Article

Tips On Using Vuity

THE INTREPID EYE SOCIETY IS A GROUP OF EMERGING THOUGHT LEADERS IN OPTOMETRY FROM ACROSS THE UNITED STATES. We asked the members to give us some tips on ways to think about Vuity, as we begin to find the best ways to help our patients. Personally, I’m really liking using Vuity in combination with the NanoDropper for early presbyopes who are experiencing adverse events. It seems to reduce adverse events and still gives plenty of miosis.

Patients need to use it more than one time if they get a headache. Patients that do experience a headache (15%) only experience it for one 1 day.

Try it out in your clinic – it works in 15 minutes and gives you the opportunity to celebrate with the patient.

20/happy or 20/functional is the goal with this drop – near-vision demands vary so much from patient to patient.

—Justin Schweitzer, OD

Choose the right patient and set proper expectations: A mild-moderate patient is ideal! See the classification consensus at https://pubmed.ncbi.nlm.nih.gov/34709607/ .

Have the patient utilize the drops for 7-10 days everyday initially (just like we do for progressive lenses or monofocal contact lenses). I have found this helps patients—if they have hyperemia, myopic shift, dimming, or headache—to get through that, as all improve with use in my experience. Tell patients that this could happen, so they aren’t surprised!

Keep an open mind. I’ve had patients tell me everything from “This is a miracle; I love this drop” to “Meh, it’s just OK.” Don’t let that n of 1 change your conversations or discourage you.

Be intentional about presbyopia and leverage this unique drop in eye care to help grow your practice and invite patients to join you on their presbyopia journey. Thirty-one million people every year buy OTC readers. Think about how many of those patients to whom you will now have access to educate, treat, and establish a relationship with. Lean into the presbyopia revolution!

—Selina McGee, OD

Underpromise and overdeliver: education helps to reduce reliance on reading glasses and gives patients the option of drop or glasses.

Let them browse your optical while experiencing the drop. They will need correction for up close too!

—Mark E. Schaeffer, OD

Discuss and offer Vuity to all patients since all presbyopes have symptoms that affect their quality of life.

Use the drop every day for 1 week to obtain the “wow” effect.

In addition to improving intermediate and near vision, Vuity helps with night driving!

—Melissa Barnett, OD

Try off-label use of Vuity to try and get pupil constriction to cut down on nighttime glare and halos in diffractive intraocular lens (IOL) cataract patients. This is mostly for older versions of monofocal IOLs.

Use in early presbyopic patients interested in laser refractive surgery (45-55 years old). Have them trial Vuity first to decide on doing full correction OU and using readers and Vuity vs. a minimonovision setup.

Off-label use can help pseudophakic monofocal patients who want better intermediate/near vision for specific tasks like golfing.

—Mitch Ibach, OD

Try daily use for the first 7 days, as neuroadaptation and side effects get better with use.

If you get blurry distance vision, try dosing in 1 eye only, or try dosing 1 eye first and then the other eye 4-6 hours later.

If the near vision wears off too soon, try using more than once per day.

—Josh Johnston, OD

Warn younger patients 40-50 years old about the “dimming effects” of Vuity.

It’s a great adjunctive tool to reading glasses.

If you have dry eyes, it might sting more than if you don’t.

—Vin Dang, OD

In my experience, the key to compliance and overall success is being upfront about the potential side effects that may be experienced (including brow ache, dimming effect, and distance blur).

I encourage patients to give it a good, solid try for 5-7 days (since the effects were mild and seem to lessen some with use).

The safety profile of long-term pilocarpine use (greater than 30 days) would be helpful to know (to increase the confidence of young prescribers new to pilocarpine.)

A higher-than-anticipated number of men have requested the drops. It seems to be really split 50/50 between men and women. I thought more women would gravitate toward a cosmetic solution.

—Jade Coats, OD

The FDA indication is “treatment of presbyopia in adults.” This broad indication applies to approximately 128 million people in the United States.

Encourage patients to try it for at least 1 week to best understand when the optimal dosing time is for them on a particular day.

If you haven’t started prescribing yet, now is the time. Allergan’s direct-to-consumer campaign will be driving patients to our practices soon, and we all need some experience with Vuity to be able to manage these folks appropriately.

—Damon Dierker, OD

Experiment by trying the drops at home and at various times during the day to best avoid adverse events such as dimming and myopic shifts that may be a benefit in some situations and a detriment in others.

Follow up in a week to gauge response and discuss possible modifications. For patients experiencing a myopic shift, apply the drop upon waking—after completing their morning routine enough time may have passed for the shift to settle down.

—John Gelles, OD