[HN Gopher] New FDA-approved eye drops could replace reading gla...
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New FDA-approved eye drops could replace reading glasses for
millions
Author : kyleShropshire
Score : 174 points
Date : 2021-12-10 12:39 UTC (10 hours ago)
(HTM) web link (www.cbsnews.com)
(TXT) w3m dump (www.cbsnews.com)
| its_bbq wrote:
| This is so wasteful. Buy one pair of reading glasses, use them
| forever, or keep buying plastic drop bottles.
| tiahura wrote:
| Spoken like someone not developing presbyopia in their mid 40s.
| mrob wrote:
| This is competing with contact lenses, not glasses. All types
| of eyeglasses cause image distortion. The higher the
| correction, and the greater the distance from the lens to the
| eye, the worse it looks. Correcting the eye directly, with
| contact lenses/drugs/surgery, gives you less distortion.
| caymanjim wrote:
| The article is specifically about reading glasses. Contact
| lenses have nothing to do with it, unless you think people
| are popping contact lenses in to read and taking them out
| after.
| ethanbond wrote:
| These sorts of comments are so deeply discrediting to the green
| movement.
|
| We need to focus our dialogue on _big problems_ where small
| changes yield huge environmental results (like transportation
| and meat production) rather than _small problems_ where even
| outright perfection (100% of people wearing glasses, no one
| using these drops) does literally nothing for the outcomes we
| care about.
|
| If plastics is the thing you care about (which is completely
| reasonable), we should be approaching as how to produce better
| plastics with less environmentally harmful production and
| discard. Choosing not to make this particular object or that
| particular object is simply not going to move the needle.
| clairity wrote:
| yes, that's been california 'environmental' policy in a
| nutshell: take the smallest problem, pass an uncritical law
| based on manufactured sentiment, back-slap all around, and
| put hat in hand to elicit political reward. plastic bag bans,
| lawn watering restrictions, prop 65 warnings, bike lanes to
| nowhere, even leafblower bans (as much as i hate the
| pollution i endure from these twice a week) are all examples
| of empty feel-good legislation.
|
| it avoids taking actual political risk and spending real
| political capital on things that matter (and against moneyed
| interests) while still reaping political rewards. (this is
| incidentally why i've started to think that we should be able
| to vote 'null' for a given office, meaning no one should be
| in it for the upcoming term.)
| _jal wrote:
| Poe's law in action, combined with youth's lack of empathy for
| their future self.
|
| Amusingly, this same account was recently discussing space
| elevators. Talk about wasting carbon emissions on toys for the
| rich!
| fargle wrote:
| The problem is that as it progresses, that little extra range you
| get from hacking the aperture is going to eventually not be
| enough. So this might free you from reading glasses for even a
| few years, but eventually it will probably not be enough.
|
| An interesting thing happened to me. As natural aging occurred, I
| began to need readers for some things but not always. Then, over
| the course of about a week I went from just barely being able to
| use the computer without them to nope.
|
| The weird thing was that I'd use my computer at home and
| definitely absolutely could not see a word without them. I'd get
| to work and, same monitor, distance, resolution, could still read
| just fine. I chalked it up to dehydration or just being tired in
| the morning. But then I go home and couldn't read my home
| computer again, which was weird.
|
| What was happening was this exact effect! My home office is
| mellow and quite a bit darker. Work is pretty bright (but
| depressing) fluorescents. I turned off the half the office lights
| and proved it. The bright light contracts the pupil and a smaller
| aperture has a deeper depth of field. It can be just enough to
| pull it back into the usable range again.
|
| However, this effect only lasted a couple months. The minimum
| near-focal range finally moved far enough that I need those
| readers either way, although it's still less pronounced with
| bright lights. But I still prefer the darker environ.
|
| For $80 a month, I could buy enough readers to throw them away
| every day.
|
| Readers are just the best invention ever - thank you Ben
| Franklin!
