The Sunday Session with Francesca Rudkin

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


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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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