Innovative Treatment for Aging Eyes and Blurry Near Vision

By the time you start holding your cellphone at arm’s length from your eyes, you probably own a pair of reading glasses. 

As you age, the lenses within your eyes become less flexible. This makes you unable to focus as well as you used to do on nearby objects. 

This gradual loss of near vision, and the blurry vision it causes, is called presbyopia. The condition usually becomes noticeable in your early to mid-40s and worsens until around age 65. Typically, it can be corrected with reading glasses, bifocals, or contact lenses. 

Now there’s a new and innovative way to treat the condition — with eye drops. In October 2021, the FDA approved VUITY, the first eyedrops for presbyopia. This modified form of pilocarpine hydrochloride ophthalmic solution, a traditional treatment for glaucoma, is optimized to increase its effectiveness and tolerability while reducing the risk of side effects.

What do VUITY eyedrops do?

VUITY works by constricting the pupil. Decreasing the pupil size increases the depth of focus. “This means that more images at varying distances will come into focus (i.e., distance and near images may be more clear at the same time),” says Kendall Donaldson, M.D., an ophthalmologist at the Bascom Palmer Eye Institute. 

“We could potentially demonstrate this by looking through a pinhole to observe the clarity of images at distance, intermediate, and near as compared to vision without a pinhole.”

Does this mean you can forget about reading glasses?

Applied once a day in both eyes, VUITY can temporarily improve near vision within 15 minutes, and the benefits may last up to six hours. The medication’s effectiveness is based on the severity of your presbyopia, which is based on your natural lens flexibility.

“These eyedrops allow patients to see approximately three lines of print smaller than they would see without them,” Dr. Donaldson says. This may enable patients in the earlier stages of presbyopia (ages 40 to 55) to read without being dependent on reading glasses. Patients in later stages of presbyopia (age 55 and older) may experience some improvement in their near vision, but it may not be sufficient to read the very small print. 

Once the medication’s effect wears off (after approximately six hours), you’ll still need to wear corrective lenses until you take the following day’s dose. “However, it can allow you to go out to dinner without carrying a pair of reading glasses. So, it can have some very practical uses,” Dr. Donaldson says.

VUITY isn’t right for everyone.

Anyone considering this form of vision correction should discuss their particular situation with their eye care professional.

“A patient may not be an ideal candidate if they are too presbyopic,” Dr. Donaldson says. “This typically occurs in someone experiencing the later stages of presbyopia (i.e., age 55 and older).” Patients similar to those who were studied for the drug’s FDA approval should expect the best results. Those include patients ages 40 to 55 with low-to-no distance prescription and no other eye diseases.

“There are a variety of other studies being considered to evaluate the effectiveness and benefits of VUITY in other subgroups of patients to build upon the FDA trial data,” he says. “This may include patients that have previously undergone cataract surgery. We are looking forward to learning more about the medication, as it is now readily available to providers and our patients.”

There were no serious adverse events observed in participants receiving VUITY. The most common adverse events were headaches and eye redness, and most patients were still able to continue treatment.

Dana Kantrowitz is a contributing writer for UMiami Health News.

Tags: Bascom Palmer Eye Institute, Dr. Kendall Donaldson, eye relief, improved sight