I predict a low acceptance of Vuity (pilocarpine drops). There are several reasons. Many years ago ophthalmologists used strengths of pilocarpine from 1 to 6 % to treat glaucoma. Then, medicines like Timolol, Xalatan, Cosopt and others came along and pilocarpine was dropped like a hot potato by most ophthalmologists.
Why? Pilocarpine constricts the pupil giving it an “angry” and “elderly” look. It also causes the ciliary muscle inside the eye to contract giving “brow ache” similar to what some people experience when going outdoors on a very bright day.
Atropine drops were called “bella donna”, which means “beautiful lady”, because they dilate the pupil. The dilated pupil is regarded as a sign of youth and beauty. In today’s beauty-conscious world, I don’t see a lot of people running out to constrict their pupils just so they don’t need reading glasses as much.
One reason that we have pupils that can dilate and constrict is to vary the amount of light coming into the eyes. When we drive through a dark tunnel in the day time our pupils dilate to let in more light. When we go to the beach on a bright day, the pupils constrict to reduce the light entering the eyes. With pilocarpine the pupil stays constricted. I predict an insert warning about driving when using Vuity drops.
One more reason that Vuity won’t be popular is the cost is almost $1000 per year. That will buy a lot of reading glasses. When Pfizer found that its pulmonary hypertension drug, sildenafil, caused erections in men, they quickly patented it as Viagra and made a fortune charging up to $90 per pill. Now that it has gone off patent and become generic it can be had for about $4.00 per pill.
Most modern glaucoma meds cost $10 or $15 per month for a bottle of drops. Pilocarpine has been in use for over one hundred years and until recently, has always been inexpensive. Now Allergan is charging $80 for a bottle of weak strength pilocarpine touting its use for improving reading.
Lastly, modern frames are seen as fashion accessories. One can get high quality progressive lenses and see far and near with no bifocal line in the lenses.
It’s just a thought.
