Overview of The Pharmacological Treatments for Presbyopia

Background: Presbyopia is the normal progressive waning of accommodation with loss of the visual ability to focusing on objects reside different distances. Presbyopia triggers a cost in quality of life and professional efficiency of many people over 40. Presbyopia is likely to be one of the main pressing visual concerns of the 21st century, given that life expectancy increases and with it the aging of the population comes. This review aimed to address the three strategies of the pharmacological treatment for presbyopia. Methods: A review on PubMed, Google Scholar, and Clinicaltrials.gov was performed to investigate the English literature on pharmacological treatment for presbyopia from 2012 to September 30, 2020. Results: In addition to the treatment of presbyopia with glasses or contact lenses, new surgical strategies developed, some of them with success. However, during the last decade, a new promising not invasive option for treating presbyopia emerged called the pharmacological approach. Many researchers have developed three different lines of investigation from different assumptions on a pharmacological basis. The first consists of producing miosis, to take advantage of pharmacologically-induced pinhole effect, depth of focus increases and thus the uncorrected near visual acuity (UNVA) could be improved. The second aims to rehabilitate accommodation binocularly to enable good vision at all distances. Finally, the third development attempted to rehabilitate the lost elasticity of the human crystalline lens. Conclusions: None of the three discussed strategies of the pharmacological treatment for presbyopia, prescribed globally, but patients of restoring accommodation strategy can adhere locally, where they are sold so far as master prescriptions.