Solutions to age-related vision problems now come in a bottle. How well do they work?
After I hit middle age, I noticed that printed words on a page didn’t look as crisp as they used to. Like many people, I’ve been wearing reading glasses ever since. But one day recently I squeezed a few drops of a new prescription drug into my eyes instead. A few minutes later, the text in front of me was clearer and more sharply focused. But I also noticed the shared kitchen in my office suite was strangely dim, even with the lights on. And I had the faintest whiff of a headache.
The treatment I used, an Allergan product called Vuity, is the first to reach the market. The drops were approved by the U.S. Food and Drug Administration late last year. Nearly a dozen companies have similar drops in clinical trials, each of them aiming for a “safe, effective, reversible therapy that gives people what they want, which is good near vision,” says Eric Donnenfeld, an ophthalmologist at New York University, who consults for Allergan and another drop manufacturer.
So how do these drops fix that problem? They do so by shrinking the pupil, the part of the eye that channels light toward the retina, which turns this stimulation into visual signals for the brain. Reducing the pupil opening is similar to reducing the aperture on a camera lens. It blocks extraneous light from more distant objects, bringing the nearby ones into sharper focus. Similarly, a smaller pupil “precludes aberrant light rays from reaching the retina,” Donnenfeld says.
During clinical testing with Vuity, about 30 percent of treated subjects gained the ability to read three added rows of text on a chart positioned at arm’s length. The effects wore off gradually over a period of six hours, but other companies are working on longer-acting compounds. Visus Therapeutics in Irvine, Calif., for instance, is developing an eye drop with two active ingredients: one called carbachol that constricts the pupil and another called brimonidine that prevents it from dilating.
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