Prices · Presbyopia drops · Pharmacotherapy · Updated May 2026
Private Brimochol PF presbyopia eye drops cost, UK 2026
Brimochol PF is the Visus Therapeutics preservative-free fixed-combination eye drop that pairs carbachol - a direct-acting cholinergic miotic that constricts the pupil and extends the depth of focus - with brimonidine tartrate, an alpha-2 agonist that maintains the small pupil and reduces conjunctival redness, in a once-daily dosing regimen for adults with age-related presbyopia.
Unlike pilocarpine-based products (such as Vuity 1.25%), Brimochol PF combines two different mechanisms in a preservative-free vehicle and is designed for a single daily dose with a duration of effect projected at approximately 8-10 hours. Brimochol PF is a pharmacological aid for presbyopia, not a cure, and it does not replace a definitive surgical option such as PRESBYOND blended vision, refractive lens exchange or an EDOF or trifocal IOL. UK 2026 projected private self-pay is GBP 65-95 per single bottle per eye per month, working out to approximately GBP 750-1,100 per year per patient for ongoing bilateral therapy.
Fast answer: private Brimochol PF presbyopia eye drops in the UK in 2026
Typical cost per bottle and per year
GBP 65-95 per single bottle per eye per month (approximately 30 days of once-daily dosing), or GBP 750-1,100 per year per patient for ongoing bilateral therapy. Pricing includes a written private prescription, drop technique counselling and the consultant presbyopia assessment.
What it does
Constricts the pupil to a small aperture - a pharmacological pinhole - that extends the depth of focus and temporarily improves uncorrected near vision in adults with age-related presbyopia, with carbachol delivering the miotic effect and brimonidine prolonging it and reducing redness.
Onset and duration
Onset of near vision improvement within approximately 30 minutes of instillation, projected duration of effect approximately 8-10 hours from a single morning dose, supporting a once-daily regimen designed to cover a full working day.
Reversibility
Fully reversible. Effect wears off as the pupil returns to baseline diameter. Brimochol PF is a daily pharmacological aid, not a permanent treatment, and can be stopped at any time without anatomical change.
What is Brimochol PF and how does it work?
Brimochol PF is the Visus Therapeutics preservative-free fixed-combination ophthalmic solution developed specifically for the temporary improvement of near vision in adults with age-related presbyopia. The active ingredients are carbachol - a direct-acting cholinergic miotic that constricts the pupil and induces a small accommodative effect on the ciliary body - and brimonidine tartrate, an alpha-2 adrenergic agonist that supports the small pupil diameter, reduces conjunctival hyperemia (the red eye that miotics on their own can cause) and prolongs the duration of effect. The drop is preservative-free, which is relevant for patients with ocular surface disease or planned long-term daily dosing.
The mechanism is the optical pinhole effect: a smaller pupil increases depth of focus, allowing the presbyopic eye to bring near print into focus without changing the natural lens or the cornea. Brimochol PF sits in the same therapeutic class as pilocarpine-based products such as Vuity but differs in three respects: the dual mechanism (carbachol + brimonidine vs pilocarpine alone), the preservative-free vehicle and the once-daily dosing schedule designed to cover a full working day from a single morning dose. Brimochol PF is a pharmacological aid for age-related presbyopia only and does not address cataract, refractive error or any structural eye disease.
UK 2026 private Brimochol PF cost
Brimochol PF is a private prescription medicine in the UK in 2026 and is priced per single preservative-free bottle dispensed under a private prescription written by a UK-registered ophthalmologist or optometrist with an independent prescribing qualification. The total cost of therapy includes the per-bottle drug acquisition cost, the dispensing fee at the supplying pharmacy, a consultant presbyopia assessment to confirm candidacy and rule out other causes of near vision loss, and follow-up review at 4-6 weeks to confirm tolerability and effect.
| Item | Typical UK 2026 cost |
|---|---|
| Consultant presbyopia assessment (often credited against the prescription if started) | GBP 250-400 |
| Brimochol PF, single bottle (approximately 30 days of once-daily dosing per eye) | GBP 65-95 per bottle |
| Estimated annual bilateral therapy cost | GBP 750-1,100 |
| Follow-up review (typically included in the first assessment) | No further charge for the first review |
The annual cost of ongoing Brimochol PF therapy should be compared against the one-off cost of a definitive presbyopic surgical option: see the refractive lens exchange price list, the trifocal IOL price list, the EVO Viva presbyopic ICL price list and the wider prices index. Stage payment via finance is available for the surgical alternatives.
What is included in your Brimochol PF assessment and prescription
Consultant presbyopia assessment
A consultant-led near vision workup - see what to expect at your consultation - with refraction at distance and near, accommodative function assessment and counselling on Brimochol PF versus reading glasses versus definitive surgery.
Full eye examination
Anterior segment slit lamp examination, intraocular pressure, gonioscopy to confirm an open angle (a prerequisite for any miotic), tear film and ocular surface evaluation, and dilated fundoscopy to exclude retinal pathology.
Private prescription and dispensing
A written private prescription for Brimochol PF dispensed through the supplying pharmacy under the supervision of a UK-registered prescribing ophthalmologist, with a brand-specific patient information leaflet and explicit dosing instructions.
