Eye drops could replace glasses or surgery for longsightedness, study says
19 comments
·September 14, 2025cianmm
If they invented this for shortsightedness, which I have very slightly, I would pay a huge amount of money (in European medical cost terms) for it.
I mildly dislike wearing glasses but need them or I have a headache within an hour, I can’t overcome my blink reactions to put in contacts (after several hour long sessions with my optometrist) and my shortsightedness isn’t strong enough to convince myself to go for laser eye surgery.
lbourdages
Have you looked into orthokeratology?
Basically, contact lenses you wear at night (which could perhaps be tolerable for you). Then, your vision stays fine during the day (mostly, it worsens gradually but it's manageable).
I don't use it myself but I have a relative that does and they love it.
summarity
EVO ICL. Or even pinned ICL. Just got it recently, would recommend.
LASIK/SMILE/etc were never and are not safe. At least ICL is fully reversible.
Note that is the current version (EVO) I’m referring to, not the older (Visian) which still involved irreversible steps.
Info: https://eyewiki.org/Implantable_Collamer_Lens
Patient info (simpler language): https://www.rcophth.ac.uk/wp-content/uploads/2020/05/Phakic-...
(I paid out of pocket for this and have no affiliation with any clinics)
nickjj
I've been wearing glasses for short sightedness for my whole life and also don't wear contacts because the idea of putting them in freaks me out.
I always think about it from the point of view of what would happen if I want to do extended travel. Which method minimizes risk around something going wrong.
For example:
If you put your contacts in luggage and that gets lost or stolen now you have a really big problem with your sight in a foreign country.
If you're dependent on drops, it's the same problem as contacts.
In both cases, even if you do things to minimize losing them they have a limited supply. What if you want to travel for a year, are you comfortable getting the same type you have at home sent to you in a foreign country?
If you're dependent on glasses, typically you wear them all the time so the risk is them getting broken somehow which is rare. I've been wearing glasses my whole life and have never once broke or damaged them. The biggest risk is falling asleep with them on and rolling over them so it's critically important to move them off to the side somewhere. That also means being extra careful if you're sleeping on a bus or outdoors, you need to be really mindful of where your glasses are at all times if you're not wearing them.
The downside to glasses is they can prevent you from experiences. Casual swimming is annoying, especially alone where you also want to watch your bag that could be hundreds of feet away. Also practicing martial arts with sparring is a problem. Showering without being able to see clear isn't too bad in practice but it's a daily thing.
Surgery has the highest potential upside since you effectively become "normal" but the surgery has to go well so there's a risk factor to think about now. I only know 3 people who have gotten lasik in the last ~15 years. 1 of them sees massive halos at night time with lights so they can't drive at night. 1 of them has to use eye drops for dryness even 2 years after surgery. 1 of them had it done about 10 years ago and has no negative side effects but the effects of the surgery are slowly wearing off to where they will need another surgery in the next few years since their eyes have changed.
Personally if I knew surgery had a 99.999% side effect free success rate and at worst I would only need to do it every 10-15 years I would do it but I just can't get past the risk factor. Sight is just too important. I look forward to a day where this is a fully solved problem in a non-invasive way.
Until then I compromise with glasses.
heavyset_go
> I always think about it from the point of view of what would happen if I want to do extended travel. Which method minimizes risk around something going wrong.
This actually happened to me. Spent two months on the other side of the planet. When I landed I realized I didn't pack my contacts. I just wore the same pair the whole time and was fine.
terribleperson
The travel risks of contacts are manageable. Always travel with a fresh spare pair, a contacts case (to store the old pair), and a pair of glasses in a hard case. The glasses go in your personal bag, not your luggage.
Telaneo
If the risk management strategy of contacts involves having a pair of glasses on hand, why not jump straight to that (unless you don't like glasses in the first place and only use them if all else fails)?
