Aging often brings the unwelcome challenge of declining reading vision, leading many to rely on reading glasses. However, recent research suggests that special eye drops may offer a new solution. A study presented in mid-September at the 43rd Congress of the European Society of Cataract and Refractive Surgeons in Denmark involved 766 patients and found that most participants could read two to three additional lines on a standard eye test chart after using the drops.

Dr. Giovanna Benozzi, director of the Center for Advanced Research for Presbyopia in Buenos Aires, Argentina, noted that this improvement could last for up to two years. "In ophthalmology, each line on the reading chart represents a meaningful improvement in real life," she said. "Gaining two or three lines means a patient who previously struggled to read a text message or a menu can now do so with ease."

The study addressed a significant unmet medical need in managing presbyopia, which is the age-related difficulty in focusing on nearby objects. The research targeted patients who had limited options beyond reading glasses and were not candidates for surgery. "We sought to provide robust clinical evidence supporting an innovative pharmacological solution to offer patients a non-invasive, convenient, and effective alternative," Benozzi explained.

The eye drops, developed by Dr. Benozzi’s late father, Dr. Jorge Benozzi, contain two active ingredients: pilocarpine and diclofenac. Pilocarpine helps constrict the pupils and contract the ciliary muscle, which is essential for focusing on objects at different distances. Diclofenac, a non-steroidal anti-inflammatory drug, helps alleviate the inflammation and discomfort that pilocarpine may cause.

In the study, patients used the eye drops twice daily, typically upon waking and again six hours later. A third dose was available if needed. The participants, consisting of 373 women and 393 men with an average age of 55, were divided into three groups, each receiving a different concentration of pilocarpine (1%, 2%, or 3%) alongside a fixed dose of diclofenac.

Researchers evaluated the patients' reading ability one hour after the first dose and monitored them for two years. The results showed significant improvements in near vision across all three concentrations. One hour after the initial application, patients experienced an average improvement of 3.45 lines on the eye chart. In the 1% pilocarpine group, 99% of patients achieved optimal near vision, while 83% maintained good near vision after one year. In the 2% group, 69% could read three or more extra lines, and in the 3% group, 84% achieved similar results.

Benozzi reported that adverse side effects were mild, and no patients discontinued treatment. "Nearly all patients experienced positive improvements in near visual acuity, although the magnitude of the improvement depended on the status of their vision before treatment," she said. The findings suggest that this therapy could be a safe and effective alternative, significantly reducing reliance on reading glasses, though it may not eliminate the need for glasses entirely.

Benozzi emphasized that the treatment is not meant to replace surgical options but could serve as a valuable alternative. "Eye care professionals now have an evidence-based pharmacological option that expands the spectrum of presbyopia care beyond glasses and surgery."

Burkhard Dick, chair of ophthalmology at the University Eye Hospital Bochum in Germany, who reviewed the findings, noted the importance of these results for individuals not eligible for surgery due to age-related nearsightedness. However, he cautioned that long-term use of the medications in the drops may have potential side effects. "Broader, long-term, multi-center studies are needed to confirm safety and effectiveness before this treatment can be widely recommended," he said.

It is important to note that findings presented at medical conferences are considered preliminary until published in a peer-reviewed journal. Benozzi mentioned that some patients have been using the treatment for over ten years, and she plans to conduct further research. Her lab is also seeking partners to help internationalize the findings.