Pharmacological treatments of presbyopia: a review of modern perspectives

Antonio Renna, Jorge L. Alió, Luis Felipe Vejarano

Presbyopia affects people from the 4(th) decade of life and is characterized by accommodative loss that leads to negative effects on vision-targeted health-related quality of life. A non-invasive pharmacological treatment providing near-lenses independence would be a truly groundbreaking approach in the treatment of presbyopia. The purpose of this review is to analyze the emerging pharmacological solutions proposed to address presbyopia. Several ophthalmic eye drops compounds solutions have been described in peer-reviewed papers or presented in ophthalmological tabloids and congresses. Each topical treatment deals with drug combinations aimed to modify one or more factors involved in the accommodative process and have been proposed to be instilled either monocularly or binocularly. It remains unclear how much each drug in the final combined form is involved in the achievement of the outcome and contributes to it. Despite the lack of a completely well understood mechanism, pharmacological control of presbyopia seems to be a possible and very attractive alternative for presbyopic patients. The studies mentioned in this review are to be considered pilot investigations as they involve either a small number of subjects or are single case series. Complete studies are needed to confirm which will be the more effective pharmacological compound for the treatment of presbyopia.