Then again, my eyesight isn't bad enough for me breaking my glasses on a holiday to be a potential problem. I've never broken any of my pairs before, and even if they were lost, I'm still able to read and get around. It's just more unpleasant to do so. But I still prefer glasses and wear them pretty much at all times.
secondcoming
But then you need to make sure you have access to clean water in order to put in your lenses.
secondcoming
I wore glasses since I was maybe 10 and then contact lenses for decades.
I got sick of the daily ritual of having to clean my hands, put them in and then take them out at night.
My eyesight was pretty bad with a large prescription and keratoconus on top (that I did have C3R surgery for). I was dismayed when I found out I wasn't eligible for laser surgery so I just accepted that I'd have to deal with the inconvenience of glasses/lenses during the most active years of my life.
Then I found out that you can do Refractive Lens Exchange (same surgery that they do for people with cataracts) and went for that a few years ago. It isn't perfect but - for me at least - it was worth the risk. I do get issues with glares when it's dark but when it's bright there are no side effects. I also had to get a YAG laser treatment about a year later due to some 'clouding' but that not a big deal other than the expense.
When I last went for an eye test I was told I had 20/20 vision in one eye and I didn't believe the optician. I've long forgotten what 20/20 vision is like so maybe it's just overrated.
I can also never get cataracts!
HWR_14
There are new non laser surgeries either in the testing or just released stages. I only know about them because they were on HN in the past 6 months.
Easiest link I found: https://news.ycombinator.com/item?id=44938818
ceejayoz
I suspect the issue is less the "laser" bit than the "eye surgery" bit.
rr808
US has a few look at Vuity - which is for age releated.
alborzb
Vuity is just Pilocarpine -- https://en.wikipedia.org/wiki/Pilocarpine
Not something that is recommended for ordinary bad vision - as it mostly works to treat eye pressure (one particular type of age related vision correction).
basisword
I had a similar issue with lenses. Those appointments are hell and counter-productive. Firstly, it's a difficult thing to do under pressure. Secondly the more you attempt it the more your eyes get irritated and the more difficult it becomes. Eventually I managed to sort of just shove it in when the optometrist wasn't looking. Then they gave me some to take home and I was able to practice in a less stressful environment and finally got the hang of it. Saying that, if I stop for a while and then go back to them it can take a couple of days to get the reflexes to slow down again. If you can order a pack online without a prescription I'd say it's relatively safe to do that and practice at home provided they've already explained the hygiene basics and you know how to put them in/out, you're just having issues with the blinking.
atombender
Pilocarpine has been already approved in the US since 2021 under the trade name Vuity (pilocarpine hydrochloride 1.25%), which was discussed on HN [1]. Another version, Qlosi (pilocarpine HC 0.4%), was approved in 2023.
It seems that this formulation differs by adding naproxen, an NSAID. I'm not sure why they believe this is needed.
sroussey
Is this different from QLOSI?
russellbeattie
I'm nearsighted with simple myopia and most of my life I've used contacts for distance vision. I never had any problems reading close up with my contacts in. Then I turned 50, and within a year, I suddenly needed to use either reading glasses with my contacts or bifocal glasses in order to both see long distance and use a computer or my phone.
It wasn't a slow decline. One day my eyes worked like they had for my entire life, and the next my eyes went wonky. Getting older sucks! Without glasses, I can still read books and my phone just fine. I've just lost my "middle vision" of about an arm's length away.
Anyways, all my fifty-something peers are going through the same thing. It's a really inconvenient life change. I imagine something like this would be popular if it were more well known. My optometrist didn't say anything at all about it.
Side note: Laser surgery can only fix one type of vision problem. So if I were to go in to fix my myopia, I'd still have presbyopia (age related hyperopia), or vice versa. There doesn't seem to be a one-size-fits-all surgery for vision.
> The drops contain pilocarpine, a drug that constricts the pupils and contracts the muscle that controls the shape of the eye’s lens to enable focus on objects at different distances...
I wonder if using that might be dangerous for people with people with conditions that could lead to macular damage ... (by adding pressure)