Doctors have developed a new type of eye drops that could provide relief for people with longsightedness, potentially reducing dependence on reading glasses or surgery.
Presbyopia, often described as age-related longsightedness, makes it difficult to focus on nearby objects or text. The condition affects hundreds of millions globally and is commonly managed with glasses or surgical interventions. However, many people find spectacles inconvenient, and not all patients are suitable candidates for surgery.
A Simple, Twice-Daily Alternative
At the annual meeting of the European Society of Cataract and Refractive Surgeons (ESCRS) in Copenhagen, researchers presented promising results from a large study on presbyopia eye drops.
The drops combine two components. Pilocarpine is a drug that constricts the pupils and adjusts the eye’s lens for near focus. Diclofenac is a non-steroidal anti-inflammatory drug (NSAID) that reduces irritation and inflammation.
The study included 766 participants who used the drops twice daily, once upon waking and again six hours later. Patients were divided into groups receiving different pilocarpine concentrations—1%, 2%, and 3%—alongside a fixed dose of diclofenac.
Significant Gains in Near Vision
According to lead researcher Dr Giovanna Benozzi, director of the Centre for Advanced Research for Presbyopia in Buenos Aires, the results were striking.
One hour after administration, patients showed an average improvement of 3.45 Jaeger lines on vision charts, a commonly used measure of near vision.
- In the 1% pilocarpine group, nearly all participants could read two or more additional lines.
- In the 2% group, 69% of patients managed three or more extra lines.
- In the 3% group, 84% achieved three or more extra lines.
Importantly, these improvements were sustained for up to two years of continued use. The most frequently reported side effects included temporary dim vision, mild irritation, and occasional headaches.
Addressing a Major Unmet Need
Dr Benozzi explained that the motivation behind the research was the limited options available for certain patients with presbyopia.
“Current solutions like reading glasses or surgery have drawbacks, including inconvenience, social discomfort, or surgical risks,” she said. “Our results show rapid and sustained improvements in near vision across all concentrations. This offers a safe and effective option for patients who are not good candidates for surgery.”
The drops are not expected to completely remove the need for glasses in every patient. However, they may significantly reduce dependence on eyewear for daily activities.
Expert Reactions and Caution
While the findings generated excitement, experts cautioned that further studies are essential before the treatment can be widely adopted.
Professor Burkhard Dick, chair of the ophthalmology department at the University Eye Hospital Bochum in Germany and president-elect of ESCRS, noted the promise but also the limitations.
“The study suggests that eye drops containing pilocarpine and diclofenac may improve near vision for up to two years,” he said. “However, as a single-centre retrospective study, the results may not be generalisable.”
He also highlighted potential risks, including reduced night vision, eye strain, and in rare cases, retinal detachment from long-term pilocarpine use. Prolonged use of topical NSAIDs can also pose corneal health risks.
Broader, multi-centre trials with long-term follow-up are needed to confirm both the safety and effectiveness of the therapy.
Looking Ahead
If confirmed, these eye drops could represent a significant shift in presbyopia management, offering a convenient, non-invasive option for patients who seek alternatives to glasses or surgery.
For now, experts stress the importance of cautious optimism. While the early data are encouraging, regulatory approval and larger clinical trials will be necessary before the treatment can be offered on a wide scale.
