Presbyopia, or difficulty reading up close, hits almost all of us in our 40s. Now there’s an FDA-approved eye drop that may help you ditch your drugstore magnifiers for good.
In most ways, I’m fine with getting older. I’m 53, and don’t care that I have grays on what hair I have left or that I prefer hanging out at home with my wonderful, brilliant, desirable girlfriend (who, ahem, covers health at Good Housekeeping) to partying all night like I did in my 20s. Thanks to her, my life is perfect. (She’s sitting right next me.)
There is one aspect of getting older that I’m not fine with, however: reading glasses. They are incredibly annoying, and I never have a pair handy when I need them, even though between the two of us, we have readers on every surface in our home. I have 20/20 vision otherwise, so dealing with glasses is new to me — my presbyopia, which is a gradual loss of the ability to focus on things that are close up — began in my 40s. That’s typical. In fact, around 90% of people over age 45 has some degree of presbyopia, according to research.
So when I read about Vuity (while holding my phone two feet away from my face with the print enlarged), I was psyched! These drops are designed to address presbyopia, so users can see things up close without those glasses displayed on a rack at the drugstore. The research that led to Vuity’s FDA approval in October looked promising: A statistically significant percentage of users gained three lines on an up-close reading chart, without losing distance vision, according to clinical trials on 750 patients between ages 40 and 55.
The biggest reason I want to ditch reading glasses is because I spend a lot of time fixing things on my boat. The bilge is hot and dark and grimy, and I often need to hang upside-down like a bat to see inside the engine and figure out what isn’t connecting or what’s clogged up. I hate using my greasy black fingers to put my reading glasses on and off when I need to loosen a screw or whatever, and the worst is when they fall into the oily bilge water. So as soon as Vuity got approved, I signed up to try it.
How do Vuity eyedrops for presbyopia work?
Vuity works primarily by shrinking your pupil to the optimal size it needs to be to focus on things that are close, explains ophthalmologist Y. Ralph Chu, M.D., CEO of Chu Vision Institute in Bloomington, MD, and a principal investigator for the FDA approval of the drops. You put them in once a day and they kick in after 15 minutes; the strongest effects last up to six hours, and then start to fade.
Let me back up a sec and explain how eyes ideally work: When you’re young, the lens of your eye is flexible, and refracts when light enters it; a little muscle helps it to change shape as you focus on stuff that’s far away or up close. There’s also another tiny muscle that opens and closes your pupil, to allow the light in. Fast forward to that time of life when you have to hold the votive candle up to the menu — by then your lens is stiffer and so doesn’t refract as much, which means you can’t focus up close and things look blurry.
What Vuity does is kick both of those muscles (the one that shrinks your pupil and the one that bends your lens) into gear. “It’s a dual mechanism of action,” says Dr. Chu. For most patients, he says, the pin-holing of the pupil is what sharpens your up-close focus. “By making the pupil smaller you improve the reading vision because it increases the depth of focus,” he explains.
And people with a still-somewhat-flexible lens (that is, perhaps younger people whose up-close vision is just starting to blur) also get the benefit of more refraction. “It doesn’t freeze your pupil, so your eye can adjust to different lighting situations,” he says. For most people, it also doesn’t noticeably affect distance vision.
What kind of person is Vuity for?
Vuity works, to some degree, for anyone with presbyopia, but it works better for people who don’t yet need major magnifiers. “If you wear a higher power reader, you might not be able to read as small print as someone with a lesser power reader,” says Dr. Chu.
For example, someone who normally wears 1.00 magnification readers might be able to pop in some drops and 15 minutes later read the dosage instructions on a bottle of Advil. Someone like me, with a 2.00, might be able to see a price tag I couldn’t see before, but not the pill label.
How many hours you find Vuity helpful also depends on your vision to begin with, says Dr. Chu, since the strongest effects last for up to six hours. “If you’re 47 or 48 and wear 1.50 readers, you may get six great hours of ‘superhuman’ powers,” says Dr. Chu, referring to the ability to read perfectly without glasses (which does feel superhuman when you can’t do it anymore!). Over the next four or so hours, the effect fades, but you may still see well in front of a computer without glasses.
But if you wear a greater magnification, your first six hours might give you glasses-free computer work (as opposed to looking at your phone up close). Then, when the effect fades, you’ll need to put on your readers again. “If you’re 55, and wear a 2.5 reader, you may never get those ‘superhuman’ powers,” he says, but you may see better in a conference room.
