The Common Understanding of Presbyopia Might Change: Seeing Up Close in 30 Minutes — Up to 10 Hours with a Single Dose, VIZZ Paves the Way for "The Next After Reading Glasses"

The Beginning of "Chapter 2" in Presbyopia Treatment?

The U.S. Food and Drug Administration (FDA) has approved a new eye drop medication, VIZZ (aceclidine 1.44%), to correct presbyopia (age-related farsightedness). The target is adults with presbyopia. It is said to improve near vision in about 30 minutes, with effects lasting up to 10 hours. The approval date is July 31, 2025. The company plans to distribute samples by October and begin widespread distribution by the end of the year (mid-Q4).LENZ Therapeutics, Inc.NDTV ProfitHCP Live

What's New: The Key Mechanism is "Selective Pupil Constriction"

The main feature of VIZZ is its use of aceclidine, a muscarinic receptor agonist, which primarily affects the pupil. It contracts the iris sphincter muscle, reducing the pupil diameter to sub-2mm, thereby enhancing the depth of focus through the pinhole effect, making near vision clearer. Meanwhile, it minimizes stimulation to the ciliary muscle that pulls the lens, designed to be "pupil-selective." Compared to existing pharmacology (pilocarpine), it can be said to use the "optical pathway" for near vision improvement more purely.NDTV Profit

Evidence: Three CLARITY Trials

The basis for approval is three pillars of randomized, double-masked, controlled Phase 3 trials. CLARITY1/2 (466 cases, 42 days of once-daily dosing) confirmed efficacy and safety, and CLARITY3 (217 cases) confirmed long-term safety over six months. The details of the primary endpoints are within the scope of published abstracts, but the statistical support for improvement in near vision function in daily life was central to the evaluation.NDTV Profit

Differences with Vuity and Qlosi

When it comes to presbyopia eye drops, Vuity (pilocarpine 1.25%) approved in 2021 and Qlosi (0.4%) approved in 2023 are already in clinical use. Vuity starts working in about 15 minutes with once-daily dosing (twice daily if needed is approved), showing improvement for up to six hours. On the other hand, Qlosi emphasizes comfort with a low-dose design. VIZZ enters this space with "aceclidine/pupil selectivity." While the pharmacology is a similar yet different "miosis route," there may be differences in how it works (duration, experience in dark places) and side effect profiles.AbbVie News CenterFDA Access Data

How Much Can You "See"?

Summaries from the company and media state that "near vision improves 30 minutes after administration and lasts up to 10 hours." The figure exceeding the "up to six hours" of conventional pilocarpine formulations is impactful. However, visibility depends on lighting conditions. The pinhole effect is powerful in bright conditions, but in dark places, the pupil cannot dilate, leading to insufficient light intake, which may result in a "hard to see" experience in dim restaurants or movie theaters.NDTV ProfitAbbVie News CenterReddit

When Will It Be Available? What About the Price?

In the U.S., the roadmap indicates sample distribution in October and commercial distribution by the end of the year. Currently, official information on pricing is limited, and insurance reimbursement is unclear. Based on experiences with pilocarpine formulations, out-of-pocket costs tend to be a challenge, but the actual price and coverage of VIZZ await future announcements.HCP Live

What Is Being Said on Social Media (Summary of Voices)

• Positive reactions expecting a "daily life without reading glasses": On Instagram and news spread posts, hopeful messages like "over 100 million American adults will benefit" stand out.Instagram

• On the other hand, users claiming to be ophthalmologists point out realistic limitations such as "reduced visibility in dark places" and "high effectiveness in early to moderate presbyopia." Concerns about "cost barriers" are also shared based on existing Vuity usage experiences.Reddit

• In Reddit's science and tech communities, while the novelty of mechanisms like "10-hour duration" and "pupil selectivity" is appreciated, many questions about implementation arise, such as "what about the side effect profile?" and "how comfortable is it in practice?"Reddit

Risks, Side Effects, and the Reality of Applicability

Common potential side effects of miotic drugs include headaches, eye pain, darkened vision, and temporary myopia. With pilocarpine-based drugs, "comfort" during daily use has often been a topic of discussion. Although VIZZ is designed to minimize ciliary muscle stimulation, the comfort in actual clinical use will require the accumulation of usage data. Regarding age, as presbyopia progresses, it becomes more challenging to "solve with just miosis," so satisfaction may be higher in early to moderate stages.NDTV ProfitReddit

Impact on Japan?

This approval is for the U.S. At present, information on approval or supply plans in Japan is limited, and the introduction timing is unclear. However, the prevalence of presbyopia is high in Japan as well, and as an "expansion of options" combining optics and pharmacology, it is attracting attention. For clinical introduction, grounded discussions on the impact on night vision and work scenes (such as nighttime driving), cost-effectiveness, and daily adherence will be required.Nature

How to Design the "Next After Glasses"

VIZZ is a presence that strengthens the third route of "pharmacology + optics" beyond lenses (glasses, contacts) or surgery for presbyopia. Clinically,

• Usage: Administered in alignment with the peak of the day for "near vision tasks in bright places" such as reading, writing, and PC work.

• Caution Scenes: Activities in dark places (movies, bars, nighttime driving) or long periods of precise work.

• Positioning: Not a complete substitute for glasses but one of the tools for "task optimization."
  This realistic compromise lies between the enthusiasm on social media and the cautiousness of experts.Reddit