Monday, January 3, 2022

How does Vuity (Pilocarpine HCl 1.25%) Eye Drop Works?

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Recently, a lot of my patients have been asking about the newly FDA-approved vuity eye drop made by Allergan. Vuity is a prescription eye drop that contains 1.25% pilocarpine as its active ingredient.


Mechanism of Vuity (Pilocarpine)

Pilocarpine temporarily improves near vision through two mechanisms.

1. Temporarily Stimulates Contraction of the Ciliar Body Muscle to shift the eye into a more nearsighted state

First off, if your lenses still have any residual elasticity, Pilocarpine will stimulate contraction of the ciliary body muscle to shift your eyes into a more nearsighted state as I mentioned earlier, temporarily improving near vision.

2. Temporarily Constricts the Pupil and Creates a Pinhole Effect

The second and main way that vuity affects near vision is by stimulating the parasympathetic muscles in the iris to constrict the pupil which creates a pinhole effect. You may likely be experienced the pinhole effect yourself when you go to your eye doctor's office and have your vision checked with one of these.


This is called an occluder. You may have noticed that when you look through one of the small holes with the flap down, you see more clearly. This phenomenon is called the pinhole effect.

Pilocarpine constricts the pupil size causing a pinhole effect. Pilocarpine was initially approved by the FDA in 1974 to treat glaucoma or to constrict the pupil when needed for eye exams or eye surgeries.

Vuity (Pilocarpine) for Presbyopia

Vuity contains 1.25% pilocarpine and was recently approved by FDA in October 2021 for the treatment for Presbyopia. It is dosed at one eye drop in each eye once a day. According to the clinical trial data from the Gemini 1 and 2 studies, the effect of near vision improvement from vuity eye drop can be seen as early as 15 minutes after applying the eye drop and can last up to 6 to 10 hours. 

Side Effects of Vuity Eye drop

However, there are some potential side effects of vuity in the Gemini 1 and 2 studies. Patients reported eye redness and headaches. Using vuity may also decrease night vision by reducing the amount of light entering your eyes at night through a small constricted pupil.

So you may need to be very careful when using it at night. Pilocarpine can also rarely cause retinal detachment. So it is important to consult with your eye doctor if you are considering using vuity.

At the current time, vuity is not covered by most insurance and costs about 75$ for each 2.5 ml bottle. As vuity is newly approved for presbyopia we will likely learn more and more about this medication as it becomes more widely available in the US.

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