“FDA-approved Vuity eyedrops could replace your reading glasses” (Today):
Just approved by the Food and Drug Administration, Vuity’s new product has been found to take effect in as little as 15 minutes.
A newly approved eye drop hitting the market on Thursday could change the lives of millions of Americans with age-related blurred near vision, a condition affecting mostly people 40 and older.
Vuity, which was approved by the Food and Drug Administration in October, would potentially replace reading glasses for some of the 128 million Americans who have trouble seeing close-up. The new medicine takes effect in about 15 minutes, with one drop on each eye providing sharper vision for six to 10 hours, according to the company.
“I Swapped My Reading Glasses for Magical Eyedrops” (NYT):
To make matters worse, the whites of my eyes had a pink tinge. Picture Campbell’s tomato soup when you add an extra can of milk. My 20-year-old daughter assured me I did not look high: “But your eye bags are bigger than usual,” she said.
Not only did my eyes retain their bloodshot, rheumy cast during the five days I used the drops, my close-up vision never improved significantly enough to make reading glasses redundant. The drops burned as they went in, too. I’m not talking about an acid kind of pain, more like a lash in your eye, but still unpleasant.
A NYT reader’s comment:
I am an ophthalmologist. This “new” drop is just a rebranding and remarketing of a weaker version of pilocarpine, that we used ages ago to manage glaucoma. The drug is almost never used now to manage glaucoma because of its side effects, including the development of headaches, and, more importantly, an increased risk of retinal detachment. I think this drug represents extraordinary marketing of a very poor idea. The drug was very cheap in higher concentrations, and raising the price for a lower concentration of a drug that isn’t a good idea in the first place is quite extraordinary. I have been wearing progressive bifocals for 20 years. They took about a day to get used to, and provide me with excellent vision at distance near and points in between. and they have no possible side effects.
Is the doc correct? Wikipedia says pilocarpine dates to 1874 (Ulysses S. Grant was president) and, as a friend likes to point out, “If it’s not on the Internet, I don’t believe it.”
Another doc comments:
As an ophthalmologist, I will say that the amount of confusion and general lack of understanding of how eyes actually work that is on display in this article and in the comments here is astonishing. I don’t even know where to begin. To be clear, everyone will eventually experience the effects of presbyopia and cataracts. This is universal, not a “condition” that only some people get. Achieving better vision for near targets can be managed with glasses, contacts, laser refractive surgery (LASIK or PRK) or choice of refractive target when implanting an IOL in cataract surgery. Normal age related presbyopia, as occurs in all human beings, on its own is absolutely not a good reason to undergo surgery, though if there were other good indications to undergo surgery (LASIK, PRK, or cataract extraction) then as I said the near vision can be improved if one wanted through refractive target, though at some expense to the quality of distance vision. Looking through a pinhole aperture can offset some refractive error and enhance depth of focus, but it will reduce peripheral vision and make your vision dimmer. Rebranding Pilocarpine (which we have used for decades to constrict the pupil) seems really ill advised and I wouldn’t recommend it to a patient. But brilliant marketing that they managed to get it approved and have articles in the media calling it a “cure” for the mysterious “disease” of presbyopia. The only cure for presbyopia is for nobody to live beyond the age of 40.
I think that the above is a good illustration of how powerfully we want to believe that the latest products of the pharma industry are safe and effective and that health care = health.
Apart from cannabis, it may soon be possible to take literal snake oil against the Wuhan virus:
https://www.reuters.com/business/healthcare-pharmaceuticals/brazilian-viper-venom-may-become-tool-fight-against-coronavirus-study-shows-2021-08-31/
Any new medical breakthrough nowadays is too good to be true. There’s quite a palpable slowdown compared to 40 years ago, when it was soft contact lenses one day, then radial keratotomy the next day, then lasik.
