Eye drops could replace reading glasses for age-related vision loss
Study finds pilocarpine-diclofenac eye drops improved near vision in presbyopia patients over two years, offering a non-surgical option that may reduce reliance on glasses, though further trials are needed.
A new pilot study suggests specially formulated eye drops may restore near vision for many people with presbyopia, offering a non-surgical alternative to reading glasses. The research was presented on Sept. 14 at the 43rd Congress of the European Society of Cataract and Refractive Surgeons in Denmark and followed 766 participants, most in their mid-50s, who reported difficulty reading small print.
The eye-drop formulation combines pilocarpine, a drug that helps the eye adjust its focus, with diclofenac, a mild anti-inflammatory intended to improve comfort during use. Dr. Giovanna Benozzi, director of the Center for Advanced Research for Presbyopia in Buenos Aires, led the study, which was prompted by the significant unmet need in presbyopia management. Participants were instructed to administer the drops twice daily—once in the morning and again about six hours later—with an optional third dose if needed. Their progress was tracked over two years using standard near-vision charts.
Within an hour of the first dose, participants showed a measurable improvement on the near-vision chart. In the lowest concentration, nearly all could read at least two additional lines; stronger formulations enabled many to read three or more lines. After a full year of daily use, more than eight in 10 patients maintained improved near vision without glasses, and many retained the benefit for longer than a year. The study reported relatively modest side effects: roughly one third noticed brief dimming of vision, while smaller numbers experienced mild irritation or headaches. None of the participants stopped using the drops due to these adverse effects, which the researchers described as temporary and manageable.
Benozzi stressed that the treatment is not intended to replace surgical options for those seeking a permanent solution. “This gives patients flexibility, and could spare many from having to constantly reach for their reading glasses,” she said. The lead researcher also noted that the intervention is meant to complement existing treatments rather than supplant them for those who want a long-lasting fix.
Despite the encouraging results, experts caution that more work is needed before the drops become a mainstream option. The trial was conducted at a single center, which may limit how its findings apply to broader populations. Additional research across multiple centers with longer follow-up periods is required to confirm safety and effectiveness on diverse groups and in real-world settings.
Long-term safety remains a key question. Pilocarpine has been used in eye care for decades, but daily, long-term use raises concerns about potential effects such as reduced night vision or, in rare cases, retinal issues. Prolonged use of diclofenac may also pose risks to the surface of the eye, underscoring the need for ongoing monitoring. Researchers and clinicians alike say that while the results are promising, they should be interpreted cautiously until larger, multi-center trials with extended follow-up are completed.
If future studies corroborate these findings, presbyopia management could include non-invasive topical options as a meaningful alternative for people who are not ready or able to pursue glasses or surgery. For now, vision experts emphasize that presbyopia remains nearly universal with aging, and existing strategies—glasses, contacts, and certain surgical methods—continue to be the standard of care while new approaches undergo further evaluation.
Researchers emphasized that this line of investigation is in its early stages. The study’s authors and independent ophthalmology experts alike say that larger, multi-center trials with longer observation periods are essential before any formal recommendations can be made for clinical practice. In the meantime, presbyopia remains a common condition that can affect daily activities, and new options that reduce dependency on corrective eyewear are of strong interest to patients and healthcare providers alike.
As the medical community awaits more data, patients and clinicians should weigh current benefits and risks of pilot therapies against established remedies, considering individual needs and tolerances. The field will likely see continued exploration of topical agents, formulations, and dosing regimens as researchers seek a safe, effective, and accessible solution to age-related vision loss.