As you become old, your body witnesses many changes. Of the various parts /organs, your eye (and its lens) is vulnerable to several age-linked effects. One such age-related condition that affects the eye is presbyopia. This condition makes it difficult for your eye to focus on objects. It is likely to occur when you cross 40 years of age. It starts with your inability to read fine print as well as contents written in smaller fonts. This condition may occur even among those who have never had an eyesight-related condition when they were young. But, can you use pilocarpine for presbyopia? It is important to have more information on this.

Age-linked eye problems are of many types; presbyopia is one among such ocular conditions. This condition is associated with the changes in the protein content of your lens. Due to this, your lens may tend to lose its elasticity and may hence get hardened. Along with the protein chains of your lens, tissues surrounding your eye (and lens) may also undergo some changes as you age. All these changes collectively contribute to your inability to focus on items closer to your eyes.

Symptoms of presbyopia

One of the most characteristic signs of presbyopia is the need to hold things farther, so as to see them clearly. For example, you may be holding your phone at a distance to read from it. The same is true with printed items – such as a book or your newspaper. The irony is the more you move things far, the more strain it gives to your eyes. Other symptoms of this ocular problem include frequent spells of migraine or headache, strain on eyes and tired eyes.

Treatment of this eye problem is through prescription of reading glass (eye glasses), use of contact lens and / or an eye surgery. Based on the nature of aging, bifocal-lenses are often prescribed. But, this approach only aids to a lesser extent; this is because of the limited range of eyesight this treatment offers. As a related development, aged people with presbyopia may tend to become more sensitive to sunlight. Such sensitivity is attributed to aging of fiber / muscles around your lens and also to a reduction in its elasticity. One other alternative is the use of glasses for reading purposes only.

The advantage of using glasses for reading is that you can remove them off when you are not viewing smaller items or those written in fine print. This is unlike progressive lens or bifocal lenses; these two categories of glasses are to be worn throughout the day. It is often your choice whether to go with contact lenses, bifocals or reading glasses. In general, it is a safe practice to buy lens with anti-reflective properties or a special coating. Such a coating removes distracting reflections; this can be helpful especially while you are driving during night times.

Use of pilocarpine for presbyopia

Pilocarpine is an FDA-approved medication for treating eye problems such as presbyopia. In order to view closer objects or items that are nearer to you, pupils need to constrict. Such constriction helps sharpen the images. This process is known as pinhole effect. Pilocarpine eye drops help pupils to constrict and thus enables a sharper focus on items closer to you, or those in fine print. Key ingredients of this drug help alter the pH balance and works to contract your pupils for greater focus. The results can be felt fast; it may take only ~ 20 minutes for these eye drops to start working. The effects of this drug are however known to last for more than 5 hours.

Pilocarpine is not an over the counter (OTC) eye drop. Its use is strictly as per the instructions of your treating eye doctor i.e., a qualified ophthalmologist. Typical use is a single drop per day; those who are wearing contact lenses are advised to remove them off. Also, you are advised to wait for about 15 minutes prior to wearing your lens again. Those who are using other forms of eye drops are recommended to wait for 10 minutes in between doses. As these drops successfully make your pupils to constrict, you may not need reading glasses. Also, as you start using this med, you may see an improvement in your eyesight – especially to see objects that are nearer to you.

Pilocarpine is commonly sold through drugstores; you may however need to have a prescription from a qualified eye doctor to procure this eye drop. It is essential to wash and wipe your hands prior to using this med. As a safety measure, never touch the dispenser or dropper as it can infect your eyes. You are advised to use this med regularly – as per your medication plan. Discontinuation of this eye drop midway into your treatment may cause severe eye conditions. But, if your eye condition does not improve or gets worse with the continued use of this med, it is a safe practice to inform your treating physician of such problems immediately.

Side effects pilocarpine is likely to trigger

This eye drop may cause a few adverse side effects and undesired reactions. Commonly experienced adverse effects are blurring of eyesight (on a temporary basis though), reddening of eyes, migraines or headache, irritation in your eyes, etc. In some rare cases, users have experienced an altered vision, painful eyes, etc. This medication is unlikely to cause allergies among users; however, a small percentage of users have experienced allergic conditions such as dizziness or feeling drowsy, itchiness, inflammation of skin, rashes, etc. A smaller number of users witnessed a few severe allergies such as respiratory problems such as wheezing or gasping for breath.

Upon sensing any of these adverse effects, it is a safe practice to seek medical support by reaching out to 911 on an emergency basis i.e., if you are resident of the US. You may also call the helpline numbers of the federal drug approving agency, food and drug administration (FDA). This drug clearing body has its own helpdesk to address adverse reactions and undesired side effects caused by the drugs it cleared. Users of pilocarpine in Canada may either call Health Canada for needful medical attention or go to a poison control center on an urgent mode.

In this milieu, it becomes important to know that the above listed side effects and allergies do not constitute a complete list of discomforts pilocarpine may cause. It is hence possible to witness side effects that are not listed here. Upon encountering any unknown reactions and side effects, it is a wise thing to call your treating doctor as quickly as you possibly can. As this med can blur your vision and may alter eyesight, never indulge in adventurous activities such as cycling or jumping. It is unsafe to drive vehicles soon after using these eye drops. On a related note, never work on heavy machinery; in general, stay away activities that may need a high level of mental focus and / or concentration.

Those who are planning to undergo a surgery or a dental treatment must tell their surgical / caregiving team about their medication plan. Your surgeon / dentist may advise you to stop using this med for a few days prior to the date of your dental / surgical intervention. As an extended precaution, it is a good practice to tell your caregiver of the drugs you are currently consuming. While you are informing of such drugs, ensure to add prescription drugs, over the counter meds, herbal supplements, proteins, minerals or vitamin supplements as well as dietary aids. Once you have shared the list of treatment plans, never make changes to such plans without the consent of your eye doctor.

Women who are pregnant must talk to their caregiver prior to using this eye drop. As studies done on pregnant women are few and far between, needful precautionary measures are required during all stages of pregnancy. Similarly, those who are sexually active must talk to their eye doctor of the risks of an unplanned pregnancy. As a safety measure, it is essential to use a contraceptive (preferably, a non-hormonal birth control method such as a skin patch or a vaginal ring) while using this eye drop. Women who are currently nursing a baby must understand the risks of using this med; this is mainly to avoid likely risks associated with the entry of key chemicals of pilocarpine into mother’s milk.

Those who have missed a dose are advised to skip the dose you missed. Never apply this eye drop twice i.e., to make up for the dose you forgot to apply. A double dose of pilocarpine may lead to an overdosed condition. You can tell if you are overdosed from the symptoms; these include respiratory problems such as panting, loss of coordination or passing out. In all such instances, rush to a nearby poison control unit quickly.

In sum, ocular med pilocarpine is approved by FDA for the treatment of eye problems including farsightedness / presbyopia. Pilocarpine helps your pupils to shrink and constrict; this action facilitates a sharp focus on objects in fine print or those closer to you. You may see the outcomes within a short time, of about 15 to 20 minutes; effects may last for 5 hours or more. You are advised to talk to a qualified eye doctor / ophthalmologist to know about the safe use of pilocarpine for eye conditions such as presbyopia.

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