Can eye drops treat presbyopia?

You may have heard in recent years that ophthalmologists are developing new eye drops which can relieve the symptoms of presbyopia (ageing eyes). This is an exciting prospect in recent medical news and aims to create further non-invasive treatment options for those who may be hesitant about glasses or contacts or eye surgery. However, as we will discuss, there are still a few problems with this option.

Presbyopia is recognised as age-related blurry near vision because of the internal lens of your eye. Over time your lens in your eye becomes less flexible making it challenging to see things up-close or do close-work. Typically this eye condition may affect you at the age of 40 or older which would mean you’d need to start wearing reading glasses or contacts.

In late 2021, the U.S Food and Drug Administration approved a new eye drop medication to treat presbyopia¹https://theconversation.com/new-eye-drops-can-help-aging-people-see-better-an-optometrist-explains-how-vuity-treats-presbyopia-180762 called Vuity.

The aim of this is to offer a ‘lifestyle’ eye drop solution which people can apply twice daily. The vision-improving effects last between 4-6 hours²https://www.issaquaheyeworks.com/eye-care-services/vuity/#:~:text=How%20Long%20Does%20it%20Take,days%20to%20experience%20optimal%20results..

Described as a “gateway drug”, it offers a temporary solution³https://www.healio.com/news/ophthalmology/20220629/presbyopiacorrecting-drops-broaden-options-for-younger-patients for people who may eventually choose laser or surgical procedures.

The main agent in these newly developed eye-drops is pilocarpine. Previously, it has been used to treat glaucoma. Known as a ‘miotic’, it constricts the pupil and creates a ‘pinhole’ effect that increases the depth of field⁴https://www.healio.com/news/ophthalmology/20220629/presbyopiacorrecting-drops-broaden-options-for-younger-patients. Vuity eye-drops work by changing the shape and size of the pupil – just like a camera lens, and therefore improve vision.

This new product is of course, exciting and contributes to the question “can you reverse presbyopia?”. The most obvious advantages are that this would be a great low-commitment and non-invasive solution towards better eye health. However, it is a topic of debate reported in Ophthalmologist Magazine, with a lot of surgeons describing that “the approval of Vuity is not a milestone”.

The problems that arise with Vuity are:

• It’s not widely accessible: Few countries have access to this treatment, it’s mainly available in the states. Vuity is not available in Australia.
• It is very new to the market: There are some studies published, but not nearly enough to distribute this globally.
• It can cause complications: Some common side effects are developing a tolerance to the eyedrops and a lack of optical performance. It can also lead to corneal irregularity later in life. In other cases, it can decrease a patient’s light perception, cause headaches⁵https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7414614/, burning and dizziness as well.
• Another concerning factor about using pilocarpine, is that it’s commonly associated with retinal detachment⁶https://www.healio.com/news/ophthalmology/20220629/presbyopiacorrecting-drops-broaden-options-for-younger-patients. In May 2022, a paper published by Chang, in the American Journal of Ophthalmology showed that 2 out of 3 patients who used Vuity long-term, developed this emergency condition.
• It is expensive and temporary: It requires daily maintenance and a small bottle of eye-drop solution costs around $117 AUD! The continual life-time costs of this would inevitably surpass a surgical procedure.

1. Lens replacement surgery

This is when we remove your naturally hardened lens and replace it with an artificial one called an IOL (Intraocular lens). You will be able to see clearly and permanently after this procedure. This procedure has a high success rate with few complications.

2. LASIK blended vision

LASIK blended vision allows you to see up-close and far away without glasses and at the best possible definition. This is a form of laser eye surgery that uses LASIK technology. We correct the dominant eye for distance vision, and the non-dominant eye to improve shortsightedness. This is a great non-invasive solution that accommodates the symptoms of presbyopia.

Hopefully this answers the question, “can eye drops treat presbyopia?”. If you’d like to find out more about the presbyopia treatments we offer, and how we can relieve vision problems, book a free assessment here.