FDA-Approved Drops Improve Near Vision in 30 Minutes and Last Up to 10 Hours

If you are over 45, you probably know the routine. You hold your phone at arm’s length. You squint at restaurant menus. You dig through bags and drawers looking for reading glasses you swore were right there a minute ago. Age-related blurry near vision, called presbyopia, affects roughly 128 million adults in the United States alone. For most people, the fix has been simple: grab a pair of readers and accept that your eyes are not what they used to be. But a newly approved prescription eye drop is offering a different option. One drop per day, and many adults can see clearly up close for up to 10 hours without reaching for glasses. It is not a cure for aging eyes. But for millions of people frustrated by the daily hassle of reading glasses, it could change how they get through the day.

What Presbyopia Actually Does to Your Eyes

Presbyopia is not a disease. It is a natural part of aging that catches up with nearly everyone. Starting in your mid-40s, the crystalline lens inside your eye gradually hardens and loses its ability to change shape. That flexibility is what allows your eye to shift focus between distant and nearby objects.

As the lens stiffens, it can no longer bend enough to focus incoming light from close-up objects onto your retina. Words on a page blur. Screens become harder to read. Fine print becomes nearly impossible without help.

Presbyopia progresses over time. Adults over 50 lose, on average, 1.5 lines of near vision every six years. While the decline is gradual, many people experience a sudden moment in their mid-40s when they realize they can no longer read a text message or a label without holding it further away. That moment sends millions of people to the drugstore for their first pair of reading glasses.

Until recently, the options for managing presbyopia were limited to glasses, contact lenses, or surgery. Each comes with tradeoffs in convenience, comfort, cost, and appearance. For people who have never worn glasses before, the adjustment can feel frustrating.

Vizz: A New Kind of Eye Drop

In July 2025, the FDA approved Vizz (aceclidine ophthalmic solution) 1.44%, the first aceclidine-based eye drop approved in the United States for treating presbyopia in adults. Developed by Lenz Therapeutics, Vizz is a once-daily, preservative-free drop delivered in single-use vials.

Aceclidine, the active ingredient, works differently from the eye drops that came before it. It is what scientists call a predominantly pupil-selective miotic. In plain language, it causes the iris sphincter muscle to contract, creating a “pinhole effect” that extends your eye’s depth of focus. Think of it like narrowing the aperture on a camera lens: a smaller opening allows a wider range of distances to stay in focus at the same time.

What makes Vizz different from earlier presbyopia drops is how tightly it constricts the pupil. Vizz achieves a sub-2mm pupil size, which provides a stronger near vision improvement without causing a myopic shift (an unwanted change in distance vision).

Daniel Diamond, an assistant professor of optometric science at Columbia University, noted that drops are a good option for people who cannot use glasses or contact lenses, or who do not want the burden of carrying separate pairs for distance and reading correction.

How Fast It Works and How Long It Lasts

FDA approval was based on results from three Phase 3 clinical trials involving nearly 700 participants. In the two main trials (CLARITY 1 and CLARITY 2), people with presbyopia received either Vizz or placebo drops once daily for 42 days. A third trial (CLARITY 3) tracked 217 participants for six months to evaluate long-term safety.

Vizz improved near vision within 30 minutes of application. The effect lasted for up to 10 hours, making it the longest-acting once-daily presbyopia drop currently available.

Both primary and secondary endpoints for near vision improvement were met in CLARITY 1 and 2. Results were consistent and reproducible across both trials. Across more than 30,000 treatment days in all three studies, no serious treatment-related side effects were reported.

Common side effects were mild, temporary, and resolved on their own. About 20% of participants experienced brief irritation at the site where the drop was applied. Roughly 16% noticed temporary dim vision. About 13% reported headaches. Some participants had mild eye redness.

How Vizz Compares to Other Presbyopia Drops

Vizz is not the first eye drop approved for presbyopia, but it may be the most effective option available. Two older products, Vuity and Qlosi, both use a different active ingredient called pilocarpine hydrochloride. Like aceclidine, pilocarpine works by causing eye muscles to contract, but the results differ in duration and pupil response.

Vuity, made by AbbVie, is approved for once or twice daily use. In clinical trials testing twice-daily application, it improved near vision for up to nine hours. Qlosi, made by Orasis Pharmaceuticals, lasts up to eight hours.

Eric Donnenfeld, a clinical professor of ophthalmology at New York University, explained the practical difference: from a patient perspective, Vizz lasts longer and produces a smaller pupil, providing better near vision than previous-generation medications.

Because Vizz achieves a tighter pupil constriction, it creates a sharper pinhole effect and a broader depth of focus. For patients, that translates to clearer near vision with fewer visual disturbances during the day.

