Reading glasses are a necessity for almost everyone over age 50, but a newly approved eye drop promises to make them obsolete. We reached out to Michael J. Shumski, MD, MSE, a cataract and refractive surgeon at Magruder Laser Vision, to find out if Vuity (pilocarpine hydrochloride ophthalmic solution 1.25%) lives up to the hype. Pilocarpine has been used as a glaucoma medication for many decades, but this is a new indication.

What is Vuity?

Starting in the mid-40s the natural lens inside the eye starts to stiffen, resulting in a loss of one’s range of vision. This is called presbyopia, and it’s why we eventually all need reading glasses. Some people become bothered by these symptoms in their mid-40s, while others make it a little longer until closer to 50. This is a natural part of aging and eventually happens to everyone.

Vuity works by constricting the pupil, which causes a pinhole effect. (It’s similar to squinting to see better.) When peripheral light rays are blocked from making their way to the retina, and central light rays don’t have to be refracted as much by the cornea and lens, the depth of focus is extended. To benefit from Vuity, you must have good uncorrected distance vision. The drops then extend that range of vision to include intermediate and near vision without the need for reading glasses.

Implications for cataract surgery

When you have cataract-removal surgery, you are usually offered the option to replace your natural lens with one that corrects your vision. This is called an intraocular lens (IOL). Vuity does not change the prescription of the eye, so it should not be considered as an alternative to an upgraded IOL. However, if you have already had cataract surgery and are happy with your distance vision, you may be a good candidate for Vuity to replace your reading glasses.

Things to watch out for

When using Vuity, be cautious when driving at night or working in poor illumination. Don’t drive or use machinery if your vision isn’t clear. If you wear contact lenses, wait 10 minutes after administering the eye drop before inserting the contacts. If you have an increased risk of retinal detachment or iritis, you may need to take additional precautions. One of the most common side effects of Vuity is a mild headache.

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