Vuity eye drops (pilocarpine 1.25%) and Qlosi (pilocarpine 0.4%) are prescription drops approved to treat presbyopia in adults, the age-related loss of close-up focus. Both shrink the pupil, which can make small print clearer for part of the day. Qlosi's label reports an effect from 20 minutes after the first drop, lasting up to 8 hours with a second drop used as prescribed. Vuity's label gives no duration, and its main studies checked near vision 3 hours after the drop. Headache is a common side effect, vision can dim in poor light, and rare retinal detachments have been reported with drops of this type. Our doctors prescribe both, and our presbyopia guide covers the other ways to read comfortably again.
Key takeaways
- Vuity and Qlosi are prescription pilocarpine eye drops approved to treat presbyopia in adults, and they work by shrinking the pupil to sharpen near vision.
- Qlosi's label reports an effect starting 20 minutes after the first drop and lasting up to 8 hours with a second drop, while Vuity's label gives no duration.
- Headache is a common side effect, and both drops can dim vision in poor light, so take extra care driving at night.
- New flashes, new floaters or a curtain over your vision need a same-day exam, or an emergency room when we're closed.
01
What are Vuity and Qlosi eye drops?
Vuity and Qlosi are pilocarpine eye drops for presbyopia. Both contain pilocarpine hydrochloride, and each label says the drug is indicated for the treatment of presbyopia in adults. Vuity is a 1.25% solution and Qlosi is a 0.4% solution, and both need a prescription. Because the aim is clearer print up close without reaching for glasses, people often call them eye drops for reading.
Presbyopia is a refractive error that makes it hard for middle-aged and older adults to see things up close. The lens inside the eye gets harder and less flexible with age, and you start holding reading material farther away to focus on it. Everyone gets it eventually, usually after age 45.
02
How do eye drops for presbyopia work?
They make the pupil smaller. Pilocarpine contracts the iris sphincter muscle, and the narrower pupil increases depth of focus (the range of distances that look sharp at the same time), which improves near vision.
The drug also acts on the ciliary muscle, the focusing muscle inside the eye. Vuity's label says it may shift the eye to a more myopic state, meaning more nearsighted, and both labels warn that changing focus between near and distant objects can be temporarily harder.
Each dose wears off, and presbyopia itself gets worse over time and usually stops getting worse after age 65.
03
How long do Vuity and Qlosi last?
Qlosi's label puts it at up to 8 hours, with a second drop used as prescribed. In its studies the effect began 20 minutes after the first drop and lasted until 5 hours after the second.
Vuity's label also allows a second drop, used as prescribed, but doesn't give a duration. Its two main studies measured near vision 3 hours after the drop, on day 30, and a later study, in which people also used a second drop, measured it 3 hours after that second drop.
The studies counted someone as a responder if they could read at least 3 more lines on a near-vision chart and their distance vision held: Vuity's studies allowed a drop of no more than 1 line on the distance chart, and Qlosi's allowed less than 1 line. Vuity's studies tested near vision in dim light.
| Study | Who took part | Reached the 3-line mark |
|---|---|---|
| Vuity: GEMINI 1 and 2 | 750 adults aged 40 to 55 | 31% and 26% at hour 3 on day 30, vs 8% and 11% with a vehicle drop |
| Vuity: VIRGO | 230 adults aged 40 to 55 | 35% at hour 9 on day 14, 3 hours after a second drop, vs 8% |
| Qlosi: NEAR-1 and NEAR-2 | 613 adults aged 45 to 64 | 39% and 42% one hour after the first drop on day 8, vs 17% and 21% |
A vehicle drop is the same liquid without the drug. More people reached the 3-line mark with the drug than with the vehicle in every study, but many did not, and group results can't predict how your own eyes will respond. The two drugs were tested in separate studies, with different ages, time points and test conditions, so their percentages can't be compared with each other.
04
What are the side effects of Vuity and Qlosi?
Headache is common with both drops. The most common side effects of Vuity, each reported by more than 5% of people in at least one of its studies, were headache, conjunctival hyperemia and eye irritation; conjunctival hyperemia is redness of the white of the eye. Qlosi's most common side effects were instillation site pain and headache, in 5% to 8% of people. Instillation site pain is discomfort where the drop goes in.
Blurred vision was less common: 1% to 5% of people in Vuity's studies and 2% to 5% in Qlosi's. Don't drive or operate machinery if your vision isn't clear after a dose.
Dim light and night driving
Both drugs are miotics, medicines that make the pupil smaller, and the labels say people may experience temporary dim or dark vision. They advise caution with night driving and other risky activities in poor light. That dimming is a known effect of these drops. Sudden loss of vision in one or both eyes is not: it's a 911 call, even if you've just used a drop.
Our page on night vision and glare covers other common reasons night driving gets harder.
Retinal detachment warning
Rare cases of retinal detachment and retinal tear have been reported with miotics, Vuity included, and people who already have retinal disease are at higher risk. In a retinal detachment, the retina, the light-sensitive layer at the back of the eye, is pulled away from its normal position.
Both labels advise an exam of the retina in all patients before starting. They also tell patients to seek immediate medical care for sudden flashes of light, floaters or vision loss. For flashes or new floaters, call us right away at 310-828-2010 for a same-day exam, or go to an emergency room when we're closed; for sudden loss of vision, call 911.
Iritis
Iritis is a form of uveitis, or inflammation inside the eye: anterior uveitis affects the iris, the colored part of the eye. Neither drop is recommended while iritis is present, because the iris can stick to the lens, forming adhesions called synechiae.
Uveitis can cause blurry vision, floaters, eye pain, red eyes and sensitivity to light. We diagnose it at the slit lamp, as our uveitis page explains.
05
When should you get care right away?
