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First FDA-approved eye drops to replace reading glasses go on sale

First FDA-approved eye drops t...
Vuity eyedrops have gone on sale as an alternative to reading glasses
Vuity eyedrops have gone on sale as an alternative to reading glasses
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Vuity eyedrops have gone on sale as an alternative to reading glasses
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Vuity eyedrops have gone on sale as an alternative to reading glasses
Age-related hardening of the lenses makes it harder to focus the eyes on closer objects as we age
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Age-related hardening of the lenses makes it harder to focus the eyes on closer objects as we age

The first FDA-approved eye drops to treat age-related blurry near vision (presbyopia) has gone on sale in the US, offering a potential alternative to reading glasses for the estimated 128 million Americans affected by this common condition.

As we age, our lenses begin to harden, with the result being that it begins to take more and more effort for our eye muscles to squeeze them into different shapes to change their focal point. So we start squinting to see, or holding things at arm's length to read them; "reading with my [crotch]," as my grandpa used to say in slightly more florid language.

Presbyopia is a normal part of the aging process, and the first time you look at yourself in the mirror with reading glasses on is an excellent reminder to get your affairs in order. But a new eye drop medication promises to stave off that inevitability a little longer.

New prescription medication Vuity is administered once daily to the eyes, and its active ingredient pilocarpine is designed to stimulate the eye to reduce its pupil size, an effect which should last most of the day. Reducing the size of the pupil, as any photographer who's ventured out of automatic mode will attest, increases the depth of field of an image, meaning that more of it should look sharp wherever the lens is focused. It's the reason why pinhole cameras give you sharper images than hole punch cameras.

Age-related hardening of the lenses makes it harder to focus the eyes on closer objects as we age
Age-related hardening of the lenses makes it harder to focus the eyes on closer objects as we age

In Phase 3 human studies, run on 750 individuals aged 40-55 with presbyopia, patients using Vuity were found on average to be able to read an extra three or more lines on an optometrist's vision chart "in mesopic (in low light), high contrast, binocular Distance Corrected Near Visual Acuity (DCNVA), without losing more than 1 line (5 letters) of Corrected Distance Visual Acuity (CDVA) at day 30, hour 3, versus placebo."

Of course, reducing the iris size has another effect: it reduces the amount of light coming in. This doesn't necessarily mean the world will look darker to you with Vuity eyedrops in. Much like a camera, the human eye can adjust its sensitivity. "Under bright sunny skies the human eye has an effective ISO of about 1," writes Allen Weitz for B&H, "and under low-light conditions an ISO of about 800. It's also worth mentioning the contrast range detectable by a typical human eye under brighter lighting conditions is in excess of 10,000 to 1, which blows away any camera/lens combination, film or digital."

So for most purposes, Vuity users shouldn't notice the world becoming a darker place – although the company does recommend against driving at night while using it, or "performing hazardous activities in poor lighting." Side effects including headaches and eye redness affected less than 5 percent of subjects in the trial, and none of the cohort experienced any "serious adverse effects." It's possible to use with other eye drop medications, provided you apply them five minutes apart.

Vuity manufacturer Allergan says that while the drops improve near and intermediate vision, they won't impact distance vision – and they are less likely to be helpful past the age of 65.

Source: Abbvie / Allergan

11 comments
11 comments
sidmehta
An interesting approach but once again a drug you need to buy lifelong. Instead, research why the eye can't focus anymore. Find the underlying cause.
paul314
Or you could just read in brighter light so that your pupil contracted normally.
niio
Increased low light sensitivity in eyes does not prevent the loss of color perception. This happens whether it is dark or the iris is artificially closed.
Username
@sidmehta The article actually states what the cause is. A hardening of the lens which prevents it of bending properly to focus. There are several projects developing artificial lenses.
Gregg Eshelman
The cause of lens hardening is an enzyme that depletes as people age. It's not water soluble so getting it into the lens was a problem. The treatment drops are called UNR844, containing lipoic acid choline ester. A test with 75 subjects (72 completed the test) who were treated for 91 days showed significant improvement in near vision VS the placebo group. Followups were scheduled after the end of testing and only at 6 months was there significant reduction.

What would be nice is if a longer treatment time of daily eye drops could get the lenses pliable for many years.

Another avenue that's been investigated is lens regeneration. There have been successful experiments with dogs. It's been done on human infants born with cataracts. The process is similar to organic lens removal to prepare for implantation of a synthetic lens. Unlike in prep for synthetic lenses, a thin layer of outer lens cells is left inside the lens capsule. Those cells replicate to reform the lens, but the new lens is pliable so it can change focus.

Makes me wonder why this hasn't been trued on adults.
Douglas Rogers
The sphincster muscle of the lens contracts, releasing tension on the zonules and allowing the lens to become more spherical and have a shorter focal length. The lens age hardens and loses refractive index, and will not bulge as much with the tension released. Contracting the muscle harder will not work, as you are pushing on a string.
GregVoevodsky
What a camera cheat?! Stop smoking pot and dilating your eyes? Now, you take a drug, so when a cop pulls you over your eyes won't dilate?! Any smart person know squinting works or make a small iris in your hand in front of your eye. I figured this out in 3rd grade before I got my first soft contacts. I'm loving my bi-focal contacts at 54.
Trylon
Yes, I've noticed that my vision is sharper when I'm in the bright outdoors than when I'm in a dim interior. Luckily, I don't need this quite yet despite almost certainly suffering from presbyopia thanks to the march of time. Anisometropia gives me one near-sighted eye that allows me to read just fine at short distances. But it's nice to know it's an option.
WB
this is just so wrong! wow eye drops that artificially change eye.. just to read...
christopher
You can get the same effect for free, just by rolling up your index finger and peeking through the tiny hole it makes. Handy if you're at the shops and want to read a price-tag...
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