Accommodative Spasm Temporary problems when changing focus between near objects and distant objects may occur. Advise patients not to drive or use machinery if vision is not clear. [see Warnings and Precautions (5.1)] When to Seek Physician Advice Advise patients to seek immediate medical care with sudden onset of vision loss.
Another issue is loss of night vision- makes sense since your pupil is constricted and the natural response of the eye to dilate in low light is impeded.
Also, there is some risk of retinal detachment from pilocarpine.
I agree with Dew’s assessment- not likely to be a big seller.