| comeonseriously wrote:
| > The weird thing was that I'd use my computer at home and
| definitely absolutely could not see a word without them. I'd
| get to work and, same monitor, distance, resolution, could
| still read just fine. I chalked it up to dehydration or just
| being tired in the morning. But then I go home and couldn't
| read my home computer again, which was weird.
|
| Blood sugar, diet, stress, exercise, etc. also can all have a
| noticeable effect on vision. When my vision goes to shit, I
| think back over the past couple days of how my diet has also
| gone to shit (it's the holidays!).
| newaccount74 wrote:
| Yes! Image capture is all about light!
|
| If you want to see better, install really bright lights!
|
| I think people put way too little light into their homes. Most
| homes are dark caves. You could probably add ten times as much
| light to an average living room and it still wouldn't be
| anywhere near as bright as an average day outside.
|
| It's amazing what a difference more light makes.
| wallaBBB wrote:
| The thing with presbyopia is about losing the elasticity of your
| lens - thus not being able to change your focus (muscles pull the
| lens changing it's shape and with it the focus). With the
| hardening of the lens the range is getting narrower around the
| lens' natural focus (far field).
|
| Article does a good job at explaining briefly the limitations.
| This drug by manipulating pupil opening extends the depth of
| focus, and if the lens is not too hard, in combination with the
| extended focus you could cover the near field, but the light
| accommodation becomes a problem, by not being able to dilatate
| your pupil (driving being the biggest problem).
|
| Overall a limited application, and not so life changing as the
| article title implies. Reading glasses could very well be a
| better option for all.
| mannykannot wrote:
| One specific limitation is that it impairs your night vision,
| so driving at night while still under the influence of this
| drug becomes riskier.
| xyzzy21 wrote:
| This is NOT a good way of treating presbyopia! There absolutely
| are side effects from administering drugs that dilate or
| constrict the pupil - this is NOT a safe thing to do. There are
| general autonomic nerve effects that can have long-term harm.
| This is medicine 101.
| wintermutestwin wrote:
| I'm waiting for AR glasses tech to catch up with my imagination.
| It will fix my presbyopia (along with zoom and magnify functions)
| and do nifty things like dim oncoming headlights and highlight
| potential road hazards. I have no idea how far off this is, but
| I'm starting to wonder if I'll see it in my lifetime based on how
| weak current AR solutions are.
| soco wrote:
| I have the feeling that AR was always "around the corner". Even
| today all we have is either meager PR stunts or announcements
| about some brand starting yet another never-ending internal
| trial.
| treeman79 wrote:
| Hmm my prescription changed based on nerve strength. +3 with no
| prism, -1, with prism. Anywhere in between depending on how well
| nerves are doing/how high cranial pressure is.
|
| Seems my eye muscles distorted the eye itself.
|
| Maybe a more flexible eye would allow me to compensate better.
| bcaine wrote:
| It looks like this is just Pilocarpine, which has been used for
| decades to treat glaucoma, available at pharmacies everywhere,
| and is commonly used (perhaps off label) to shrink pupils. I
| wonder what if anything they changed compared to the generic
| version?
|
| I've been using Pilocarpine off label to shrink my pupils at
| night after ICL surgery (an alternative to lasik) to solve
| debilitating halos caused by my pupils growing larger than the
| implanted lens.
|
| In my experience, it does increase close range vision (at some
| minor expense to long range vision). That said, it also gives a
| mild headache, and blurs your vision substantially for the first
| 5-15 minutes after use. I don't really see the appeal of using it
| daily unless you really have to.
| epivosism wrote:
| supported by a couple searches eg
| https://en.wikipedia.org/wiki/Pilocarpine
| 1e-9 wrote:
| Constricting the pupil can certainly reduce the effect of defects
| in the eye lens by reducing the amount of lens used; however, it
| won't work well in dim light.
