Toni Wright, 54, a beauty industry professional from Pittsburgh, Pennsylvania, was forever squinting at her computer screen and cellphone. In restaurants, especially those with low lights, she was the one holding the menu as far away as her arm could reach. Diagnosed with presbyopia — age-related blurred near vision — when she was 50, Wright says, “I needed to have reading glasses with me at all times and almost panicked if I didn’t.”
Presbyopia is estimated to affect 2 billion people globally, according to the American Academy of Ophthalmology (AAO). But there is good news for all the squinters among us: In October, the U.S. Food and Drug Administration (FDA) approved the first (and so far, only) eye drops that treat presbyopia. The eye drops, called Vuity, contain pilocarpine, which has been used for around 120 years to treat glaucoma. This is the first formulation to target presbyopia specifically.
Allergan, a subsidiary of AbbVie, rolled out Vuity on Dec. 9. Available by prescription only, Vuity works very simply. Itslightly reduces pupil size by constricting certain muscles, explains AbbVie advisory board consultant Marguerite McDonald, M.D., a clinical professor of ophthalmology at both New York University and Tulane University. The constriction allows for improved up-close vision. Approved for use once daily, it works for up to six hours. It costs about $86 for a 2.5 milliliter bottle (about a 30-day supply), depending on the pharmacy you visit.
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Wright, who participated in the clinical trial for Vuity, would put the drops in her eyes in the morning, and she found that the effect kicked in by the time she got to work. McDonald says, on average, it should start working within 15 minutes. “I could see on my computer without struggling or needing glasses, and it lasted throughout the workday,” Wright reports. She says she felt no negative side effects. Vuity reports that users may experience temporary problems when changing focus between near and far objects.
In its development of the drops, the company found that participants achieved a “three-line gain or more reading a near-vision eye chart without losing more than one line in a distance vision eye chart at Day 30, three hours after dosing.”
“We know a great deal about the active compound pilocarpine. It was used in higher concentrations and it's very safe,” McDonald says. She adds that the drops can be used with contact lenses, but as with all eye medications, users should wait 15 minutes after application before inserting lenses. If using other eye drops, wait five minutes between different applications.
Steven Plotycia, M.D., an ophthalmologist affiliated with Mount Sinai Medical Center in New York, warns that the drops may not work for everyone with presbyopia. “The ideal patient for these drops are people in their 40s to 50s who don’t want to wear reading glasses. The age group is old enough to have developed presbyopia but young enough that they would not have started developing cataracts,” he explains. Cataracts are lenses that have started to yellow, restricting the amount of light that gets in, making vision appear darker. Since Vuity acts by constricting the iris, limiting the amount of light that hits the lens, cataract patients will find that the drops make their vision appear even darker. They would have a lot of trouble driving at night or in other situations where light is low.
“The significance of this FDA approval is massive. Glasses, contact lenses, and surgery are traditional treatments, but, for various reasons, do not work well for every patient. Having a novel treatment option in the form of a presbyopia eye drop is a welcome addition to our armamentarium against this universal age-related near vision condition that effects essentially everyone over the age of 40,” says Christopher Starr, M.D., clinical spokesperson for the AAO.
Nine similar eye drops for presbyopia are in development and may be available in the future.
Beth Levine is a health writer whose work has appeared in O: The Oprah Magazine, Woman's Day, Good Housekeeping, Reader's Digest and many more.