#LUMIFY PUPIL CONSTRICTION FULL#

A nonpilocarpine optionĬarbachol is known to be the most potent and durable of the miotic class,3 so it may have advantages over pilocarpine when it comes to peak and duration of effect as a presbyopia-correcting agent. A smaller percentage of patients (16% to 18%) still had good near vision at 6 hours.

In the GEMINI clinical trials that led to approval of pilocarpine 1.25%, between 26% and 31% of patients achieved the desired end point of a 3-line gain in near vision (without a 1-line loss of distance vision) at 3 hours.

#LUMIFY PUPIL CONSTRICTION FULL#

A key parameter for success of these miotic agents will be duration of action.įrom all our experience with eye drops to treat dry eye and glaucoma, we know people dislike using drops multiple times per day, so it is clear that most presbyopic patients are going to want a single drop to last a full workday of 8 hours or so. Several other miotic drops, mostly pilocarpine based, are in the pipeline and are likely to be introduced to the US market within 1 to 3 years. Pilocarpine 1.25% (Vuity Allergan/AbbVie) was recently approved by the US Food and Drug Administration and will soon be available to consumers by prescription. It also increases the depth of focus for improved near vision. This minimizes a wide variety of aberrations, especially chromatic aberration, to sharpen distance vision. With the smaller pupil, only the most parallel central light rays are able to enter the eye. They act on the iris sphincter to constrict the pupil, creating a pinhole effect. Miotics, such as pilocarpine and carbachol, have a rapid onset of action that is within approximately 15 minutes. The other approach-the one that can best help our patients who are already well into presbyopia-is the use of pupil-modulating drops. They will likely have an onset of action of months, making them viable for younger presbyopes or pre-presbyopes who are willing to use the drops on a regular basis until the desired physiochemical structural changes in the lens have occurred.

There are a couple such lens-altering agents currently in the pipeline that hold great promise to reverse, or at least delay, the lenticular aging process. One involves alteration of lenticular metabolism to improve elasticity of the crystalline lens. There are 2 approaches to pharmacologic control of presbyopia.

Lumify pupil constriction