Vuity Eye Drops for Presbyopia

Vuity Eye Drops for Presbyopia

We are no longer writing prescriptions for VUITYas there are an increasing number of reports of retinal detachments associated with use of the drops.


The FDA approved AbbVie’s VUITY (pilocarpine HCI ophthalmic solution) in October 2021, the only eye drops approved to treat presbyopia. Presbyopia is a progressive eye condition that makes it increasingly difficult to see near and affects billions of people around the world.

Presbyopia means you have difficulty seeing objects clearly that are close to you. It is a normal part of aging, and it happens to billions of people worldwide. It's not necessarily a medical problem, as it's a part of our natural aging process. Nonetheless, depending on how your vision changes over time, presbyopia can worsen your quality of life after you begin to notice it.

How does VUITY work for treating presbyopia?

Presbyopia is caused by an increasing lack of flexibility in the lenses of the eyes. The lenses sit just behind your pupils, and this stiffness makes it difficult to see things clearly up close. VUITY works by making your pupils smaller for a limited period of time so they can better focus on objects that are close to you, while maintaining good distance vision. The smaller pupils increase the depth of field allowing better near and distance vision simultaneously.  It's significantly more effective than placebo and it's well tolerated. The drop will improve near vision without the loss of distance vision.

VUITY contains pilocarpine hydrochloride 1.25% (12.5 mg) as the active ingredient. Pilocarpine is a medication that belongs to the class of medications called miotics – drugs that shrink the pupil of the eye.

How is VUITY dosed?

VUITY eye drops are given into each eye once daily. Only one drop of Vuity is needed per eye.

Why is FDA approval important?

It's the first eye drop that can be used to treat presbyopia. No other medications have been approved or used to treat this condition. The most common way to treat presbyopia is through eyeglasses such as bifocals or progressives. Depending on your needs, different types of glasses or contacts may be used to correct close-range vision problems.

How effective is VUITY?

FDA studies found that Vuity significantly improved short-range vision compared to the placebo after 30 days of use. These effects were studied in low level light conditions, or conditions that are about midway between daylight brightness and darkness found at nighttime.

Some patients find the drops to be helpful for their needs, others find that the side effects and cost outweigh any perceived benefit.

Read recent review in Good Housekeeping about one couple's experience using Vuity.

Elisabeth Egan wrote another review using Vuity eye drops in the New York Times.

Can VUITY drops be used with contact lenses?

You can certainly use the drops if you are a contact lens wearer.  You may find your reading improves if you have borderline presbyopia and you're wearing single vison contact lenses for distance.

If you are currently wearing multifocal contact lenses, you may find that your distance vision may be compromised as your pupils will be come smaller and you won't be able to see through the distance portion of the lens.  The only way to definitively know is to try the drops with your current contact lens prescription and see how your vision is affected.

If you are wearing monovision contacts for reading, your experience will probably be similar to wearing glasses or single vision contacts.

When using the drops be sure to remove your contact lenses first, instill the drops, wait ten minutes and then put your contacts back in.

When first trying the drops, take the time to test them out when you're in a safe place and don't need to use your vision for any important tasks like driving or reviewing important documents.

What are the known side effects of VUITY?

The most common side effects found in about 15% of patients were headaches and conjunctival redness. Less common side effects that occurred  included blurry vision at distance and near, blurry vision at night. eye irritation, eye pain and watery eyes.  There are an increasing number of reports of retinal detachments using the drops. 

What are the contraindications to using VUITY?

Other miotic drugs, similar to Vuity, have been linked to rare incidences of retinal detachment when administered to patients with certain risk factors, such as underlying retinal illness.

Vuity should not be used by patients who are highly myopic.  Myopic patients have a greater chance of developing retinal detachments.

Patients who have a sudden loss of eyesight should be encouraged to seek medical attention right once.

Adhesions (synechiae) can form between an inflamed iris and the lens when VUITY is used.  Therefore patients with chronic iritis or uveitis should not use Vuity.

Before using VUITY, contact lens wearers should remove their lenses and wait 10 minutes before re-inserting their contact lenses.

Avoid contacting the dispensing bottle to the eye or any other surface in order to avoid eye injury or contamination.

How much will VUITY cost?

The drops currently cost about $87 for a 2.5 ml bottle which should last for about 50 drops, or about one month of daily use when used in both eyes.  The cost is not covered by medical insurance.

How can I get a prescription for VUITY?

Vuity is not an over the counter eye drop.  It's only available with a prescription.  To obtain a prescription for the drops, you need to make appointment to have your eyes examined.  The doctor needs to determine your current prescription and to evaluate the health of your eyes to make sure you don't have any of the conditions that would make using this drop unsafe.  Call our office or make an online appointment for a complete eye examination.

Important Safety considerations when using VUITY

Do not use VUITY if you are allergic to any of the ingredients.

Use caution with night driving or with hazardous activities performed in low light conditions.

Temporary difficulty in adjusting focus between near and distance objects may occur.

Do not drive or use machinery if vision is not clear.  Patients should be warned about the dangers of night driving and other potentially dangerous activities in bad light.

Miotics can also trigger accommodative spasms. If your eyesight is blurry, you should not drive or operate machinery.

Seek immediate medical care if any sudden vision loss occurs.

If you wear contact lenses, they should be removed prior to VUITY use and can be reinserted 10 minutes after dosing.

Do not touch the dropper tip to any surface to help avoid contamination.

If more than one topical eye medication is being used, they should be administered at least 5 minutes apart.

The most common side effects are headache and eye redness.

VUITY is the first and only medication that can be used to treat presbyopia. Presbyopia is a normal part of aging that can affect your near vision.

VUITY is a once-daily eye drop that can only be obtained with a prescription after seeing an eye doctor.