{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T06:03:30Z","timestamp":1789193010419,"version":"build-2803163510"},"reference-count":104,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T00:00:00Z","timestamp":1708473600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Tistou and Charlotte Kerstan Foundation","award":["Vision 2000"],"award-info":[{"award-number":["Vision 2000"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Presbyopia is an age-related ocular condition, typically affecting individuals aged over 40 years, characterized by a gradual and irreversible decline in the eye\u2019s ability to focus on nearby objects. Correction methods for presbyopia encompass the use of corrective lenses, surgical interventions (corneal or lens based), and, more recently, the FDA-approved topical administration of 1.25% pilocarpine. While prior research has demonstrated the efficacy of daily pilocarpine eye drop application in enhancing near visual acuity by increasing the depth of focus leveraging the pinhole effect, limited knowledge exists regarding its influence on visual acuity under varying conditions of contrast and ambient luminance. Methods: This study aims to investigate the impact of these variables on visual acuity, employing the VA-CAL test, among 11 emmetropic and 11 presbyopic volunteers who reported subjective difficulties with near vision. This study includes evaluations under natural conditions with a pinhole occluder (diameter of 2 mm), and subsequent administration of 1% pilocarpine (Pilomann, Bausch + Lomb, Laval, Canada). Results: The VA-CAL results demonstrate the expected, statistically significant effects of contrast and ambient luminance on visual acuity in both emmetropic and presbyopic volunteers. Furthermore, in emmetropic individuals, the application of pilocarpine resulted in a statistically significant reduction in visual acuity. In contrast, presbyopes did not exhibit statistically significant differences in the visual acuity space under either the pinhole or pilocarpine conditions when compared to natural conditions. Conclusions: The pharmacological treatment of presbyopia with pilocarpine eye drops, intended to enhance near vision, does not adversely affect visual acuity in presbyopes. This suggests that pilocarpine may offer a viable alternative for individuals averse to wearing corrective eyewear.<\/jats:p>","DOI":"10.3390\/jcm13051209","type":"journal-article","created":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T04:23:10Z","timestamp":1708489390000},"page":"1209","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effects of Miosis on the Visual Acuity Space under Varying Conditions of Contrast and Ambient Luminance in Presbyopia"],"prefix":"10.3390","volume":"13","author":[{"given":"Maksymilian","family":"Onyszkiewicz","sequence":"first","affiliation":[{"name":"Institute for Ophthalmic Research, University of Tuebingen, 72076 Tuebingen, Germany"},{"name":"Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-059 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Hilmers","sequence":"additional","affiliation":[{"name":"Institute for Ophthalmic Research, University of Tuebingen, 72076 Tuebingen, Germany"},{"name":"STZ Eyetrial, University Eye Hospital Tuebingen, 72076 Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Rejdak","sequence":"additional","affiliation":[{"name":"STZ Eyetrial, University Eye Hospital Tuebingen, 72076 Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eberhart","family":"Zrenner","sequence":"additional","affiliation":[{"name":"Institute for Ophthalmic Research, University of Tuebingen, 72076 Tuebingen, Germany"},{"name":"University Eye Hospital Tuebingen, 72076 Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7725-7961","authenticated-orcid":false,"given":"Torsten","family":"Stra\u00dfer","sequence":"additional","affiliation":[{"name":"Institute for Ophthalmic Research, University of Tuebingen, 72076 Tuebingen, Germany"},{"name":"Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-059 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1016\/S0002-9394(22)90793-7","article-title":"Studies in Monocular and Binocular Accommodation with their Clinical Applications","volume":"5","author":"Duane","year":"1922","journal-title":"Am. 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