How Does Vuity Work? What to Know About Pilocarpine’s Mechanism of Action

As we grow older, our bodies go through changes. Some of them are welcome, while others may need some management. Short-range vision issues are one common complaint. It can be a burden to have newfound trouble reading small text on signs, screens, and magazines.

Symptoms like these are related to presbyopia (age-related farsightedness). This is a vision problem that’s more likely to happen after you enter your forties, and affects almost everyone to some degree over time.

Thankfully, presbyopia is manageable. Glasses, contacts, and surgery are mainstay treatment options. Vuity (pilocarpine) eye drops are a newer option to consider too. If your eye doctor has written you a prescription for Vuity, think of it as another tool that can help you on your journey to clearer vision.

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What causes presbyopia?

Your eyes have a lens, much like a camera. The job of the lens is to focus on objects that you’re looking at, such as a book, a menu, or your phone.

In our younger years, our eyes can easily focus on objects both near and far. This is because our lenses are flexible. They can tighten and relax as needed to help us analyze objects at different distances. But as the years go on, our lenses stiffen and lose their flexibility, causing presbyopia. This usually affects short-range vision.

What’s the difference between nearsightedness and farsightedness?

Presbyopia has a similar effect on your vision as what’s known as “farsightedness.” This is when it’s hard to clearly see things that are close to you.  

It’s also possible to be unable to focus on objects that are far away. This is a common eye problem known as “nearsightedness” (myopia). It can be easy to mix up these terms. If you have nearsightedness, think of nearby objects as easier to see. If you have farsightedness, you have more luck seeing things that are far away. In this article, we’ll be focusing on farsightedness and how Vuity can help.

How does Vuity treat presbyopia?

Vuity treats presbyopia by telling specific muscles in your eyes to tighten up. It’s a type of cholinergic agonist.

What does this mean? In dimly-lit places, your pupils dilate (widen) to let in more light. And when exposed to bright lights, they constrict (get smaller). When your pupils are smaller, fewer rays of light make it to the back of your eyes, therefore reducing the blurriness of objects close to your face. One muscle responsible for changing the size of your pupils is your iris sphincter muscle.

The iris sphincter muscle is sensitive to certain chemicals, including Vuity. Vuity tells your iris sphincter muscle to contract, making your pupils smaller. This helps your eyes focus on objects that are close to you and shouldn’t impact your distance vision.

However, Vuity’s effects are only temporary. Each dose lasts for about 6 hours or less. If you need short-range vision support after this time window, you may need a second dose.

Good to know: Vuity is approved for a maximum of two doses per day. Depending on how long you’re doing up-close work, it may not last for your entire workday. If this happens, you should continue to use your contacts or eyeglasses for presbyopia.

How is Vuity different from wearing glasses or contacts?

Vuity is a short-acting, prescription-only medication for presbyopia. When you use Vuity, you can benefit from clearer vision without glasses, contacts, or surgery.

Vuity is an eye drop that you apply once daily to each eye. You can apply one more drop to each eye 3 to 6 hours after your first dose, if needed. If you wear contact lenses, you’ll need to remove your contacts, apply Vuity, and wait 10 minutes before putting your contacts back in. If you use other prescription eye drops, you’ll need to administer them at least 5 minutes apart from Vuity.

However, Vuity is not without side effects. Headaches and eye redness are two common complaints. Vuity may also temporarily dim or darken your vision, so you should use caution when performing certain activities, such as driving at night.

Comparison to glasses and contact lenses

Unlike medications, glasses don’t have side effects. But they still have some cons. You must wear and maintain glasses for clear vision. They can sometimes get in the way during certain activities, such as exercise, or fog up when you come in from the cold. They may also reduce your peripheral vision. What’s more, if you have nearsightedness and farsightedness, you may need bifocal or progressive lenses. Some people don’t prefer them for aesthetic reasons.

Contact lenses provide a better field of vision than eyeglasses, but they have their own problems, too. Many contact lens wearers experience dry eye. Routine contact use also leads to a greater potential for eye infections. Applying them can feel uncomfortable, as well.

Is Vuity a long-term solution for vision problems?

No. While it’s safe to administer Vuity every day, it’s not considered a long-term solution for presbyopia. Vuity is also not meant to fully replace glasses or contacts.

The only true long-term solution for people with presbyopia is surgery. Laser eye surgery, including PRK or LASIK, is one possible choice for correcting vision. Other procedures are also available.

Whether you opt for prescription eye drops, surgery, or another treatment, it’s important to regularly see your eye doctor to help maintain optimal eye health.

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Written by:

Mandeep Sohal, PharmD

Mandeep Sohal, PharmD, has more than 7 years of experience in the pharmaceutical industry and is licensed in California. In his career, he’s had experience with specialty pharmacy, community pharmacy, pharmacy benefit management, and pharmaceutical manufacturers.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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