On the one paw, all the easy cures have been found. Then, we’re mandated to pay insurance companies not to innovate. Finally, there’s the extremely slow & inefficient FDA. There are still plenty of smart people in China developing cures, even when they’re not upselling vaporware.
Yes, the medical-industrial complex is rotten to the bone. Sometimes the corpse of integrity still twitches a little, to no effect. Likewise in the UK dubious drugs get approved with hardly a pretense of evidence. Then there’s the revolving door between industry and regulators. Nothing they say is to be trusted.
There’s really a case to be made that morning news programs and other sources like this, pimping these “new products” should themselves be sued for not bringing on an alternative view like an ophthalmologist to shoot them down. Why not some rebranded Krazy Glue to curb incontinence? One drop needed!
>I think that the above is a good illustration of how powerfully we want to believe that the latest products of the pharma industry are safe and effective and that health care = health.
Understated humor of my year award. You can be very dry, Philip.
Whist driving myself to my many health care appointments and procedures during the past 18 months, I’ve taken to the habit of coming up with alternative side effects and sometimes active ingredients during medical commercials. I crack myself up. It’s therapy.
News used to be a 30 min prime time daily show where the anchor read the event of the day as news worthy. The news anchor and reporters did their job by masking their feelings and opinion as they presented. It was news after all that they were reporting, no more no less. If you wanted to have some laugh, or experience drama, or sports, learn about science, et. al. there were shows for those and were clearly defined.
Now days, thanks to 24×7 media, the line between news and fiction is all gone. That 30 min news reporting is insignificant in the face of any other shows. Almost all TV shows have some sort of social messaging that will fry your brains. And don’t get me started on the ads, especially the ones about health (or injury lawsuit). Those so called health ads chuckle me up. Why use nice looking, always smiling, healthy actors to pitch a miracle-pill? Why the announcer ends the ad with “Ask your Dr. if XYZ is best for you?” and why there is a fast talker listing all the side effect and a disclaimer in fine prints lasting 3 seconds?
I much rather see ads promoting cigarettes vs some miracle-pills. Smoking is safer than some brainwash quick-fix pharma ad.
The same is true on the internet or printed paper. Even respected journals are now filled with “opinions” or “analysis” that are reported as fact “news”.
“everyone will eventually experience the effects of presbyopia and cataracts.”
Everyone? What population is his patient base drawn from? All of us old people better make an ophthalmologist appointment right now!
Mine began at age 45 and I already have a replacement lens in my right eye. The cataract came on so fast I went from perfect vision to near blind in that eye in one month. I have a very good opth. and he did a 35 minute local anesthesia procedure to replace the lens with a unifocal, not variable focus lens (they’re less good long haul and I was relatively young.) His last name? “Greenspan.” Lol. I wear bifocal reading glasses because the lens he chose basically perfectly matches the presbyopia in the other eye. 🙂
re: ” unifocal, not variable focus lens (they’re less good long haul ”
There are also multifocal and extended depth of focus (EDOF) lens implants that provide a wider range of focus and can solve both the issue of cataracts and presbyopia at the same time. I went outside the US to get the Symfony EDOF lens a couple of years before it was approved here and have about 20/15 vision at distance and 20/25 near so I don’t need reading glasses except for things like threading a needle.
I also had the unfortunate luck of having a cataract in my forties that rapidly impacted vision within a month in one eye, but since the other eye was fine I held out a few years hoping for a better lens to come out. I’d always needed contacts or glasses and liked the idea of perhaps not needing them anymore.
Another approach is to use monofocal lenses for each eye set to focus well at different distances, whats called monovision, but that can reduce depth perception.
Contact lenses or laser surgery can also be used to set eyes to focus at different distances. There are also multifocal contact lenses (and I *think* they now have extended depth of focus contacts) that also can be used to see over a wider range of distances. I’d used multifocal contacts before the cataract and liked that better than monofocal contacts set for monovision.
