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Presbyopia is finally meeting its match in-clinic with Qlosi™ presbyopia eye drops (pilocarpine 0.4%), offering a practical, performance-based option alongside glasses, contact lenses, and surgery. In this episode, Dr. Jennifer Lyerly and Dr. Derek Cunningham discuss how to position presbyopia drops for success, including who to treat, how to dose, what to say chairside, and why athletes appreciate the functional freedom.
Table of Contents
Why Presbyopia Drops Now?
Modern presbyopes want flexibility, not just prescriptions. Qlosi offers a solution to reduce dependence on readers or multifocals for everyday tasks, without promising a return to youthful accommodation. Framed correctly—as functional freedom for specific times of day—presbyopia eye drops expand the toolbox and increase patient satisfaction.
Clinical takeaway: lead with “less dependence” and “more usable near vision,” not “no glasses ever.”
Setting Expectations (and Avoiding the In-Office Trial)
Success hinges on expectation management and neuroadaptation. Dosing cadence: Start with one drop in each eye, then apply a second drop in each eye two to three hours later, as discussed in the podcast. Adaptation period: Encourage consistent use for 8–10 days to allow the brain to adjust to the extended depth of focus. Functional goals: Target comfortable vision for tasks like reading a phone, menus, or dashboards, not fine print. Avoid single in-office “trial drops.” Real success is based on functional adaptation over a short course, not a one-time test. Remember that if patients experience any issues, concerns, or adverse events with their drops, encourage them to consult their physician.
Safety and Candidacy
Two steps help ensure patient safety and confidence. Perform and document a peripheral retinal evaluation before initiating presbyopia drops. Avoid treating high myopes or patients with lattice degeneration until more safety data are available. Qlosi’s low pilocarpine concentration (0.4%) minimizes ciliary body stress and related concerns. Educate patients to report new flashes or floaters immediately.
Side Effects to Discuss Up Front
Proactive education reduces callbacks and discontinuation. Mild frontal headache occurs in approximately 6% of users and is often transient. Instillation burning or stinging occurs in single-digit percentages and is typically short-lived. About 1% discontinue use, consistent with other topical ocular therapies.
Normalize expectations: “You may feel mild stinging or a brief headache the first couple of days, which usually resolves with continued use.”
Performance Framing: Let Patients Decide
Presbyopia management is personal. Two patients can have identical results yet rate satisfaction differently. Treat Qlosi as a performance enhancer for near vision improvement, not a one-size-fits-all solution. Offer to all appropriate presbyopes after safety screening. Focus on binocular, real-world tasks over tiny print. Reassess after the adaptation period and simply ask, “Did it make your day easier?” Patients who say yes have found a tool that improves their near vision.
Practice Integration and Business Impact
Adding presbyopia eye drops to your standard discussion (“glasses, contacts, surgery, and drops”) positions your practice as innovative and patient-focused. It enhances your reputation for modern care, increases interest in surgical options for those seeking more permanent correction, and encourages additional eyewear purchases as patients appreciate the complement between functional drops and dedicated near or computer glasses. Qlosi distribution through eye care–specific pharmacy channels ensures accurate screening and consistent patient education.
Sports Vision Benefits
Athletes and active adults are a perfect demographic for presbyopia drops. Pickleball and golf players maintain outdoor clarity with sunglasses while reading scorecards afterward. Target and tactical athletes can simplify task-specific eyewear setups. Frame Qlosi as an option that helps patients enjoy sharper near vision for the moments that matter most.
Implementing Qlosi in Practice
Update your presbyopia discussion to include drops. Conduct and document retinal health checks. Explain dosing and adaptation clearly: first drop, second drop 2–3 hours later, consistent use for 8–10 days. Define success as functional vision improvement, not total spectacle independence. Schedule a two-to-three-week follow-up to discuss near vision outcomes.
Qlosi™ presbyopia eye drops offer an adaptable and functional way to enhance near vision when expectations are appropriately managed. Introduce the option early, communicate clearly, and empower patients to make informed decisions based on their own experiences.
INDICATION
QLOSI is a cholinergic agonist indicated for the treatment of presbyopia in adults.
IMPORTANT SAFETY INFORMATION
CONTRAINDICATIONS
Hypersensitivity
WARNINGS AND PRECAUTIONS
Advise patients to not drive or operate machinery if vision is not clear (e.g., blurred vision). Exercise caution in night driving and other hazardous occupations in poor illumination.
Rare cases of retinal detachment have been reported with miotics. Examination of the retina is advised in all patients prior to initiation of therapy. Advise patients to seek immediate medical care with sudden onset of flashes of lights, floaters, or vision loss.
QLOSI is not recommended to be used when iritis is present.
QLOSI should not be administered while wearing contact lenses. Remove lenses prior to the installation of QLOSI and wait 10 minutes before reinsertion.
Avoid touching the tip of the vial to the eye or any other surface.
ADVERSE REACTIONS
The most common adverse reactions (5% to 8%) are instillation site pain and headaches.
For full prescribing information on Qlosi, visit qlosiECP.com