|
| Alternative: Increase environmental lighting and use bright, high
| contrast displays with dark text on bright backgrounds (no dark
| mode). This will not just constrict your pupils (as the eyedrops
| do), but also increase the rate of photons reaching your retina
| in bright areas of the scene relative to dark areas (in other
| words, improves contrast, which the eyedrops won't do).
| Kneecaps07 wrote:
| > "I was in denial because to me that was a sign of growing
| older, you know, needing to wear glasses"
|
| Seriously? I had to start wearing glasses when I was 11.
| rkangel wrote:
| There's two different things - the stuff you get at birth and
| the stuff you get as you get older.
|
| Short sightedness (myopia), long sightedness (hyperopia) and
| astigmatism are effectively genetic conditions that you are
| born with. They are variations of your eye being slightly the
| wrong shape to focus correctly. The precise impact of this
| varies as you grow with your prescription changing, but if you
| need correction then you'll need it from a young age onwards
| (unless you have it permanently treated - e.g. Lasik, or
| cataract surgery).
|
| Presbyopia is an effect that happens over time. The lens
| hardens and so the muscles that manipulate it to refocus can't
| quite do the job any more. This impacts on your ability to
| close distances, and so you can off the shelf reading glasses
| to aid in that.
| jabroni_salad wrote:
| Somewhere between ages 40-50 everyone's eyes lose their ability
| to refocus. Instead of having a limited range of focus, you
| will have a single fixed point and your prescription will be
| changed to suit that need, or maybe you will have multiple
| pairs of glasses for different situations (computer glasses,
| car glasses, etc). Look forward to it!
|
| Telling people about this is one of those xkcd 'my hobby:'
| things for me. It seems like it is widely not in our public
| health curriculum even though it is something almost all humans
| will get to enjoy at that age.
| swader999 wrote:
| Yep, that's me right now. Gets a little worse every year.
| kwhitefoot wrote:
| Not everyone. I am 66 and do not need glasses either for
| reading or driving. My sight is clearly not as good as it was
| though.
|
| So what proportion of people really lose all focussing
| ability before the age of 50?
| casion wrote:
| Reading glasses specifically. Presbyopia is a sign of aging for
| many, and is usually corrected with reading glasses.
| tiahura wrote:
| Or bifocals if you already wear glasses for nearsightedness.
| frankfury wrote:
| This will definitely revolutionize the eye care industry.
| rubylark wrote:
| Interesting, this eye drop seems to just do the opposite of what
| those eye dilation drops used at the eye doctor. It makes sense
| considering that dilation drops make it impossible to read things
| up close that an inverted purpose drop could help people with
| weak pupil response.
| kortex wrote:
| In optics, there's a thing called the circle of confusion (1).
| It's the locus of points that maps to a single point source of
| photons. A "perfect" focus maps a point source to a point on
| the image: perfect contrast. Ability to focus is basically how
| tight you can get this circle, for a focal distance. (this is
| all super simplified, perfect lenses, no aberration, etc).
|
| The smaller the aperture, the more constrained the light field,
| thus the smaller the circle of confusion (at the expense of
| light collection). That's how pinhole cameras work in fact.
|
| Shrinking the aperture also increases the depth of focus.
| Pinhole cameras have ~[?] depth of field because there is ~1
| path every photon can take (ignoring hole width, diffraction,
| etc).
|
| 1 - https://en.m.wikipedia.org/wiki/Circle_of_confusion
| toss1 wrote:
| Yup, and this makes me think that the advice to put brighter
| light on your reading to make things sharper doesn't work
| because of greater light availability, but because it provokes
| the pupil to narrow and increase the pinhole camera effect --
| or more to the point, not that the bright light doesn't itself
| help, but how much is due to more light vs provoking smaller
| pupil opening?
| gwbas1c wrote:
| I'm wondering if anyone has or knows anyone who has experience
| with Vuity?
|
| Now that I'm reaching that age, I can definitely tell that my
| eyes are changing... And I really, really don't want to have to
| wear reading glasses or bifocals.
