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Could eye drops soon be used to treat presbyopia?

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  • Eye drops that temporarily relieve the symptoms of presbyopia have been submitted to the FDA for approval.

  • If approved, the eye drops would be the first of their kind available to the public.

  • Presbyopia, also called age-related farsightedness, occurs naturally with age and causes difficulty focusing on close-up objects.

If you use reading glasses to help with presbyopia, it may be hard to imagine doing certain activities without them.

But you may soon be able to find out what it feels like to comfortably read a book or use a smartphone with little more than a drop in each eye.

Experimental presbyopia eye drops from the pharmaceutical company Allergan have been submitted to the U.S. Food and Drug Administration (FDA) for approval, the company said in a February press release.

The eye drops currently go by the investigational name AGN-190584 (pilocarpine 1.25%). The FDA will likely act on the New Drug Application before January 2022, according to Allergan.

SEE RELATED: Presbyopia Q&A with an optometrist

Presbyopia: Age-related farsightedness

Presbyopia, essentially, is universal: It affects everyone sooner or later. It’s sometimes called age-related farsightedness and typically becomes noticeable sometime after age 40.

More than two billion people worldwide are believed to have presbyopia.

Someone with presbyopia has a harder time seeing close objects clearly. Holding reading materials at arm’s length is one of the hallmark signs of the condition.

Presbyopia is a gradual stiffening of the eye’s lens and weakening of the muscles attached to it. Since focusing on close objects requires the most work, an inflexible lens with weaker muscles leads to difficulty maintaining near focus.

Presbyopia is not an eye disease or illness. Instead, it’s a refractive error, like nearsightedness, farsightedness or astigmatism, and it changes the way light registers inside the eye.

Reading glasses and glasses with multifocal lenses (progressives, bifocals and trifocals) are the most common treatments for presbyopia. Special contact lenses and surgery are also treatment options.

Soon, eye drops could find their way onto that list of treatments.

How the eye drops work

Allergan’s presbyopia drops utilize the drug pilocarpine, which is also used to treat glaucoma at higher concentrations.

The goal of the pilocarpine drops is to reduce the size of the pupils by causing the tiny iris muscle to contract, according to the company. It will also help the muscle along the lens itself contract.

Combined, these actions should improve someone’s ability to focus on near- and medium-distance objects.

Participants in the most recent studies used the drops once per day. During Phase III clinical trials, participants were between the ages of 40 and 55.

No serious side effects were noted among the trials’ 750 total participants, according to Allergan. Non-serious side effects included headache, eye redness, blurry vision and eye pain.

“Presbyopia is a significant source of frustration for most adults over age 40 who find current treatments inconvenient or invasive,” said Tom Hudson, MD, the senior vice president of research and development and chief scientific officer at AbbVie, Allergan’s parent company, in a statement.

“If approved, AGN-190584 is expected to be the first eye drop to treat presbyopia, providing a novel option to those affected in the U.S.,” Hudson said.

The first of their kind

Allergan’s eye drops aren’t the only presbyopia drops in development. At least two other companies, Presbyopia Therapies and Orasis Pharmaceuticals, are working on similar eye drops.

Allergan’s product, however, is the furthest along in the FDA approval process. By submitting a New Drug Application, Allergan has taken the formal step of getting the eye drops approved for marketing.

If Allergan’s eye drops for presbyopia are approved — and other products like them in the future — they could change the way billions of people are able to manage their vision care.

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