What is the difference between Qlosi and Vuity?

Both use pilocarpine, but Qlosi uses a much lower dose (0.4% vs 1.25%) with a sustained-release formulation. This results in fewer headaches (5-7% vs 15%), less dim vision, and a longer duration (8 hours vs 6). The tradeoff is a slightly lower responder rate (26% vs 31%).

How long does Qlosi last?

Qlosi provides approximately 8 hours of improved near vision per dose, compared to Vuity's 6 hours. This improvement comes from the sustained-release micro-emulsion formulation that delivers pilocarpine gradually.

Does Qlosi cause headaches?

Qlosi has a significantly lower headache rate (5-7%) compared to Vuity (15%). The lower 0.4% pilocarpine concentration causes less ciliary muscle spasm, which is the primary mechanism behind pilocarpine-induced headaches.

Qlosi Eye Drops Review: Low-Dose Pilocarpine for Presbyopia (2026)

How Qlosi Works: Less Is More

Qlosi takes a "less is more" approach to pilocarpine. At just 0.4%, it contains roughly one-third the concentration of Vuity (1.25%).[FDA] The key innovation is Orasis Pharmaceuticals' micro-emulsion sustained-release formulation — rather than delivering a large dose that peaks and fades, Qlosi gradually releases pilocarpine over an extended period.

This sustained release achieves two goals simultaneously: it extends the duration from Vuity's ~6 hours to ~8 hours, and it reduces peak drug concentration in the eye, which is what causes the worst side effects (headache, brow ache, dim vision).

Clinical Trial Results

Qlosi's approval was based on Phase III trial data submitted to the FDA in 2023.[FDA]

Key Efficacy Results

Participants gaining ≥3 lines near vision ~26%

Duration of effect ~8 hours

Headache rate 5-7% (vs Vuity 15%)

Dim vision complaints Reduced vs Vuity

Dosing Once daily, both eyes

The 26% responder rate is numerically lower than Vuity's 31%, and significantly behind VIZZ's 71%. However, the real-world tolerability is where Qlosi shines — patients who couldn't stick with Vuity due to headaches or dim vision often find Qlosi usable for daily wear.

Qlosi vs Vuity: The Direct Comparison

Feature	Qlosi (0.4%)	Vuity (1.25%)
Active ingredient	Pilocarpine 0.4%	Pilocarpine 1.25%
Duration	~8 hours	~6 hours
Responder rate	~26%	~31%
Headache	5-7%	~15%
Dim vision	Moderate	Significant
Formulation	Sustained-release micro-emulsion	pHast pH-adjusted
Manufacturer	Orasis Pharmaceuticals	AbbVie / Allergan

Side Effects

Since Qlosi is still pilocarpine-based, it shares the same types of side effects as Vuity — just at reduced frequency and severity due to the lower concentration:

Headache / brow ache5-7% (improved over Vuity)

Dim vision in low lightModerate

Eye rednessMild-moderate

Blurred distance visionMild

Because Qlosi still uses pilocarpine, the same retinal detachment risk applies — patients with high myopia (>-6D) or lattice degeneration should discuss this with their ophthalmologist. For the full safety analysis, see our comprehensive side effects guide.

Who Is Qlosi Best For?

Qlosi occupies a specific niche: it's the "gentle pilocarpine" option for patients who value tolerability over maximum efficacy.

Best for:

• Patients who tried Vuity but couldn't tolerate headaches
• Those who want a daily-use drop with minimal side effects
• Patients in the 40-50 age range with mild presbyopia
• People who prefer a familiar drug class (pilocarpine) with decades of safety data

Consider alternatives if:

• You want the highest efficacy → VIZZ (71% responders)
• You want anti-redness benefits → Yuvezzi
• You had LASIK → VIZZ has specific post-LASIK data
• You want a non-pilocarpine option → VIZZ or Yuvezzi

For even better results, consider combining Qlosi with Gabor patch brain training — drops fix the optics while training fixes the neural processing. Read the full comparison →

Qlosi Eye Drops: The Gentler Presbyopia Option