Who can use Vizz and what are its potential downsides?

Who Can Use Vizz and Potential Downsides

Vizz is indicated for adults with presbyopia and has no absolute contraindications, making it broadly usable in this population, though several important safety considerations and common adverse effects should be discussed with patients. 1

Who Can Use Vizz

Approved Population

• Adults with presbyopia are the indicated population for Vizz (aceclidine ophthalmic solution 1.44%) 1
• No age restrictions exist within the adult population, and no differences in safety or effectiveness have been observed between patients ≥65 years and younger adults 1
• No absolute contraindications are listed in the FDA labeling 1

Special Populations

Pregnancy and Lactation:

• Animal studies showed no adverse maternal, fetal, or neonatal effects at clinically relevant doses (110-fold higher than human exposure) 1
• Systemic exposure following topical ocular administration is low, though presence in breast milk is unknown 1
• The developmental benefits of breastfeeding should be weighed against the mother's clinical need for Vizz 1

Contact Lens Wearers:

• Contact lenses must be removed prior to instillation and may be reinserted 10 minutes after administration 1

Potential Downsides and Safety Concerns

Common Adverse Reactions (from Phase 3 trials with 466 participants)

The most frequent adverse reactions were: 1

• Instillation site irritation (20%)
• Dim vision (16%)
• Headache (13%)
• Conjunctival hyperemia (8%)
• Ocular hyperemia (7%)

The majority of these reactions were mild, transient, and self-resolving 1

Serious Safety Warnings

Vision-Related Risks:

• Accommodative spasm may occur, causing blurred vision that impairs driving or operating machinery 1
• Temporary dim or dark vision is common, requiring caution during night driving and hazardous activities in poor illumination 1
• Patients must be counseled not to drive or operate machinery if vision is not clear 1

Retinal Complications:

• Rare cases of retinal tear and detachment have been reported with miotics in susceptible individuals and those with pre-existing retinal disease 1
• Retinal examination is advised in all patients prior to initiating treatment 1
• Patients should seek immediate care with sudden onset of flashing lights, floaters, or vision loss 1

Ocular Inflammation:

• Iritis sequelae (adhesions/synechiae between iris and lens) may be exacerbated in patients with known history of iritis 1

Hypersensitivity:

• Vizz is not recommended for patients with known hypersensitivity to aceclidine or any ingredient in the formulation 1

Practical Administration Concerns

Contamination Risk:

• Care must be taken to avoid touching the single-dose vial to the eye or any surface to prevent eye injury or contamination 1
• The opened single-dose vial must be discarded after use 1

Drug Interactions:

• If using multiple topical ophthalmic products, they should be administered at least 5 minutes apart 1

Overdosage Considerations

While systemic toxicity is rare with topical ocular administration, sensitive patients may develop: 1

• Increased salivation and sweating
• Gastrointestinal overactivity
• Slowing of the pulse
• In accidental ingestion: nausea, tremors, decreased blood pressure

Spontaneous recovery is expected with supportive care including intravenous fluids for dehydration 1