Call us immediately at 310-828-2010 for a same-day exam if you notice new flashes of light, a sudden new floater or a shower of new floaters, or a curtain or shadow over part of your vision. When we're closed, go to an emergency room. These can be signs of a retinal detachment, a medical emergency, and our guide to floaters and flashes explains the same-day retina exam.
Sudden loss of vision in one or both eyes, even if it comes back, is a 911 call: sudden trouble seeing in one or both eyes can be a warning sign of stroke.
If the eye turns red and painful, becomes sensitive to light, or blur doesn't clear once the drop wears off, call us right away for a same-day urgent eye care exam, or go to an emergency room when we're closed.
06
Vuity vs Qlosi: how do they differ?
The two contain the same drug at different strengths, and they come in different containers.
| Feature | Vuity | Qlosi |
|---|---|---|
| Pilocarpine strength | 1.25% | 0.4% |
| Container | Dropper bottle | Single-use vials |
| Preservative | Yes (benzalkonium chloride) | None |
| Ages in the main studies | 40 to 55 | 45 to 64 |
| Second drop in a day | Allowed, as prescribed | Allowed, as prescribed |
| How long the label says it lasts | Not stated | Up to 8 hours with a second drop |
| Most common side effects | Headache, eye redness, eye irritation | Pain where the drop goes in, headache |
Sources for the table: the Vuity label and the Qlosi label. Neither label compares the two drops head to head.
07
Can eye drops replace reading glasses?
For a few hours, in some people. The drops wear off and don't work for everyone, and as presbyopia progresses, you'll probably need glasses or contact lenses to help you read anyway.
| Option | How it helps up close | Points to weigh |
|---|---|---|
| Presbyopia drops (Vuity, Qlosi) | Shrink the pupil for a few hours | Prescription only; dim vision in poor light; rare retinal detachment warning |
| Readers | Sharpen print at reading distance | Sold over the counter, or made to your prescription |
| Progressive lenses | Distance, desk and reading zones in one pair | Fitted in our optical |
| Multifocal contact lenses | Distance and near power in rings across the pupil | Fitted and refined over several visits |
| Monovision contacts | One eye set for near, the other for distance | Trialed before you commit |
Readers come two ways: some people use over-the-counter reading glasses, and others have an eye doctor prescribe them. With monovision, one eye wears a contact lens for near and, if needed, the other wears one for distance.
Our multifocal contact lens fittings start with pupil and tear film measurements, and our optical boutique fits progressive lenses in the same office.
08
Who should ask about presbyopia eye drops?
Adults with presbyopia who'd like to read without glasses for part of the day can ask whether the drops suit their eyes. Vuity was studied in adults aged 40 to 55 and Qlosi in adults aged 45 to 64. Neither study program included people 65 and over, and Qlosi's label says safety and effectiveness have not been established in that age group.
Tell us before you start if any of these apply:
- You've had a retinal tear, a retinal detachment or another retinal disease.
- You've had iritis or uveitis.
- You drive at night or work in dim light.
- You wear contact lenses or use other eye drops.
Our optometrists in Los Angeles prescribe both Vuity and Qlosi. At a comprehensive eye exam we look at the retina, by dilation or wide-field imaging as appropriate, and check eye pressure, the macula and lens clarity: the eye health questions that start in the same decade as presbyopia. The same visit compares the drops with glasses and contact lenses, which we also fit.
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Questions patients ask
Can you use Vuity or Qlosi with contact lenses?
Yes, with a short wait. Both labels say to take your lenses out before the drop and wait 10 minutes before putting them back in. If you'd like help with near vision without daily drops, multifocal contact lenses put distance and near power in one lens, and monovision sets one eye for near and the other for distance.
Can an optometrist prescribe Vuity or Qlosi?
Yes. Both are prescription drops, and optometrists can prescribe medicines, as ophthalmologists can. A doctor of optometry completes four years of professional education at a college of optometry after college and holds an OD degree. Our three doctors are optometrists, and they prescribe both Vuity and Qlosi.
Is pilocarpine used to lower eye pressure?
Yes. Pilocarpine drops in 1%, 2% and 4% strengths are approved to lower high eye pressure in people with open-angle glaucoma or ocular hypertension, and the drug was first approved in the U.S. in 1974. Vuity and Qlosi contain the same drug but are approved only to treat presbyopia, so they don't replace glaucoma treatment. Bring every eye drop you use to your visit.
Can lens replacement surgery correct near vision?
For some people, yes. In cataract surgery, the surgeon removes the cloudy lens and replaces it with an artificial lens, called an intraocular lens or IOL. Like any surgery, it has risks. In an FDA-reviewed trial in adults having cataract surgery, people given a multifocal IOL, which has zones for distance and near, reported less use of near vision glasses or contact lenses than those given a single-focus IOL. Done before a cataract forms, the same operation is called refractive lens exchange, which we co-manage with surgeons.
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Sources
- FDA: Vuity prescribing information
- DailyMed: Qlosi prescribing information
- National Eye Institute: Presbyopia
- American Optometric Association: Presbyopia
- National Eye Institute: Retinal detachment
- National Eye Institute: Uveitis
- American Stroke Association: Stroke warning signs and symptoms
- National Eye Institute: Cataract surgery
- FDA: SBL-3 multifocal intraocular lens
- DailyMed: Pilocarpine hydrochloride ophthalmic solution 1%, 2% and 4%
- National Eye Institute: Finding an eye doctor
- American Optometric Association: What's a doctor of optometry?
Written by
Dr. Bijan Cohenmehr, OD
Founder of Cohenmehr Optometry, in practice for over 40 years. He leads the practice’s dry eye care and myopia management. A graduate of SUNY College of Optometry.
About Dr. Bijan →
