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Evaluating Pilocarpine 1% Eye Drops in Presbyopia: A Triple-Blinded Randomized Trial
Mohsen Gohari1, Mohammad Hosein Abootorabi2, Fateme Heidari3
1Ophthalmologist, Shahid Sadoughi University of Medical Sciences, Yazd, Iran, ssu.ac.ir.
Journal of Ophthalmology
|July 28, 2026
Summary
1% pilocarpine eye drops significantly improved near vision in presbyopia patients, offering a safe and effective treatment option with high patient satisfaction. This study provides valuable data on pilocarpine
Area of Science:
- Ophthalmology
- Pharmacology
Background:
- Presbyopia is an age-related decline in near vision, impacting daily activities.
- Current correction methods have limitations, driving interest in pharmacologic solutions like pilocarpine eye drops.
- Limited data exists on the safety and effectiveness of 1% pilocarpine eye drops for presbyopia.
Purpose of the Study:
- To evaluate the safety and clinical effectiveness of 1% pilocarpine eye drops in treating presbyopia.
- To assess the impact of pilocarpine on near and distance visual acuity.
- To monitor patient satisfaction and side effects associated with pilocarpine treatment.
Main Methods:
- A triple-blinded clinical trial involving 60 patients aged 40-60 with presbyopia.
- Participants received either 1% pilocarpine eye drops or a placebo daily for 30 days.
- Visual acuity was assessed under mesopic conditions at six intervals, with safety and satisfaction monitored.
Main Results:
- Significant improvement in uncorrected near visual acuity (UNVA) was observed in the pilocarpine group compared to placebo (p ≤ 0.001).
- While distance visual acuity (UDVA) improved from baseline in the treatment group, no significant between-group difference was noted at 30 days.
- Patient satisfaction was significantly higher in the pilocarpine group (p ≤ 0.001).
Conclusions:
- 1% pilocarpine eye drops offer a safe and effective treatment for improving near vision in presbyopia.
- The treatment demonstrates rapid onset of action and high patient satisfaction with minimal side effects.
- This study, with its rigorous triple-blinded design, contributes valuable insights into pilocarpine's efficacy and duration of effect.
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