Clinical Scorecard: The Evolution of Treatments for Emmetropic Presbyopia

At a Glance

Key Highlights

• Emmetropic presbyopes require vision correction for the first time after age 40.
• Reading glasses and contact lenses are common but may not be well-tolerated.
• Pupil-constricting eyedrops like pilocarpine offer a pharmaceutical option for near vision, but may cause side effects such as headaches and dim vision.
• New therapies are in development to improve near vision without compromising distance vision.
• Patients often prefer to avoid glasses, leading to a demand for innovative treatments.

Guideline-Based Recommendations

Diagnosis

• Evaluate visual acuity and near vision difficulties in patients over 40.

Management

• Consider reading glasses, progressive lenses, or contact lenses based on patient preference and educate patients on potential side effects.

Monitoring & Follow-up

• Assess for side effects of treatments, particularly with pupil-constricting drops, and ensure patients understand these risks.

Risks

• Evaluate patients for retinal complications before prescribing pupil-constricting eyedrops.

Patient & Prescribing Data

Pupil-constricting drops can improve near vision but may cause side effects like headaches and dim vision; monitor patient tolerance.

Clinical Best Practices

• Discuss the pros and cons of each treatment option with patients.
• Monitor for side effects and adjust treatment as necessary.
• Stay updated on emerging therapies and their clinical implications.
• Encourage follow-up visits to reassess treatment efficacy and side effects.

References

• Orasis Licensing Agreement
• LENZ Therapeutics FDA Acceptance
• Phentolamine Trial
• Visus Therapeutics Clinical Data
• Vuity Overview
• ASCRS Consensus Statement