BLOG: Four more predictions about presbyopia drops
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By the end of 2021, we will likely see FDA approval of the first presbyopia-reversing eye drops here in the United States. Media advertising is likely to draw much public interest to our clinics. Adding to my 2019 thoughts about these medications, I’d like to make four predictions about their adoption:
1. Patients will be more interested than doctors are.
Some practitioners will view these patient requests as an annoyance or a threat to their optical or LASIK practices. The wiser will recognize and lean into an immutable trend that will add to the current resurgence in refractive surgery. My practice hopes to be recognized as a “presbyopia center of excellence” known for all modalities of treatment.
2. Patients will not tolerate unpleasant side effects.
Patients desiring presbyopia drops want life to be simpler, and they are willing to pay $100 per month or more out of pocket. If they experience significant headache or loss of distance vision, they will lose faith quickly in these products, perhaps never trying another brand. With the earliest products, we need to warn them of side effects and let them know future offerings may be different.
3. Duration of effect will be highly important — but variable.
While market research tells us that close to 90% of patients want a product that will last a full day at work, that may not be appropriate for all. Some will want to go out to dinner and read the menu but have their night vision unaffected by the time they drive home. There is probably room for products with varying durations of action.
4. Formulation will be as important as pharmacology.
If we have learned anything from the drug cyclosporin, it is that differing formulations can have very different side effect profiles. Similarly, the same active ingredient for presbyopia mixed in different formulations may have better or worse tolerability and duration of action. We must judge these drugs not on active ingredients alone but on how they work in actual patients who have given them a try for an extended period.
As always accompanies the release of a new class of product, much spirited debate will stir among clinicians around the release of the first presbyopia drops. Those willing judiciously to try these medications will likely be rewarded with high patient interest, loyalty and — hopefully — therapeutic success.
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