|
| One thing that concerns me is that Vuity constricts the pupil. I
| definitely can't see as well in low-light situations compared to
| when I was a kid. Makes me wonder if Vuity will just make
| everything too dim.
| par wrote:
| will this work for cataracts patients?
| Malic wrote:
| I'm more interested in UNR844-Cl (by Novartis). It appears that
| it has longer lasting, possibly age-correcting, effects.
|
| "This prodrug is topically instilled binocularly, whereupon it
| penetrates the cornea and degrades into two naturally occurring
| substances, lipoic acid and choline. The lipoic acid is then
| hydrolyzed by esterase in the tear film into dihydrolipoic acid,
| which destroys the disulfide bonds in the lens, improving
| flexibility as noted earlier. An interesting hypothesis regarding
| this medication is that it may potentially halt or even reverse
| the natural lens hardening that occurs with age, thereby allowing
| a potential restoration of natural accommodation."
|
| Source - https://modernod.com/articles/2020-sept/coming-soon-
| presbyop...
| BurningFrog wrote:
| > _This prodrug is topically instilled binocularly_
|
| Can anyone translate?
| germinalphrase wrote:
| Eyedropper into both eyes?
| Malic wrote:
| Yup. Twice a day, results show up somewhere before 90 days,
| ceasing treatment after point _appears_ to continue to
| provide results.
|
| "In phase 1 and 2 studies, UNR844 exhibited a good safety
| profile and there were no treatment-related study
| discontinuations. In addition, all patients showed
| substantial near visual acuity improvements by day 15.3,4
| By day 91, 82% of patients had 20/40 or better near vision
| and 36% had 20/25 or better near vision. Novartis expects
| the drop to be labeled for use twice daily for
| approximately 90 days. The effects of this dosing regimen
| have been found to last up to 7 months without further
| dosing. "
|
| https://modernod.com/articles/2020-sept/coming-soon-
| presbyop...
|
| Article mentions a marketing file year of 2021 but I have
| read that they did a Phase IIa trial that should finish in
| 2022 (2023? Can't find the citation ATM)
| bavent wrote:
| It's put on your eyeballs, both of them.
| BurningFrog wrote:
| _prodrug:_ "a biologically inactive compound which can be
| metabolized in the body to produce a drug."
| wallaBBB wrote:
| This is the second attempt of this kind at tackling aging of
| the lens by Novartis (formerly Alcon). Unfortunately previous
| drug (some 10ish years ago) got pulled off the market after
| studies couldn't confirm the claims - basically it did nothing.
| Hopefully this time it works, because this is the only real
| solution, and not pupil size manipulation.
| phkahler wrote:
| >> Hopefully this time it works, because this is the only
| real solution, and not pupil size manipulation.
|
| My optometrist told me something I had a hard time believing.
| He said there are progressive lenses you can get with
| cataract surgery. I still can't believe that. This came up
| after talking about the long term problems with lasik. I said
| what if I just got cataract surgery now? I still can't
| believe they can do progressives.
| quitit wrote:
| There are a range of IOLs (intraocular lenses) which can
| provide more than a single range (monofocal) of vision.
| While bifocal has existed on the market for some time,
| trifocal iols now also exist and mostly use a lenticular
| lens to present focus of near, intermediate and far vision
| together - however like other multifocal technologies an
| adjustment period is required and they are not for everyone
| (your brain needs to adjust to the fuzziness and the fact
| that the image is not resultant from the natural lens being
| manipulated can be difficult for some people to work with).
| There are also other approaches to this problem such as
| crystalens which is an iol that attempts to solve the same
| issue by moving forwards and backwards - however this kind
| of approach is falling out of favour.
