exams, and by age 50, people should have an exam every 12 to 18 months.”

    Clifton Cokingtin, of Cokingtin Eye Center, said it’s important to think of proper eye health just as you would think about blood pressure, cholesterol or weight. “It’s critical to remember that eyes need to have preventive healthcare like everything else,” he said. Too often, he said, people will come to him seeking remedies for serious conditions, “but if they had come in five years ago, we could have done something proactive to prevent this, but now they’re coming in with glaucoma, diabetic retinopathy, or some other issue to manage.”

    That last one is particularly a concern, healthcare professional say, because up to a third of the adult population is overweight, and another third clinically obese. The nation is sunning itself on the beach as a tidal wave of diabetes bears down on it, and the illness is associated with a range of eye maladies.


    When it comes to work-force administration, there’s more going on than what was considered population health for vision even a decade ago.

    “It’s a combination of the changes in the population, with more people living longer, and more of them working longer,” said Dan Durrie of Durrie Vision. “The demands on our vision are changing, too—there’s a  lot more ‘near’ work.” Among his executive clients, Durrie said, “they’re complaining about their ability to use a computer, about reading glasses and bifocals”

    The good part, he said, is that there are more vision-correction options than ever, and they’re increasingly effective and decreasingly expensive. “Our business development is in seeing patients who are in the transition phase, age 40-60, and creating lifetime vision plan to give them near and distance vision without glasses for a lifetime.”

    All well and good for the executive, but ophthalmologists and other vision professionals say the demands of an older work force are going to apply additional pressure on business leadership.

    “People are having to work longer, and the workforce is getting older,” said Nelson Sabates of Sabates Eye Centers. “And as it does, age-related diseases are going to be an increasing healthcare expenditure for any company.” And that’s not limited to ophthalmological needs, Sabates said.

    “A lot of employers are noticing now that they’re expenditures are going up and insurance companies are raising premiums through the roof,” he said. “Healthcare for any company and any executive trying to control expenses, is going to be an even bigger ticket as we move forward.”

    Silverstein pointed out that conventional wisdom—as is often the case—was wrong about the nature of the association between computer screens in the workplace and eye problems.

    “It’s a myth about looking  at a computer screen too long hurts your eyes,” he said. “It really doesn’t harm you with radiation or cause other harm to your health. The issue is when you are staring at a screen, or even reading for extended periods of time, we don’t blink as commonly as we do otherwise, so our eyes dry out.” He recommends keeping a bottle of artificial tears on the nightstand or in the office desk. You may be mentally fatigued by processing written information, he said, “but you cannot over-use your eyes.”

     Doctors agreed that this might be the most exciting time ever to be in their line of work, thanks to the nature of the treatment options and emerging technologies, and the impact that they can have on the quality of a patient’s life.

    “The most exciting opportunity for people  in the Baby Boom generation is lens replacement, taking out mild cataracts or even a clear lens, and putting in one that gives distance and near vision in same eye,” said Silverstein. “That’s something that standard lens surgery and even Lasik cannot do.”


    Cokingtin said the market for services is changing as people become more sophisticated about what’s happening to their vision. “If you look at where we are today vs. 20 years ago, people certainly are more demanding relative to quality,” he said. “They used to come in for a consultation on cataract surgery only when they couldn’t pass the test for an updated driver’s license. Now, they’re coming in as soon as they notice their vision is not as good as it used to be, and they tend to seek intervention at an earlier stage—which is a good thing.”

    Down the road, Sabates, said, some intriguing developments will continue to change both the caregiver’s role and the patient outcomes.

    “Everybody is well-versed on Lasik; it’s been around for quite some time to correct distance issues,” he said. “But the holy grail of refractive surgery is presbyopia correction, and there are now quite a few options out there, and quite a few more in clinical trials. I would suspect that sometime in the next few years, there will be a new presbyopia-correction procedure that will be reproducible, that will not be overly difficult to perform, and will stand the test of time.”

    When it comes to the difference that professional eye care can make, everyone—executive or front-line worker—needs to consider factors beyond the office or shop floor.

    “We shouldn’t think just in term of workplace,” said Silverstein, “but in terms of our hobbies, daily life activities, how it impacts avid readers or golfers trying to track a ball downrange. This is about the quality of your entire life, and that’s how these newer procedures are truly helpful.”