VIZZ vs. Vuity: Is the New Presbyopia Eye Drop Better?

At a glance: The new presbyopia eye drop people are talking about is VIZZ (aceclidine). It was approved by the FDA in July 2025, about four years after Vuity. VIZZ lasts longer from one daily dose in its studies and works mostly on the pupil. But no study has compared it head to head with Vuity, and side effects like headache and dim vision still happen. If you want to try it, see our page on VIZZ and Vuity presbyopia eye drops in Alpharetta.

Why is everyone talking about a new eye drop?

After about 40, almost everyone starts holding their phone farther away. This is presbyopia. The lens inside the eye gets stiffer and can't focus up close like it used to. For years the answer was readers, bifocals, progressives or multifocal contacts. Then in 2021 came Vuity, the first eye drop for presbyopia. Now there is a newer drop, VIZZ, with TV ads and a lot of buzz.

How do presbyopia eye drops work?

These drops shrink the pupil, the black circle in the center of your eye. A small pupil acts like a pinhole camera. More of what you see stays in focus, so reading up close gets easier. When the drop wears off, your vision goes back to how it was. The drops don't fix presbyopia or slow it down.

What is different about VIZZ?

• It works mostly on the pupil. Vuity (pilocarpine) also squeezes the focusing muscle inside the eye. That can make distance vision a little blurry and can cause brow ache. VIZZ is designed to act mainly on the pupil, with little effect on that muscle.
• It lasts longer. VIZZ is used once a day: one drop in each eye, then a second drop two minutes later. In studies it worked within about 30 minutes and lasted up to about 10 hours. Vuity lasts about 6 hours from one drop, and a second dose later in the day is approved.
• It makes the pupil smaller. That helps focus, but it also lets in less light. Dim vision was one of the most common side effects with VIZZ.

What did the studies show?

Both drops beat a placebo drop in their own studies. In two VIZZ studies, about 2 out of 3 people gained at least 3 lines on a near-vision chart three hours after the drop. In the Vuity studies, about 1 out of 3 people did, but those were tested in dim light and in a different way. Because the tests were different, these numbers can't be compared directly. No study has tested VIZZ and Vuity side by side.

So, is VIZZ better than Vuity?

It might be better for some people. It lasts longer, and it puts less strain on the focusing muscle. In our experience, VIZZ also seems to work better than Vuity when it comes to headaches and brow ache. The likely reason is how it works: it acts mainly on the pupil and tugs less on the focusing muscle. That is what we have seen, not a guarantee, and no head-to-head study exists. It is not right for everyone. The best drop is the one that works for your eyes and your day. Talk with your eye doctor.

What side effects should I know about?

• Headache and brow ache. Headache was a common side effect for both drops.
• Dim or dark vision, mostly at night or in low light. Be careful with night driving, and don't drive if your vision is not clear. We usually tell patients to use the drop in the morning. By the time you are driving at night, the dimming has mostly faded.
• Stinging and red eyes right after the drop.
• Rare retinal tears or detachment. This is rare, but get care right away if you see sudden flashes, new floaters or a shadow over your vision. We check your retina before you start any presbyopia drop.

What we see in our office

In our experience, many patients try presbyopia drops and then don't keep buying them. Some feel the effect is too small or wears off too soon. Others don't like the side effects. People in their early 40s seem to have the hardest time. Their eyes still focus strongly, and they tend to get more headaches and brow ache from the drops. So far, VIZZ seems gentler on headaches and brow ache than Vuity for our patients.

Drops are still a good option for the right person. They tend to work best for people who want a few hours without readers, in good light, for everyday tasks.

Many people still prefer contacts or glasses

Results with drops vary. Many people are happier with multifocal contact lenses or progressive glasses, because they work all day and in any light. Some people mix and match: contacts most days, drops for a night out. You can compare all your choices on our presbyopia options page.

Try it before you commit

At Reimbold Eye Group in Alpharetta, we start with an eye exam and a check of your retina. Then you can try a presbyopia drop right in our office and test it on your phone, a menu and across the room. If you like it, we can write a prescription. If not, we'll help you find something that fits you better.

What it costs: The in-office trial of the drop is $99. It includes one follow-up visit at about one month to check your retina. This is an extra fee. Your regular eye exam is paid separately, through your insurance or our usual exam fee.

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Frequently asked questions

What is the name of the new presbyopia eye drop?

VIZZ. Its active ingredient is aceclidine 1.44%. The FDA approved it in July 2025.

Is VIZZ stronger than Vuity?

They work in a slightly different way, and VIZZ makes the pupil smaller. No study has compared the two side by side, so we can't call one stronger or better for everyone.

Why do presbyopia drops cause brow ache?

Drops like Vuity also tighten the focusing muscle inside the eye, which can cause an ache around the brow. VIZZ is designed to act mostly on the pupil. In our experience, patients seem to get fewer brow aches with it, but headaches still happened in its studies.

What does it cost to try a presbyopia drop?

Our in-office drop trial is $99, and it includes one follow-up visit about a month later to check your retina. It is an extra charge. Your regular eye exam is paid separately, through insurance or the usual exam fee.

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Sources

• VIZZ prescribing information (DailyMed)
• FDA Drug Trials Snapshot: VIZZ
• Vuity prescribing information (DailyMed)

Book a presbyopia drop visit

Curious whether VIZZ or Vuity could work for you? Book online and ask about a drop trial, or read more on our presbyopia eye drops page for Alpharetta.