@PhilH: BTW the speed the cataract progressed really startled and scared me. I didn’t even have an opth. at the time and every day my vision was perceptibly deteriorating in that eye. I thought: “Jesus, if it starts in the other eye I’ll be walking into walls and totally disabled in a month.” I got on the stick and immediately contacted an eye center in the tony area of Western Mass., near Great Barrington, home of a Theory Wellness Essential Marijuana Dispensary and of course the stomping grounds of Dr. Alan Chartock, CEO of WAMC NPR and bon vivant extraordinaire. This particular doctor had performed an identical lens replacement on my mother about a decade prior. He fit me into the schedule and did an absolutely beautiful job.
What I learned: you can have perfect vision (and I was a national-level marksman in high school) one month and be legally blind the next month, it probably depends on your genetics.
I should add there are also laser surgery techniques that can provide multifocal vision as well for those with presbyopia, though I haven’t had reason to check if they are approved in the US yet or only elsewhere.
re: ” unifocal, not variable focus lens (they’re less good long haul ”
I assume by “variable focus” you mean a lens that actually bends to adjust focus the way the natural lens does. Effective ones are still in the clinical trial phase and it seems best to be cautious about whether they are sure the movement will cause the lens or eye to have problems long term. There was a variable lens approved in Europe for a while that turned out to cause enough problems it was withdrawn from the market.
In the US there is a lens that claims to have some ability to adjust focus, the Crystalens, but its not used much anymore since it didn’t seem to have much of a range of vision, often none, and its method of action subject to some debate (some question if it does move or if some other optical property causes a larger range of focus sometimes). Though some people are happy with the lens, here is a tech type who got early cataracts that posted an extensive writeup of his lenses:
https://www.komar.org/faq/colorado-cataract-surgery-crystalens/
One item of interest is that certain lenses like that one (and mine) let through some UV light so we can see a bit of UV that people with natural lenses can’t.
@RealityEngineer: That’s all excellent information and underscores the point that problems can and do start much earlier than you expect, and consultation with a good ophthalmologist is keyt. Think of how much your vision means to your life. Don’t take the morning talk/newsy show as Grail.
re: “that problems can and do start much earlier than you expect, and consultation with a good ophthalmologist is keyt.”
Yup, though fortunately its rare for cataracts to develop that quickly, or in your forties. In my case I was using an optometrist for contacts who hadn’t a clue what was wrong with my eye that had suddenly had a major change in prescription within a few weeks and it took an ophthalmologist to spot the cataract that explained the shift. There wasn’t any obvious cause for it, likely merely bad genetic luck.
One issue many face is: once they have a cataract, they have no idea what sort of replacement lens might work for them. Its possible to get at least some clue by using contact lenses to see if they like monovision or multifocal vision. However if people wait until they get a cataract bad enough to need surgery: their vision is too degraded to do a good test.
I’d suggest people who have reached the age where they have noticeable presbyopia should consider at least a temporary experiment with contact lenses to consider options. It needs to wait until you have presbyopia so the range of vision is reduced to be able to meaningfully test the issue. Fortunately most people who get cataracts do have them develop very slowly so their vision is still good when the doctor spots an early cataract.
Unfortunately there are some tradeoffs with multifocal and EDOF lenses (or laser surgery) like risk of night vision artifacts, there isn’t yet a perfect solution.
@RE: It’s funny (well, not really) but a lot of people don’t know the (very significant) difference between an optometrist and an ophthalmologist, either. The person measuring you for reading glasses (optometrist) is usually not the same person as the one who will be deeply inspecting your vision and then also performing a surgical procedure to cut your eyeball open, remove your old lens and install a new one.
There’s a good reason optometrists exist, but they are not the same skillset as ophthalmologists. In my case, Dr. Greenspan was the latter and he was also an expert and careful *eye surgeon* who was extremely well-informed about the various treatment options I could choose from. We stuck with the solid, well-known and proven basics by my choice after reviewing a lot of options. You’ve added a lot to this discussion!