New Eye Drops Show Promise for Treating Presbyopia

An estimated 1.8 billion people worldwide suffer from presbyopia, an age-related condition that makes it difficult to see things up close. Traditional treatments include reading glasses, bifocal lenses, or surgery like LASIK. However, recent advancements in eye care offer new alternatives, such as eye drops like Vuity, which use pilocarpine hydrochloride to help with near vision.

A new study presented at the 43rd Congress of the European Society of Cataract and Refractive Surgeons (ESCRS) reveals an exciting development: a new eye drop formula combining pilocarpine with diclofenac, a nonsteroidal anti-inflammatory drug (NSAID). This combination has been shown to significantly improve participants' ability to read up close, with many gaining an additional two or more lines on a Jaeger eye chart, a test for near visual acuity.

How Do These New Eye Drops Work?

The study involved 766 participants diagnosed with presbyopia, who were treated with eye drops containing pilocarpine and diclofenac at different concentrations (1%, 2%, or 3%) twice a day. According to Dr. Giovanna Benozzi, the lead author of the study and director of the Center for Advanced Research for Presbyopia in Argentina, the eye drops work by restoring the eye's natural ability to focus. The combined formulation targets both the ciliary muscle (responsible for focusing) and the iris, creating a pinhole effect that improves near vision without relying on glasses.

Dr. Benozzi explained that the drops enhance the eye's natural focusing mechanism, allowing patients to read comfortably again, even without glasses.

Significant Improvement in Reading Ability

At the end of the study, the majority of participants saw a marked improvement in their ability to read small print. Many could read two to three additional lines on the Jaeger chart, which translates to a real-life improvement—patients who previously struggled to read a text message or menu could do so with ease.

For those with mild to moderate presbyopia, the results were even more promising, with some participants achieving near-normal vision without the need for reading glasses. Dr. Benozzi emphasized that this improvement restores independence in daily tasks like using a cell phone, reading menus, or navigating a GPS.

Long-Lasting Results

One of the most promising aspects of this treatment is its long-term effectiveness. The study found that the improvement in near vision lasted for up to two years, with a median duration of 434 days. Dr. Benozzi highlighted that the durability of the results is crucial for a condition like presbyopia, which is chronic and progressive.

The New Treatment's Advantages

The new eye drops' combination of pilocarpine and diclofenac provides a distinct advantage over existing treatments, such as Vuity, which only uses pilocarpine. Diclofenac, an NSAID, helps counteract some of the discomfort associated with pilocarpine, such as a pressure sensation or headaches. This added medication improves the overall comfort and effectiveness of the treatment.

Caution and Future Research

While the new eye drops show great potential, experts advise caution, particularly for patients with high myopia (nearsightedness). Dr. David Geffen, an optometrist in La Jolla, CA, noted that pilocarpine can exert some pulling on the eye, which could pose risks for individuals with certain eye conditions. He also mentioned that other alternatives, such as aceclidine, which targets the iris sphincter, may offer a safer and longer-lasting solution for presbyopia.

Despite these cautions, the new treatment represents a real, evidence-based option for improving near vision without relying on glasses, especially for those not yet candidates for presbyopia surgery. Researchers are optimistic that further studies will continue to support the effectiveness and safety of this treatment, with the goal of making it widely available to those affected by presbyopia.

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MedicalNewsToday