Ask an Optometrist: Can the New Prescription Eyedrops for Presbyopia Replace My Reading Glasses?

Interested in looking for a different way to read menus and labels without readers? Here’s an overview of your latest options.

Person using eye drops

If you’re tired of wearing, losing, or borrowing reading glasses — or you just want to delay buying a pair — you might be curious about the new prescription eyedrops that offer a short-term fix.

The product, called Vuity™ (pilocarpine hydrochloride ophthalmic solution) 1.25%, by Allergan, was approved by the FDA in 2021. And since then, Raul Ramos, O.D., has seen some interest in it.

“It’s exciting to hear about a new option for age-related farsightedness, or presbyopia, but these eyedrops aren’t for everyone,” says Dr. Ramos. He’s an optometrist with South Florida Regional Eye Associates, located within America’s Best Contacts & Eyeglasses in Miami.

Here’s how to decide whether they’re worth chatting about with your optometrist.

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How often are these eyedrops needed?

Vuity is approved for use once a day, placing one drop in each eye. It’s available only with a prescription from your optometrist, which can be filled at pharmacies nationwide.

“The active ingredient in Vuity, which is pilocarpine, is not new,” adds Dr. Ramos. “It’s been used for many years to treat glaucoma. Vuity was formulated with a different concentration and inactive ingredients.”

These drops usually start working after about 15 minutes and last about six hours.

“This is an estimation, and everyone is different,” says Dr. Ramos. “However, most people will experience effects for up to six hours as indicated.”

The effects are most noticeable in the first hour and then start to wear off slowly, he adds. It’s not like turning the lights on and off.

How do the eyedrops work?

Vuity works in two ways, says Dr. Ramos.

It makes the pupil smaller. These eyedrops affect the iris — the colorful part of the eye — by targeting cells called receptors.

The receptors react by making the eye’s pupil get smaller. (It’s the opposite of what happens when you get eyedrops for a dilated eye exam.) When the pupil is smaller, you can see objects at a wider array of distances, including near your face.

“It’s like looking through a pinhole in a piece of paper,” says Dr. Ramos. “When you do that, you can see better up close.”

It makes the eye muscles flex. The eyedrops also cause the ciliary muscle in the eye to contract or squeeze.

When your eye has to change focus (near to far, or far to near), this muscle contracts and relaxes as needed. When it contracts, the lens of the eye becomes rounder, and when it releases, the lens becomes flatter.

As we age, this muscle starts to weaken, and so does our close vision. Vuity helps this muscle by forcing it to contract, which shifts the lens of the eye into a rounder shape. This is better suited to viewing things up close.

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Can these eyedrops replace my reading glasses?

If any of these statements apply to you, the eyedrops might help. But Dr. Ramos says it’s important to talk with your optometrist about what’s best for you. (You’ll have to anyway, as these are available only by prescription.)

You’re in your 40s or early 50s. Vuity was designed for adults over the age of 40. In fact, in the study on Vuity, the patients were 40 to 55 years old.

Why the age limit? People tend to notice changes in close vision in their 40s. But by age 55 or older, your prescription would likely be strong enough that you’d need reading glasses even with the eyedrops.

You have good distance vision. If you’re in the above age range and don’t need glasses or contact lenses for distance, you might be able to avoid getting “cheaters” (reading glasses) if you use these eyedrops, says Dr. Ramos.

You need help with distance vision. Good news: These drops may allow some patients in their 40s and early 50s to avoid having to juggle two pairs of glasses, wear contacts and readers, or try different contact lenses or eyeglass lenses that can correct for both types of loss.

Your reading glasses are lower than +2.50. If you need more power than that, the eyedrops won’t correct your vision enough to be helpful. (You’d need readers anyway.) But there are other options besides reading glasses, such as monovision or progressive contact lenses or progressive eyeglass lenses. For more information, read “How to Decide if Your Next Eyeglasses Should Be Multifocal” here.

Are there any reasons I might want to use another type of vision correction?

The short answer is yes. Here are a few reasons you might want to stick with your reading glasses instead.

These eyedrops have side effects. Two of the most common ones are headaches and eye redness.

The headaches, which can last the whole time the drops are working, have been described as an eyebrow or forehead headache.

Of course, you can take over-the-counter headache medication or use artificial tears to counter these effects. “But once you start having to use one drug to fix side effects of another, it may make more sense to try something else,” says Dr. Ramos.

You may still need glasses. As mentioned earlier, depending on your prescription for reading glasses, the drops may not do enough good to make a difference. And if you need contacts or glasses for distance, you’ll definitely need to keep those too. (If you do wear contact lenses, you’ll need to wait 10 minutes between using Vuity and putting in your lenses.)

The eyedrops are not usually covered by insurance. A bottle of Vuity costs about $79 for eligible patients, and you can earn rewards points through Vuity to score coupons and even a free bottle. (Of course, you’ll need to read the fine print on the Vuity website, as prices and deals can change over time.)

The good news is you don’t have to use Vuity every day. You might just want it when you go out to lunch, for example, or you have a lot of reading to do for work. So depending on your needs, that bottle may last more than a month.

They shouldn’t be used at night. Vuity shrinks the pupil, which is the part of the eye that lets in light. At night, your pupils get bigger to help you see better in the dark. But if you’re using Vuity, your pupils will be stuck in pinhole mode. That’s not safe, especially when driving. So these drops aren’t the best choice if you do lots of close work at night (such as reading or sewing before bed).

They may be risky with certain health issues. Vuity may increase the risk for a detached retina. Therefore, it is not recommended for those who are at high risk for a detached retina — or for those who have had a detached retina. Other conditions may be affected too, says Dr. Ramos. Always share your full medical history with your optometrist at every exam.

Is there anything else I should know before asking my optometrist about vision correcting eyedrops?

“Always have realistic expectations,” says Dr. Ramos. That starts with being clear up front with why you want to try the drops (for reading a book, working at a computer, fine work such as sewing or tying fishing flies, etc.). And if you try the eyedrops and don’t like them, remember that you can always choose a different option.

“Your eye doctor will be happy to work with you to find a way to correct your vision that best meets your needs,” he says. “That’s what we’re here for.”