Death, Taxes, and Mosquitoes

Published October 4, 2025

Morning Report — Not Your Typical Medical Newsletter

We get it, you see a lot of medical newsletters, so hear us out. Once a month, we’ll highlight important medical news sprinkled with witty commentary, fun facts, giveaways, and more… because learning should be fun! Subscribe to receive the Morning Report directly. 

Researchers Drop New Fix for Presbyopia 

OPHTHALMIC OUTCOMES

Advancing age inevitably brings perspective, persistent AARP mail, and the unsettling discovery that your arms are too short to read a book. The current treatment options for presbyopia are limited: eyeglasses or surgery (for those eligible). But now, far-sighted researchers have proposed a third option—twice-daily eye drops combining pilocarpine and diclofenac.

One such researcher, Dr. Giovanna Benozzi, led a retrospective study in line with the family vision plan; her late father, Dr. Jorge Benozzi, developed the eye drops a generation ago. In an analysis of 766 patients (average age 55), participants received formulations with 1%, 2%, or 3% pilocarpine plus a fixed amount of diclofenac. Patients took the drops upon waking and then six hours later, with an optional third dose as needed.

Clear results

An hour after the first dose, text on the near-vision chart popped like a Vegas marquee. On average, participants gained 3.45 lines, with 99% of the 1% pilocarpine group hitting optimal near vision, and more than 80% of all groups maintaining functional vision at one year.

Safe at first glance 

Prior concerns about pilocarpine’s safety did not materialize during the two-year follow-up. Side effects were mild and fleeting—dim vision, brief irritation, or headache. Crucially, investigators recorded no serious complications such as elevated intraocular pressure or retinal detachment.

Key takeaways 

These findings captured attention among wide-eyed ophthalmologists at last month’s Congress of the European Society of Cataract and Refractive Surgeons. Whether patients will shed their glasses like in a '90s rom-com makeover montage is uncertain. The degree of benefit hinges on baseline vision, and only longer, prospective trials can prove lasting safety. Still, Dr. Giovanna Benozzi points to more than a decade of successfully treating patients at her center and says that, in her view, “eye care professionals now have an evidence-based pharmacological option that expands the spectrum of presbyopia care beyond glasses and surgery.”

For more education on vision concerns, check out this CME activity: Common and Urgent Eye Complaints in Primary Care

Repurposing an Antihistamine for COVID-19 Prevention 

COVID COMPENDIUM

Shortcuts usually backfire—ask Elizabeth Holmes, Gordon Gekko, or the parents who turned college admissions into a felony. In medicine, we don’t trust “quick and easy”—but when the pandemic hit, the long game wasn’t an option. Instead of inventing new drugs, we asked, "What do we already have"? Now, a nasal antihistamine approved back in 1996 shows promise in COVID-19 prevention.

Azelastine—more than just a spring fling?

Early in the pandemic, azelastine—a go-to antihistamine for seasonal allergies—sparked preclinical buzz after lab studies hinted it could block viral entry and suppress replication of SARS-CoV-2 in nasal tissue. After a handful of small pilot trials, researchers in Germany rolled out a randomized, placebo-controlled study, recently published in JAMA Internal Medicine. In this trial, 450 healthy adults—nearly all vaccinated—used azelastine or placebo three times daily for eight weeks. The azelastine group logged fewer COVID-19 infections (2.2% vs 6.7%), cleared the virus faster (3.4 vs 5.1 days), and reported fewer illness days overall.

Promising, but preliminary

That said, the study has limitations: a relatively young, healthy cohort; modest sample size; and single-site design. Azelastine isn’t yet approved for COVID-19 prevention, and no clinical guidelines endorse its use. And the dosing—three sprays per nostril, daily—may be better suited to research volunteers than to real-world patients.

Key takeaways

“Our findings suggest azelastine could serve as a scalable, over-the-counter prophylactic against COVID, especially when community transmission is elevated,” said senior author, Dr. Robert Bals, who also emphasized that it’s not a substitute for vaccinations. Outside experts praised the study design, with Dr. William Messer (OHSU) calling the findings “reasonably convincing”—which, in academia, amounts to a standing ovation. Beyond reducing COVID-19 infections threefold, azelastine cut overall viral infections by a relative 10%. Still, not everyone’s sold. Dr. Peter Chin-Hong (UCSF) said the spray may be helpful for patients with allergies, but the current evidence isn’t quite strong enough to support broader use.

To learn more about this study, check out this Frankly Speaking about Family Medicine podcast.

Interested in more healthcare news? Here are some other articles we don’t want you to miss:

• Vitamin B3 can help protect against skin cancer. Here’s who may benefit
• Can the oral microbiome help predict pancreatic cancer risk?
• Huntington’s disease successfully treated for first time
• Dietary omega-3 polyunsaturated fatty acids as a protective factor of myopia: the Hong Kong Children Eye Study
• Study suggests most Americans would be healthier without daylight saving time
• Switching off just one protein could reverse brain ageingand prevent Alzheimer’s, study finds
• The mechanosensitive adhesion G protein-coupled receptor 133 (GPR133/ADGRD1) enhances bone formation
• Vericiguat and mortality in heart failure and reduced ejection fraction: the VICTOR trial