VIZZ™ Eye Drop – Aceclidine 1.44% Ophthalmic Solution

VIZZ is a prescription ophthalmic solution by Lenz Therapeutics, specifically formulated to treat presbyopia – the age-related decline in near vision. It is the first FDA-approved once-daily eye drop (aceclidine 1.44%) shown to improve close-up vision in adults. VIZZ works as a potent cholinergic muscarinic agonist (miotic) that contracts the iris sphincter muscle, creating a “pinhole effect” to extend the eye’s depth-of-focus. In clinical studies, a single dose of VIZZ produced clear near vision for up to 10 hours, providing a convenient, non-surgical alternative to reading glasses or bifocals for tasks like reading, computer use, or smartphone navigation.

Uses and Applications

VIZZ is indicated for presbyopia – the common condition where adults gradually lose the ability to focus on close objects. By sharpening the eye’s focusing power, VIZZ helps adults regain clear near vision for up to 10 hours with each once-daily dose. Typical uses include reading, sewing, cooking, writing, and other close-up activities. It is ideal for patients seeking to reduce their dependency on reading glasses or multifocal eyewear. VIZZ does not treat or prevent other eye conditions (e.g. glaucoma, cataracts, or age-related macular degeneration) – its sole application is improving blurry near vision due to presbyopia.

Specifications

• Active Ingredient: Aceclidine Hydrochloride, 1.44% w/v (14.4 mg/mL). Aceclidine is the only active drug in this solution, acting as a pupil-selective cholinergic agonist.
• Formulation: Sterile, preservative-free ophthalmic solution (clear to slightly yellow liquid). Each single-dose vial contains 1.44% Aceclidine in 0.25 mL sterile solution.
• Packaging: Comes in a carton of 25 single-use vials. The vials are organized as 5 blister packs of 5 vials (each vial = 0.25 mL). Each vial is sealed for one-time use.
• Storage: Store unopened vials at room temperature away from direct light. Discard each vial after a single use to maintain sterility.
• Manufacturer: Lenz Therapeutics, Inc. (FDA-approved July 2025). NDC: 84226-100-21 (each box contains 25 × 0.25 mL vials).

How to Use

Use VIZZ exactly as directed by your eye doctor. Follow these steps for administration:

1. Prepare your eye: Wash hands thoroughly. Remove contact lenses and ensure eyes are clean. Contact lenses may be reinserted at least 10 minutes after dosing.
2. Open a vial: Twist and remove the top of a single-use 0.25 mL vial to expose the dropper. Do not squeeze the vial tip to avoid aerosolizing the solution.
3. Instill first drop: Tilt head back slightly, look upward, and gently pull down the lower eyelid with a clean finger. Holding the vial just above the eye, instill one drop into the lower conjunctival sac of each eye. Avoid touching your eye, eyelid, or eyelashes with the vial tip to prevent contamination.
4. Wait and instill second drop: Close your eyes or blink 1–2 times. Wait 2 minutes, then repeat the instillation of one more drop in each eye from the same vial.
5. Discard vial: After administering the second drop, discard the opened vial immediately. Do not reuse vials.
6. Aftercare: Blink or gently move eyes to distribute the medication. Wait another 10 minutes before putting contact lenses back in. If you accidentally miss instilling a drop or flush out the drop, do not double up doses – just resume normal dosing the next day.
7. Multiple eye medications: If you also use other ophthalmic drops (e.g. artificial tears or glaucoma medications), administer them at least 5 minutes apart to avoid wash-out.

Follow your doctor’s instructions for the timing of daily dosing (typically morning for all-day effectiveness). Only one VIZZ dose should be used per day. Each box contains 25 doses (use one vial per day, discard after use).

Dosage and Administration

• Recommended Dose: One drop in each eye, then a second drop in each eye (for two drops per eye total), once daily This dosing (two drops per eye) has been shown effective; do not use more than instructed.
• Frequency: VIZZ is a once-daily treatment. Do not exceed one dose every 24 hours. If a dose is missed, skip it (do not double up the next day).
• Special Populations: VIZZ is approved for adults with presbyopia. Safety and efficacy in children have not been established. Use in pregnancy or breastfeeding should be considered only if clearly needed; consult your doctor about risks.
• Administration Tips: Do not let the vial tip touch your eye or surrounding area. Dispose of the empty vial immediately after use to avoid contamination.

Always follow the dosing schedule prescribed by your eye care provider. Use exactly as directed and do not change the schedule or dosage without consulting your doctor.

Drug Interactions

No clinically significant drug-drug interactions with VIZZ have been identified. Because VIZZ is applied topically with minimal systemic absorption, routine systemic interactions are unlikely. However:

• If you use multiple ophthalmic medications (e.g. for dry eye, glaucoma), instill them at least 5 minutes apart. This prevents one drop from washing out another and ensures optimal absorption.
• VIZZ should not be used together with other miotic (pupil-constricting) eye drops unless directed by your doctor.
• Tell your physician or pharmacist about all prescription and over-the-counter medications (eye drops, oral drugs, herbal products, vitamins) you are taking to check for any potential interactions.

Always inform your eye care professional of any new medications before starting VIZZ.

Side Effects

In clinical trials, VIZZ was generally well tolerated. The most common adverse reactions included mild, transient symptoms shortly after instillation. These include:

• Instillation-site irritation: Eye discomfort, stinging or burning sensation (~20% of users).
• Temporary blurred or dimmed vision: Vision may appear slightly blurred or darkened immediately post-dose (~16%). Vision typically clears within minutes.
• Headache: Mild headache (~13%) has been reported.
• Ocular redness: Mild redness or bloodshot eyes (conjunctival/ocular hyperemia) in ~7–8% of patients.

These side effects were mostly mild to moderate and resolved without stopping therapy. If any side effect is persistent or bothersome, contact your doctor. Less common effects (<5%) can include eye itching, foreign body sensation, tearing, or eye pigment changes. To report any suspected adverse reactions, contact Lenz Therapeutics or the FDA MedWatch program (info in package insert).

Warnings

• Blurred/Darkened Vision: Temporary visual dimming or spots are common right after applying VIZZ. Do not drive, operate machinery, or perform any hazardous activities until your vision is fully clear.
• Pupil Constriction: Because VIZZ causes pupil constriction (“pinhole effect”), vision at very low light may be dimmer. Use caution in poorly lit conditions.
• Retinal Detachment Risk: Miotic agents have been rarely associated with retinal tear or detachment. An eye doctor should perform a dilated retinal exam before starting VIZZ. If you experience sudden flashes of light, new floaters, or loss of peripheral vision, discontinue use and seek immediate ophthalmic evaluation.
• Ocular Inflammation: Use with caution in patients with a history of uveitis or iritis. VIZZ may exacerbate anterior eye inflammation or adhesions of the iris or lens.
• Hypersensitivity: VIZZ is contraindicated in patients with known hypersensitivity or allergy to aceclidine or any component of the product. Do not use if you have experienced allergic eye reactions to similar glaucoma/presbyopia drops.
• Contact Lenses: Remove soft contact lenses before instillation; wait at least 10 minutes after dosing before reinserting. If using contact lenses, ensure they are disinfected.
• Sterility/Injury: Avoid touching the vial tip to your eye or any surface to keep the dropper sterile. Discard each single-dose vial promptly after use.
• Other: VIZZ is for ophthalmic use only. Avoid swallowing or touching it to skin/other areas. Keep out of reach of children.

Patients should receive counseling on these precautions. Regular follow-ups with an eye care professional are recommended to monitor vision changes and ocular health during VIZZ treatment.