|
| The names in this space are johnson and johnson, alcon
| (novartis), zeiss, bausch and lomb and hoya. This field is
| rapidly developing with new iols every year, some newer
| products are promising a wide range of vision without the
| use of a lenticular lens which seems promising but might be
| more hype than reality. As for you and your vision: only
| your ophthalmologist can truly advise if any of these will
| work for you as there are a myriad of factors at play
| including some that might not seem obvious such as the
| patient's behaviour and expectations.
| tenken wrote:
| Do you mean progressive inter ocular lens? Or like
| progressive lens (glasses)?
| wallaBBB wrote:
| Both options exist, but both are actually trade offs in
| all 3 segments (near-mid-far field). Intraocular ones
| have been existing and evolving in the market for a long
| time now, but really none are perfect. If your job or
| lifestyle dictates a good visual acuity at a certain
| distance don't go with these options.
| dbcurtis wrote:
| Its a multi-focal lens. My optometrist and another friend
| both have them. It splits the incoming light and you need
| to focus with your attention, not mechanically, which is
| interesting. The downside my friend reports is that reading
| requires a very bright light because not all of the light
| is falling on your retina.
|
| I just got an implant in one eye a month ago. I chose
| single-focus at distance. I would rather deal with reading
| glasses than the other oddities, but I did consider the
| option.
|
| BTW the implant surgery was quick and simple and life is
| much better afterwards. Recommend.
| the_d3f4ult wrote:
| Not the only real solution. Maybe the only pharmacologic
| solution, but it's only a matter of time before someone hits
| the nail on the head with an accommodating IOL.
| wallaBBB wrote:
| Considering how often a mistake is made at calculation the
| patient's lens even for the standard monofocals, I would
| not expect it to be a solution around the corner. And
| really it's not always your doctor's fault. Formulas are
| empirical, and it is more difficult for post-LASIK
| patients, as the standard formulas are not that good for
| them, and specialized ones are still maturing.
|
| And this is not including various complications in
| cataracts that could easily make you ineligible for
| progressives.
| loceng wrote:
| There's a stromal stem cell treatment that's been developed,
| went through very successful human clinical trials, and so will
| likely become standard practice for everyone to heal age
| related degeneration; it won't be a daily use, recurring
| monthly revenue stream however, so pharma industry isn't going
| to push it.
| Retric wrote:
| Even once a lifetime treatments like vaccines represent a
| significant customer base as new people are born every year.
|
| The reality is stem cells alone don't fix aging, stuff like
| rates of cancer more inherent than can be cured by such
| things. Stem cells might possibly slow or reverse bone
| deterioration etc which would be a massive boon, but this
| stuff isn't easy or risk free.
| interestica wrote:
| Interestingly, one treatment for the degenerative eye disorder
| keratoconus aims to _stiffen_ the cornea (corneal crosslinking)
| through drops+surgery.
| melling wrote:
| is the loss of flexibility caused by hardening of proteins? is
| this the same or similar to what causes cataracts?
| gardaani wrote:
| Do you mean nuclear sclerosis? This explains it well:
| https://www.healthline.com/health/nuclear-sclerosis
|
| The solutions would be to get the protein fibers sorted out.
| But how?
| the_d3f4ult wrote:
| yes
| MrWiffles wrote:
| Because why buy glasses only once when you can waste $80 bucks a
| month for the rest of your life?
| GordonS wrote:
| It's common to buy multiple pairs of glasses, and
| breaking/losing them isn't exactly unheard of. That said, aye,
| you're not going to be spending $960/y on glasses!
| Broken_Hippo wrote:
| "Vuity is by no means a cure-all, and the maker does caution
| against using the drops when driving at night or performing
| activities in low-light conditions"
|
| I'm in Norway. My days - between sunrise and sunset - are less
| than 5 hours long right now, and the light produces long shadows
| and tinted clouds throughout the day. I could not use this
| product during winter: It lasting between 6 and 10 hours means my
| daylight is gone before it wears off.
| abrowne wrote:
| If it ends up working really well, presumably they can
| reformulate it with a lower dose or one that leaves your body
| faster.
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