What to Watch Out For

Vizz is not without downsides. Sidney Gicheru, an ophthalmologist and clinical spokesperson for the American Academy of Ophthalmology, pointed out that the drops have a limited period of effectiveness. While FDA-approved as a once-daily medication, the prescribing information indicates the effect may not last a full day for everyone.

Night vision is another consideration. Because Vizz constricts the pupil, it reduces the amount of light entering the eye in dim conditions. People who drive at night or work in low-light environments should be aware that the drops can affect how well they see in the dark.

Temporary dim or dark vision may occur after application. Lenz Therapeutics advises not driving or operating machinery if vision is not clear. Contact lens wearers should remove lenses before applying the drop and wait at least 10 minutes before reinserting them. Anyone experiencing sudden flashing lights, floaters, or vision loss after using the drops should seek immediate medical care.

Who Should Consider Eye Drops Over Glasses

For most people with presbyopia, reading glasses remain a perfectly effective and affordable solution. Diamond, from Columbia, noted that the vast majority of his patients in their early forties do well with reading glasses.

But drops fill a gap for specific groups of people. Those who have never worn glasses and resist starting may find drops more appealing than frames. People who work in environments where glasses are impractical, such as operating rooms, construction sites, or athletic fields, could benefit from a lens-free option. Anyone who dislikes the appearance of reading glasses or the inconvenience of switching between distance and reading pairs may prefer a daily drop.

Cost is a factor. Vizz may run around $80 per month with insurance, according to Donnenfeld. Without insurance, the price could be higher. Comparing that monthly expense to the one-time purchase of reading glasses or the cost of multifocal contact lenses will help individuals decide which option fits their budget and lifestyle.

Vizz became available for sampling by healthcare providers starting in October 2025, with broad commercial availability expected by the end of the year.

A Growing Market With More Options Ahead

Presbyopia affects an estimated 1.8 billion people globally. As populations age, that number will continue to rise. The market for convenient, non-surgical treatments is growing, and pharmaceutical companies are investing heavily in new solutions.

Vizz represents the latest step in a shift that began with Vuity’s approval in 2021: moving presbyopia management from the optical shop to the pharmacy. While glasses and contacts are not going anywhere, having a prescription eye drop that delivers 10 hours of improved near vision gives patients and doctors another tool in the toolkit.

For the millions of adults who have been holding their phones further and further away, that extra option may be exactly what they have been squinting for.

My Personal RX on Protecting Your Vision as You Age

Your eyes age along with the rest of your body, and presbyopia is just one part of that process. Protecting your vision long-term means supporting eye health through nutrition, sleep, and habits that reduce strain and inflammation. I tell my patients that the choices they make every day affect how well they see for decades to come. Here is what I recommend:

1. Get Deep, Restorative Sleep: Your eyes repair and rehydrate during sleep. Sleep Max combines magnesium, GABA, 5-HTP, and taurine to calm your mind and promote restorative REM sleep, giving your eyes the recovery time they need each night.
2. Know Your Supplement Gaps After 40: Age-related nutrient decline affects eye health, immune function, and cellular repair. Download my free guide, The 7 Supplements You Can’t Live Without, to learn which supplements protect your eyes and overall health, which “healthy” foods may be misleading you, and how to spot quality products.
3. Follow the 20-20-20 Rule for Screen Time: Every 20 minutes, look at something 20 feet away for at least 20 seconds. Prolonged screen use strains the muscles that control focus, accelerating eye fatigue and discomfort, especially in people already developing presbyopia.
4. Wear UV-Protective Sunglasses Outdoors: Ultraviolet exposure contributes to cataracts, macular degeneration, and other age-related eye diseases. Choose sunglasses that block 100% of UVA and UVB rays, and wear them year-round, not just in summer.
5. Stay Hydrated: Dry eyes become more common with age, and dehydration worsens the problem. Aim for at least eight glasses of water per day to keep your eyes and tear film functioning properly.
6. Exercise Regularly: Physical activity improves blood flow to the eyes and reduces the risk of glaucoma and diabetic eye disease. Aim for at least 30 minutes of moderate movement most days.
7. Limit Blue Light Exposure Before Bed: Blue light from screens can disrupt your circadian rhythm and strain your eyes. Use blue light filters on devices in the evening, and stop screen use at least 30 minutes before sleep.
8. Get Annual Eye Exams After 40: Many eye conditions develop without symptoms. Annual dilated eye exams can catch glaucoma, macular degeneration, and diabetic retinopathy early, when treatment is most effective. Ask your eye doctor about presbyopia management options at your next visit.

Source: Aslam, H. G., Fatima, M., Sajid, H., Irshad, N. U. N., & Imran, S. B. (2025). FDA approval of aceclidine (Vizz): a new chapter in nonsurgical presbyopia management. Annals of Medicine and Surgery, 87(11), 6967–6969. https://doi.org/10.1097/ms9.0000000000004008