If you (or your parents) are holding menus at arm’s length, you’re not alone. Age‑related blurry near vision—presbyopia—happens to almost everyone after 40. In late July, the U.S. FDA approved VIZZ (aceclidine 1.44%), a once‑daily prescription eye drop that sharpens near vision by making the pupil a little smaller (a “pinhole” effect). It’s the first drop based on aceclidine and the third pharmacologic option overall, joining Vuity and Qlosi (both pilocarpine‑based). Samples are slated to reach clinics as early as October 2025, with broader U.S. availability by mid‑Q4. LENZ Therapeutics, Inc.
Key takeaways (for busy caregivers)
- What’s new: VIZZ is FDA‑approved for adult presbyopia; in Phase 3, it improved near vision within ~30 minutes and lasted up to 10 hours post‑dose. LENZ Therapeutics, Inc.
- How it’s taken: Per the FDA label, 1 drop in each eye, wait 2 minutes, then a second drop—once daily (single‑dose vial). Remove contacts first; you can reinsert after 10 minutes. FDA Access Data
- Safety you should hear about: Temporary dim/dark vision can happen; use extra caution with night driving. Because rare retinal tears/detachments have been reported with drugs in this class, labels advise a retinal exam before starting. FDA Access Data
- Not the first ever: Vuity (2021) and Qlosi (2023) were approved earlier; VIZZ is the first aceclidine‑based option. FDA Access Data+1LENZ Therapeutics, Inc.
- How common is presbyopia? Roughly 1.8 billion people worldwide had it in 2015; about 128 million adults in the U.S. are affected. PubMedAmerican Optometric Association
What is presbyopia—and why drops help
Presbyopia is the slow, universal stiffening of the eye’s natural lens that makes near tasks (phone screens, sewing, labels) go fuzzy. Miotic eye drops help by constricting the pupil just enough to increase depth of focus—like stepping down the aperture on a camera. VIZZ is described in its label as a predominantly pupil‑selective miotic (aimed mainly at the iris); pilocarpine drops (Vuity, Qlosi) act on both the iris and ciliary muscle. FDA Access Data+2FDA Access Data+2
How the three FDA‑approved drops compare
VIZZ (aceclidine 1.44%)
- Dose: 1 drop per eye, wait 2 minutes, then a second drop once daily (same vial). Single‑dose vials. FDA Access Data
- Onset/duration: In trials, ~30 minutes to onset; effect up to 10 hours. LENZ Therapeutics, Inc.
- Storage: Refrigerate (2–8 °C). Once out of the fridge, usable at room temp for 30 days; discard opened vial after use. FDA Access Data
Vuity (pilocarpine 1.25%)
- Dose: Once daily per label; the brand site notes some people may use a second daily dose 3–6 hours later if advised by their doctor. Multi‑dose bottle. FDA Access Datavuity.com
- Storage: Room temperature (15–25 °C). FDA Access Data
Qlosi (pilocarpine 0.4%)
- Dose: 1 drop per eye, optional second drop 2–3 hours later; up to twice daily. Single‑use vials. FDA Access Data
- Duration: Label describes effect lasting up to ~8 hours (with the second dose). Refrigerate; discard opened vial. FDA Access Data
Class‑wide safety notes (all three): Temporary blurred/dim vision; caution with night driving. Labels advise a retinal exam before starting due to rare reports of retinal tear/detachment with miotics—seek urgent care for flashes, floaters, or a curtain over vision. Contact lenses should be removed before dosing and reinserted after 10 minutes. FDA Access Data+2FDA Access Data+2
Who tends to benefit most?
Early‑to‑moderate presbyopes (often ages 40–55) typically see the most consistent “reader‑free” time, though results vary. These drops don’t cure presbyopia or replace routine eye care—they’re a flexible add‑on for “event days” (presentations, dinners, travel) or for daily use if you like the effect and tolerate it well. In the U.S., about 128 million adults live with presbyopia, underscoring how common this is for families we serve on Anneler Online. American Optometric Association
Storage & travel realities (a caregiver‑friendly heads‑up)
- Fridge vs. room temp: VIZZ and Qlosi ship refrigerated and use single‑dose vials; Vuity is a room‑temperature bottle—handy for travel. FDA Access Data+2FDA Access Data+2
- Contacts: Out before drops, back in after 10 minutes (applies to all three). FDA Access Data+2FDA Access Data+2
Cost & coverage: what we know today
These prescriptions are often cash‑pay in the U.S. (with coupons or FSA/HSA options). Qlosi’s site explicitly says insurance does not cover it, while some insurers label presbyopia drops not medically necessary—so expect variability and plan to ask about coupons. Vuity’s retail prices vary widely by pharmacy and discount program. Qlosi™CignaGoodRx+1
How big is this market—and what’s coming next?
- Scale today: Globally, ~1.8 billion people had presbyopia in 2015 (projected to rise in absolute numbers with aging populations). That’s a large potential audience for non‑surgical fixes like drops. PubMed
- Market outlook: Analysts estimate the presbyopia market across 7 major countries was about $1.76 B in 2024, with gradual growth to ~$2.5 B by 2035 as non‑invasive options—including drops—become more familiar. (Forecasts vary.) BioSpace
- Pipeline to watch: BRIMOCHOL PF (a carbachol + brimonidine combo) has an FDA PDUFA date of January 28, 2026; if approved, it would add a fourth option with a different mix. Device‑based micro‑dosing (Eyenovia’s Optejet) is also progressing through a device‑approval pathway that could influence how future presbyopia drops are delivered. tenpointtherapeutics.comOphthalmology TimesBusiness WireGlobeNewswire
Practical checklist for families (bring this to the eye appointment)
- Am I a good candidate? (Share age, near‑vision tasks, night driving habits, any history of retinal problems.) Labels recommend a retinal exam before starting. FDA Access Data
- Which product fits my day? (Onset, how long it lasts for me, storage needs, contact lens use.) FDA Access Data+2FDA Access Data+2
- Safety in my situation: Ask about driving at night, migraine history, dry eye, iritis, and what to do if you notice flashes/floaters. FDA Access Data+2FDA Access Data+2
- Pregnant or breastfeeding? Human data are limited; your clinician will weigh benefits and risks with you. FDA Access Data
- Budget basics: Is it covered? If not, ask about coupons or FSA/HSA and expected monthly cost at your local pharmacy. Qlosi™GoodRx
Bottom line for Anneler Online readers
With VIZZ’s approval, three on‑label eye‑drop choices now exist for presbyopia. That’s good news for anyone who wants more control over when they need readers. The “best” option will depend on how you feel on the drop, how long it works for you, storage convenience, and what it costs where you live. Most importantly: see an eye‑care professional, get that retinal check, and decide together whether drops fit your lifestyle (and your night‑driving needs). LENZ Therapeutics, Inc.FDA Access Data
Sources
- FDA label for VIZZ (aceclidine 1.44%); LENZ approval announcement & timing. FDA Access DataLENZ Therapeutics, Inc.
- FDA labels for Vuity and Qlosi; product sites for usage/coverage details. FDA Access Data+1vuity.comQlosi™
- Presbyopia epidemiology (global & U.S.). PubMedAmerican Optometric Association
- Market outlook (7 major countries). BioSpace
- Pipeline: BRIMOCHOL PF PDUFA & device‑delivery updates. Ophthalmology TimesBusiness WireGlobeNewswire
Friendly reminder: This article is informational and not medical advice. Always talk with a qualified eye‑care professional about your specific situation.
