Greetings, everyone!
Recently, a 'new' eyedrop has been promoted called Vuity. The medication is supposed to reduce the need for reading glasses in patients over 40. The medication, Pilocarpine 1.25%, has been used for 50 years for treatment of glaucoma. It has fallen out of favor with new classes of medications being preferred (such as Prostaglandin Analogues and Carbonic Anhydrase Inhibitors) for a combination of better effectiveness with new medications and headaches caused by Pilocarpine.
The way the medication works is by the pinhole effect. The pinhole effect is another way to correct light rays that are landing on the retina and works by extending the depth of field by shrinking the pupil size. Probably the best example of this is a Pinhole Camera. The Pinhole Effect is already being employed in some LASIK procedures, known as the Kamra Inlay. Results with that procedure have been mixed, with anywhere from outright success to blurred vision, not only at near, but at distance as well.
It is very possible that this medication will be helpful in temporarily correcting near vision for people over 40. With any miotic medication (shrinking the pupil size), a dilated eye exam is extremely important to guage whether the patient is at risk for a retinal tear or detachment, a potentially blinding condition. The medication may impact night driving, as the pupil size increases (dilates) naturally in low light situations to allow more light in. Lastly, I'm curious to see if this medication also causes headaches widely reported by previous Pilocarpine users.
I don't intend to only outline negative consequences of the medication but we need to temper expectations as this medication hits the market. I don't see them "replacing reading glasses" outright, unfortunately. I do, however, think it may enhance reading for patients temporarily.
Dr. H