Can anyone use Vuity?
There are very few contraindications, says Dr. Chu, but “We are cautious about prescribing it to people with a high degree of myopia,” he says. That is, if you are very nearsighted (or, like my otherwise perfect girlfriend, were very nearsighted before you had Lasik surgery) that should give you pause. The reason? The active ingredient, pilocarpine, is one of a class of drugs called miotics, which pose some risk of retinal detachment (although no one had that problem in the clinical trials, says Dr. Chu).
You also want to be careful using Vuity if you drive at night, because it can take longer than usual for your pupil to expand enough to let light in. “The drop is preventing the pupil from dilating, so when you go from light to dark, you may not be able to see as well,” he says.
But you can use Vuity with contacts (just wait 10 minutes before putting them in) and if you have to toggle between glasses for reading and glasses for distance, these drops can make your life easier. Ditto if you find progressives hard to get used to.
How long does Vuity last?
Vuity lasts up to six hours and then begins to gradually fade, but what that means to you depends on how well it works for you to begin with. I told Dr. Chu that I work at my computer most days for 8 or 10 hours — could I use it again once it starts to wear off?
“It hasn’t been tested for more than once-a-day use,” he answered, but he added that when it is, it will very likely be found to be safe. That’s because Pilocarpine is used safely at a much higher concentration some six times a day in patients with glaucoma. Some people, he says, will use it twice a day on occasion, if they have an evening event that they don’t want to wear glasses for.
What’s the price of Vuity and where can I buy it?
You need to see your eye doctor for a prescription and you can pick it up wherever you get your other meds, although since it’s so new they may need to order it. I paid around $75 for a 30-day supply at my local CVS, using the GoodRx app, which helps you find discounts, but how much it costs depends on where you buy it. Some have paid as much as $105. Vuity is not covered by insurance.
What are the side effects of Vuity?
Vuity’s side effects could include a minor headache, a slight burning when you first put the drops in, and eye redness, says Dr. Chu, but for most people these go away once you’ve used it for about a week. It also makes light a bit dimmer, so driving at night if you’ve recently put the drops in can be problematic. Talk to your doctor about other side effects.
So, did Vuity work for me?
The short answer is yes, it worked for me. The longer answer is, like everything in life as you get older, nothing is simple.
The drops were easy to use, and except for a minor “eyebrow headache,” the result of those two muscles I referred to earlier working overtime, I had no side effects. The headache only occurred for the first few days and lasted a couple of hours.
The first day, sure enough, after 15 minutes, I could read the instructions on the Vuity insert without my readers. My girlfriend, who also wears a 2.00 magnification, could not without her glasses. I had to hold the paper a few inches further out than I would with my reading glasses, but not at arm’s length, and I didn’t need to hold it under a lamp to see. Victory!
Later I left for work, and I was glad to have the drops in. I use a bike share, and in the winter normally I have to take off my gloves, find my glasses, put them on to check the phone app for a free bike, take my readers off, then get to the bike. Then I have to put my helmet on and remember to put away my glasses before putting my gloves back on. (See how annoying readers are?) When I pull up near the office, I have to take off my gloves and get my glasses out to check the app for an available dock for the bike. It was a lot easier — and my hands stayed warmer — not having to deal with my readers. Around five hours later, I needed my glasses to read again.
A few days later, though, I came in from walking the dog in the bright sun, and it seemed really dark in the elevator — I actually wondered if something was wrong with me! Then I remembered that my pupil was artificially small because of the drops, so not enough light could get in. Eventually my eyes adjusted to the indoor light again. That day, my up-close vision was good for five hours as well.
This is how it went over next week or so — the drops kicked in after around 15 minutes, which meant I didn’t have to wear reading glasses for four, sometimes five hours. Which was awesome. But toward the end of that five hours, the effect would fade and I’d have to start reaching for my readers. And going outside in the bright sunlight, it almost seemed like I was wearing sunglasses, it was so dim. By evening, I needed my readers to beat my girlfriend at Wordle.
My bottom line: Vuity worked as advertised, and I will continue to use them on days when I can plan all my close work for one four or five hour period. That may help for fixing stuff on my boat. But if you do close reading a lot of the time, as I do — and your presbyopia is as bad as mine — they may not be the answer to everything.