Background: Presbyopia is an age-related loss of near focusing ability due to reduced lens elasticity and ciliary muscle function, affecting over 1.8 billion people globally. While spectacles remain the primary correction method, they are often inconvenient. Surgical options exist but have limitations. Pilocarpine, a miotic agent, improves near vision by inducing miosis and enhancing depth of focus. Recently FDA-approved for presbyopia, its long-term safety and efficacy remain under study. This research evaluates the effectiveness and tolerability of 1% pilocarpine eye drops as a non-invasive alternative for presbyopia management.
Aim & Objective: Our primary objective of the study was to evaluate effect and safety of 1% pilocarpine among presbyopic subjects.
Materials and Methods: The present prospective study was conducted in the Department of Ophthalmology at tertiary care center among 100 subjects coming for evaluation of presbyopia. Between the duration of February 2023 to March 2024. Subjects were asked to instil 1% pilocarpine eye drop in each eye, one drop once daily in the morning for 30 days. The patient was followed up at 1 week, 2 weeks, 30 days and 60 days.
Results: In the present study the average age of participants was 46.34 ± 4.79 years with a higher prevalence among males (54%). The chief complaints among subjects were diminution of vision (56%), headache (40%), and watering (33%) Our results showed a significant improvement in near vision after 30 days of pilocarpine use, with many subjects achieving functional vision without additional correction. More than half of the participants (55.91%) exhibited marked improvement, often eliminating the need for reading glasses. A reduction of 26.21 cells/mm2 was noted from baseline data but was not statistically significant. While the treatment was generally well-tolerated, a small percentage (7%) of subjects experienced mild side effects, such as eye pain, irritation, and increased lacrimation. All of then voluntarily discontinued participation from study.
Conclusion: 1% pilocarpine eye drops show promising results in reducing presbyopic correction needs and may be an effective therapeutic option for presbyopia. Though individual responses may vary, warranting further research with larger sample sizes and longer follow-up periods.
Keywords: Presbyopia, Pilocarpine eye drops, Visual acuity, Pupil diameter, Refractive errors.
