Pharmacological treatment of presbyopia

Abstract

AbstractAccommodation is the dioptric change in power of the eye produced by the changes of shape and position of the lens and the modification of the focus depth produced by the changes in the pupillary size. Presbyopia occurs in the 5th decade of life and is a consequence of the normal age‐related recession of the near point making it difficult to read at a normal working distance when the eye is fully corrected for distance vision. There are many strategies to correct presbyopia available nowadays, including eyeglasses, contact lenses, cornea or intraocular surgery, however, none of them is without limitations and fits every patient. Pharmacological treatment of presbyopia is based on using ophthalmic drops, which by impact on ciliary muscle, changing pupil size and elasticity can improve near vision. Many different modifications, including combination of two parasympathomimetics and a NSAID, two parasympathomimetics and one parasympatholytic, carbachol 2.25% with brimonidine 0.2%, and a combination of Pilocarpine 0.247%, Phenylephrine 0.78%, Polyethyleneglycol 0.09%, Nepafenac 0.023%, Pheniramine 0.034%, and Naphazoline 0.003% were studied. A different strategy based on lipoic acid derivative drops aims to soften the crystalline lens.