New Medications for Dry Eye and Presbyopia - Scorecard - MDSpire

New Medications for Dry Eye and Presbyopia

Topical miotics are approved for use in all adults with presbyopia, including post-LASIK patients and pseudophakes, and acoltremon is a treatment option for multiple dry eye subtypes, either as primary therapy or adjunctive treatment.

  • By

  • Sarah Fackler, managing editor, Optometric Management

  • January 1, 2026

  • 4 min

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Clinical Scorecard: New Medications for Dry Eye and Presbyopia

At a Glance

CategoryDetail
ConditionDry Eye Disease and Presbyopia
Key MechanismsTopical prescription therapies targeting TRPM8 receptors and cholinergic pathways.
Target PopulationAdults aged 30 years and older, including post-LASIK patients and pseudophakes.
Care SettingOphthalmology clinics and outpatient settings.

Key Highlights

  • Pilocarpine 0.4% shows significant improvement in near visual acuity.
  • Aceclidine 1.44% has rapid onset and high selectivity for iris sphincter activity.
  • Acoltremon 0.003% effectively stimulates tear production in dry eye patients.

Guideline-Based Recommendations

Diagnosis

  • Assess visual acuity and perform ocular surface evaluations.

Management

  • Consider pilocarpine, aceclidine, or acoltremon based on patient needs.

Monitoring & Follow-up

  • Monitor for adverse events and visual acuity improvements.

Risks

  • Classwide warnings include blurred vision and caution with night driving.

Patient & Prescribing Data

Adults with presbyopia and dry eye disease.

Topical miotics are approved for all adults, including those with inadequate response to other treatments.

Clinical Best Practices

  • Remove contact lenses before instillation and wait 10 minutes before reinsertion.
  • Conduct retinal examination prior to initiating miotic therapies.

References

Original Source(s)

New Medications for Dry Eye and Presbyopia

  • by Sarah Fackler, managing editor, Optometric Management

  • January 1, 2026

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