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Time‐course of the visual Impact on presbyopes of a low dose miotic
Author(s) -
Xu Renfeng,
Gil Daniel,
Dibas Mohammed,
Rickert Martin,
Meyer Dawn,
Perron Laura,
Kollbaum Pete,
Bradley Arthur
Publication year - 2021
Publication title -
ophthalmic and physiological optics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.147
H-Index - 66
eISSN - 1475-1313
pISSN - 0275-5408
DOI - 10.1111/opo.12749
Subject(s) - miosis , presbyopia , optometry , pupil , ophthalmology , pupil diameter , medicine , near vision , accommodation , refractive error , visual acuity , mydriasis , mesopic vision , pupil size , intraocular pressure , optics , physics , anesthesia , retinal , photopic vision
Purpose To examine the pupil and visual impact of a single early morning drop of a low concentration miotic. Methods Pupil size, refraction, visual acuity (VA), near reading performance and intraocular pressure were monitored for 8 h at a wide range of light levels following bilateral instillation of single drops of 0.1% brimonidine tartate in 19 early presbyopes (40–50 years) and 11 mature presbyopes (>50 years). Results Pupil miosis did not alter distance VA or refraction. Significant pupil miosis peaked at 1–2 h after dosing, which expanded the depth of focus of mature presbyopes with the mean improvement in near logMAR VA of −0.15, −0.07 and −0.03, at 20, 200 and 2000 lux, respectively. One hour after instillation, near reading speed improved by 21, 24 and 5 words per min for text size commonly seen in US newspaper and cellphone text messages, 18, 21 and 19 words per min for text size of grocery labels and 12, 13 and 30 words per min for text size of over‐the‐counter medications at light levels of 20, 200 and 2000 lux, respectively. No such improvements in near VA and near reading speed were observed in the young presbyopes having some residual accommodation. Most of the pupil miosis remained 8 h after instillation, whereas near VA improvements disappeared after 4 h. Conclusion Low dose miotics can enhance near vision in presbyopic subjects while retaining high quality distance vision over a wide range of light levels. Significant improvements in near vision were observed only during the 1–2 h period after dosing when miosis peaked.