Dr Michelle Dickinson: nanotechnologist on the new eye drop treatment that promises to restore vision loss

If you’ve found yourself holding a book at arm’s length or squinting at your phone in dim light, you’re not alone. Almost everyone develops presbyopia as they get older. It’s a natural part of aging where the eye’s lens loses flexibility, making it harder to focus on nearby objects. 

Traditionally, the go-to solution has been reading glasses, or, for some, surgery. But now, a surprising contender is on the horizon: eye drops. 

At the recent Congress of the European Society of Cataract and Refractive Surgeons, researchers presented results that could change how presbyopia is treated. In a study of 766 patients, eye drops combining pilocarpine and diclofenac helped people read extra lines on a near-vision chart, and the improvements lasted for up to two years. 

The drops contain two active ingredients working in tandem: 

• Pilocarpine: an older drug that contracts the eye’s ciliary muscle and makes the pupil smaller. This helps sharpen focus for near objects.
• Diclofenac: a common anti-inflammatory drug that eases the discomfort pilocarpine can cause. 

Together, they act like a workout and cushion for the eye: one trains the focusing muscles, the other keeps irritation at bay. 

Patients in the study used the drops twice a day once in the morning and once later in the afternoon, with the option for a third dose if needed. 

The findings were striking: 

• Within one hour of the first dose, patients could typically read three extra lines on the near-vision chart.
• 99% of those using the lowest concentration (1% pilocarpine) gained at least two lines of improvement.
• For many, the improvements lasted more than a year, with some maintaining better vision for nearly two years.
• Side effects were mild and included temporary dim vision (32%), irritation (3.7%), and headaches (3.8%). Importantly, no serious complications like retinal detachment were reported. 

Imagine a future where instead of fumbling for your reading glasses at dinner, you simply use an eye drop in the morning and carry on with clear sight throughout the day. 

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Episode Transcript

Speaker 1 (00:06):
You're listening to the Sunday Session podcast with Francesca Rudgin
from News Talks.

Speaker 2 (00:11):
EDB Doctor Michelle Dickinson joins us now with a fascinating study,
How are you good morning?

Speaker 3 (00:18):
Good morning?

Speaker 2 (00:19):
I think we all get to that age and stage
where suddenly we were going, I can't really read this
menu very well, or I realized that my eyes were
slowly aging. When I couldn't thridder frids and cotton through
a needle, I was like, good, this is taking me
very long time. It's something that happens to most of us,
isn't it.

Speaker 3 (00:34):
The dreaded pres biopia. Yeah, it happens to all of
us as we get older, sadly just to eye muscles
just one as strong as they used to be, and
we've become fast sighted, which means that we can't really
see the thing. You know, when you're holding a book
at arms length and your arms don't get any longer, like, okay,
so how do you solve it? Well, right now, you
can get some reading glasses. Some people do surgery and

(00:55):
have lasic, neither of which are amazing. And so this
new study has just come out this week, and I
think it's pretty amazing because basically they're saying that do
you no longer need reading glasses or surgery or you
need are eye drops. So the study has just come
out in the Congress of the European Society of Cataract

(01:16):
and Reflective Surgeons. It is not peer reviewed, it's an
abstract and the research was just presented, so you can
you can read the abstract online. But basically what I'm
going to tell you is everything they've got. They took
seven hundred and sixty six patients, all of which have
pres BOPO, meaning they can't read things close up, and
they gave them these eye drops that have two drugs

(01:37):
in them. One of them is called a pilocarpene, which
has been used before and has been seen to have
good effects on helping you to play with the muscles
in your eye, but it's always been known to cause irritation,
be a bit painful. People are like, oh, my eye's hurt,
so they've stopped using it. So what they did is
they combined it with DICHLOPHONEC, which many of you may

(01:59):
know is just an anti inflammatory, and so the anti
inflammatory basically eases the discomfort from this pilot carpene that
has been sort of working on the eye muscles. So
the pilocarpeen does a few things. It contracts the eyes
what's called the cillery muscle, which is the one that
contracts the focus lens. It makes your pupils smaller, which

(02:20):
can affect how much light goes in, and therefore it
helps to sharpen the focus for near viewing of objects.
So this is amazing. So within one hour of putting
these eye drops in, patients could now read an extra
two or three lines on a near eye vision chart.
Now that is the difference, being able to read the
menu or not read them like that is a life

(02:42):
changing difference. And they said the perfect dose was two
drops twice a day morning and sort of mid afternoon,
and the positive effects they saw for as long as
a study around, which was for two years. So in
two years, these people taking eye drops twice a day
were able to not wear glasses anymore and be able
to see text in front of them without having to
put their arms out, read their books, read their menus,

(03:04):
reading dimly lip places, and so this drug sort of
acts like a workout on your eye, sort of helping
the muscles to get stronger and yeah, and within one
hour of the drops going in the patients could see
the only side effects they had were very minus three
percent of people said, oh, I've got a bit of
eye readiness or irate. Stuff you'd get from eye drops anyway.

(03:24):
But putting in this anti inflammatory stopped all the other
side effects, so no pain, people weren't bothered by the
I feeling tense. And one point eight billion people globally
have prespopia, so it's a pretty significant thing. As you
get older, it's going to happen to all of you.
So maybe the next solution is going to be some
eye drops and there's some glasses.

Speaker 2 (03:43):
So I should say fascinating. Thank you so much, Michelle
appreciate that.

Speaker 1 (03:48):
For more from the Sunday session with Francesca Rudken, listen
live to News Talks it'd be from nine am Sunday,
or follow the podcast on iHeartRadio.