Eye drops may replace reading glasses for presbyopia, study finds

An experimental eye-drop formulation could restore close-up vision for many people with presbyopia, offering a non-surgical alternative to reading glasses. The study was presented on Sept. 14 at the 43rd Congress of the European Society of Cataract and Refractive Surgeons in Denmark and followed 766 patients, most in their mid-50s, who reported the classic symptoms of age-related near-vision loss.

The drops combined pilocarpine, a drug that helps the eye adjust its focus, with diclofenac, a mild anti-inflammatory designed to improve comfort during treatment. Participants were instructed to use the drops twice daily, with a possible third dose if needed. Vision was monitored with small-print charts over two years to gauge how well the treatment preserved or improved near vision. Within an hour of the first dose, many participants could read more lines on the near-vision chart. In the lowest concentration, nearly all could read at least two extra lines; stronger formulations enabled reading of three or more extra lines for many patients. After a full year of daily use, more than eight in 10 participants still reported improved near vision without relying on glasses, and for many, the benefit persisted well beyond a year.

The research team, led by Dr. Giovanna Benozzi, director of the Center for Advanced Research for Presbyopia in Buenos Aires, Argentina, noted the patient need for better presbyopia management. “Current solutions, such as reading glasses or surgical interventions, have limitations, including inconvenience, social discomfort and potential risks or complications,” she said. The goal of the drops is to provide a practical, non-invasive option that could reduce the constant need for reading glasses while preserving quality of life.

This approach is not intended to replace surgery for patients seeking a permanent fix, Benozzi added. Instead, it offers flexibility and a potential substitute for days or situations when glasses are inconvenient or stigmatizing. “This gives patients flexibility, and could spare many from having to constantly reach for their reading glasses,” she said.

Yet experts caution that more work is needed before the drops become mainstream. The study was conducted at a single center, so researchers warn that the results may not apply across diverse populations or in routine clinical settings. Long-term, daily use of pilocarpine raises questions about potential side effects, such as reduced night vision or, in rare cases, retinal concerns. Prolonged diclofenac use could affect the surface of the eye, underscoring the need for ongoing monitoring. Outside researchers say the findings are promising but stress the need for larger, multi-center trials with longer follow-up periods to assess safety and durability.

Side effects reported were relatively mild. About one-third of participants noted brief dimming of vision, and a smaller number reported mild irritation or headaches. None of the participants stopped using the drops due to these issues, which investigators described as temporary and manageable. While the data are encouraging, clinicians emphasize that the drops are not a universal remedy; they may benefit many but not all patients, and careful evaluation would be needed to identify who is most likely to gain from this treatment.

Ultimately, the researchers present the eye drops as a potential complement to existing presbyopia management strategies, expanding options beyond prescription reading glasses. If larger studies corroborate these findings, the formulation could become part of a stepped approach to age-related vision loss, offering an accessible, non-surgical alternative for people who struggle with reading at near distances.