Presbyopia Treatment: Can Eye Drops Give You a Break From Reading Glasses?

Presbyopia is a natural age-related process that affects all people over the age of 40. It makes it harder to see things up close, like the newspaper or your phone. 

Until recently, options for presbyopia treatment included glasses and contacts. But now eye drops are another option for treatment. However, they won’t reverse the underlying aging of the eye. Below, we’ll cover how eye drops could help presbyopia. 

What causes presbyopia?

Presbyopia is caused by the natural aging of the lens in your eye. The lens is what lets your eye focus on objects close up and far away. As you age, the lens becomes stiffer, making it harder for the eye to focus on near objects. 

Presbyopia usually develops after the age of 40. But there are certain risk factors that can cause it to start early, like certain medications and genetics. 

How is presbyopia normally treated?

Reading glasses, prescription bifocal or progressive glasses, and bifocal or multifocal contact lenses are the best current treatment options for presbyopia. In some cases, surgery may help, but it is invasive and expensive. And it’s not an option for everyone. It’s no wonder that people are excited about eye drops as a new option for correcting their vision.

How would eye drops for presbyopia work?

There are two kinds of eye drops that are being studied to treat presbyopia:

• Miotics: Miotics make the pupil smaller, which improves the eye’s ability to focus both near and far. 

• Lens softening drops: These drops soften the eye’s lens so it is more flexible and better able to focus close up. These drops may slow down the natural progression of presbyopia that happens as we age but they work best in people with early presbyopia.

What presbyopia eye drop treatments are currently available?

Several companies are developing variations of eye drops for presbyopia. Right now, only one eyedrop has FDA approval and can be prescribed. Vuity, made by Allergan, is an eye drop that contains a dilute version of pilocarpine. 

Clinical trial data showed that people who used the Vuity eye drop every day had improved near vision. People saw results as early as 15 minutes after use, and the improvement lasted up to 6 hours. 

New data shows that Vuity can affect the retina — the back layer of the eye that senses light and sends information to the brain. Vuity use has been associated with vitreous detachment, retinal tear, and retinal detachment. 

What other eye drops are being developed?

Six other companies are working on clinical trials for miotic eye drops. Another company, Eyenovia, has a rival pilocarpine drop that is now in phase 3 clinical trials (the last phase before the FDA can approve a drug for use). 

Evenovia uses an Optejet dispenser to deliver targeted, consistent doses rather than a drop. The dispenser uses ⅕ of the medication a regular eyedropper uses. Hopefully this will prevent medication waste and improve side effects. Some companies are also including anti-inflammatory ingredients in their eye drops, which may reduce Vuity’s side effects. 

Novartis is in phase 2 trials with a lens softening drop (UNR844) that uses lipoic acid. This trial should be completed in March 2023. Initial data shows that these drops can improve vision for longer periods of time than miotic drops. So they may be a popular treatment option in the future.

Do corrective eye drops completely eliminate the need for glasses or surgery?

People will likely need to use drops in addition to glasses, contacts, and surgery. Eye drops won’t reverse presbyopia or slow it down, either. They also can’t help with other age-related eye problems like cataracts. Even so, drops may be a great lifestyle boost for some people because they can free you from glasses or contacts temporarily.

Are there any potential side effects associated with using eye drops as a presbyopia treatment?

So far, people in clinical trials have reported:

• Headaches

• Decreased vision in dim lighting

• Blurred vision

• Eye pain

Pilocarpine is a miotic drop (it makes the pupil smaller). Miotic drops can cause retinal detachment, especially in people who are nearsighted. Allergan has updated the prescribing information for Vuity, advising a complete retinal exam for everyone before starting Vuity. See an eye doctor right away if you’re taking Vuity and notice new changes, like flashing lights, floaters, or vision loss. 

Cost is another factor that you’ll have to consider with these new drops. Currently insurance does not cover Vuity. Price varies between $80 to $100, and there are no generics available. 

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Written by:

Nishika Reddy, MD

Nishika Reddy, MD, is an attending physician at the University of Utah. She provides comprehensive and cornea medical care at the Moran Eye Center and serves as clinical assistant professor.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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