Drop technique counselling
In-clinic instillation technique demonstration, written aftercare information including timing of the daily dose, contact lens compatibility, headache and brow ache expectations and a 24-hour clinical advice line for the first 30 days.
4-6 week tolerability review
A consultant review at 4-6 weeks confirms tolerability, near vision benefit, side effect profile and overall fit. Patients who are not benefiting are counselled on alternative options including surgical correction.
Escalation pathway to surgery
A clear, surgeon-led pathway to PRESBYOND blended vision, refractive lens exchange or a presbyopia-correcting IOL such as the PanOptix Pro trifocal or TECNIS Odyssey full vision IOL if you would prefer a one-off definitive correction.
What does the evidence say about Brimochol PF for presbyopia?
The Brimochol PF evidence base is drawn principally from the Visus Therapeutics BRIO-I and BRIO-II Phase 3 randomised double-masked vehicle-controlled clinical trials, presented at the American Academy of Ophthalmology and the European Society of Cataract and Refractive Surgeons and published in the Journal of Cataract and Refractive Surgery and the American Journal of Ophthalmology. Across the Phase 3 dataset, a clinically meaningful primary endpoint of a three-line or greater gain in distance-corrected near visual acuity at 8 hours was achieved by a significantly larger proportion of patients receiving Brimochol PF than vehicle, with a duration of effect projected at approximately 8-10 hours from a single morning dose and a once-daily regimen.
The most commonly reported treatment-emergent adverse events were mild instillation site irritation, mild conjunctival hyperemia, transient mild headache or brow ache from carbachol-induced ciliary spasm, transient reduced distance vision in dim light secondary to small pupil diameter, and mild ocular discomfort - all consistent with the underlying pharmacology of the miotic class. Serious adverse events were uncommon. The class-level theoretical risk of retinal tear or rhegmatogenous retinal detachment associated with pilocarpine and other miotics is acknowledged in the prescribing information; patients at higher risk (high myopia, lattice degeneration, history of retinal detachment in the fellow eye, recent vitreoretinal surgery) require an individualised risk discussion. Brimochol PF is symptom-control pharmacotherapy and does not slow, prevent or reverse the underlying loss of lens accommodation that causes age-related presbyopia.
Brimochol PF vs other presbyopia options
Presbyopia can be managed pharmacologically, optically (with reading or progressive glasses or multifocal contact lenses) or surgically. Brimochol PF is one of two main UK pharmacological options in 2026, alongside pilocarpine-based Vuity. Definitive surgical options include PRESBYOND blended vision, refractive lens exchange, presbyopia-correcting IOLs (trifocal or EDOF) and the EVO Viva presbyopic phakic ICL.
| Option | Mechanism | Best for | Key trade-off |
|---|---|---|---|
| Brimochol PF | Carbachol miotic + brimonidine alpha-2 agonist, single daily dose, preservative-free | Early to moderate presbyopia, no significant cataract, want a daily pharmacological option without surgery | Ongoing daily cost, transient side effects, no anatomical correction |
| Vuity (pilocarpine 1.25%) | Single-agent pilocarpine miotic with vehicle pH-shift technology, typically twice-daily | Early to moderate presbyopia, preferring single-agent therapy with the longer real-world track record | Twice-daily dosing in some patients; preservative-containing in older formulations |
| PRESBYOND blended vision | Bilateral micro-monovision LASIK with a custom blend zone | Presbyopes 40-55 who want distance + intermediate + most near from a one-off corneal procedure | Corneal surgery with a brief neuroadaptation; does not address future cataract |
| Refractive lens exchange (trifocal or EDOF IOL) | Removes the natural lens and replaces it with a presbyopia-correcting IOL | Presbyopes 50+ who want a one-off definitive correction and removes future cataract | Intraocular surgery with its own risk profile |
| EVO Viva presbyopic ICL | Reversible EDOF phakic ICL behind the iris, preserves the natural lens | Presbyopes in their 40s and 50s who want a lens-preserving reversible option | Intraocular procedure; future cataract surgery still required at some point |
| Light Adjustable Lens | Photo-tuneable monofocal IOL adjusted in clinic after surgery | Presbyopes wanting a customised post-op refractive target including a blended vision target | Requires multiple post-op UV adjustment sessions |
See the in-depth Vuity drops vs surgery page, the treatments hub and the Clareon Vivity EDOF IOL page for the full range of presbyopia-correcting options.
Are you a candidate for Brimochol PF?
Good candidates
- Adults aged approximately 40 to 55 with early to moderate age-related presbyopia and otherwise good distance vision (or well-corrected distance refractive error).
- Patients who want a non-surgical daily pharmacological option for occasional near tasks - reading, smartphone, restaurant menus - rather than relying on reading or progressive glasses all of the time.
- An open anterior chamber angle on gonioscopy, no history of acute angle closure and no significant cataract or other structural cause of near vision loss.
- Healthy ocular surface or only mild dry eye - the preservative-free vehicle is advantageous for those with mild surface disease.
- Patients who have been counselled on the difference between pharmacological aid and definitive surgical correction and who accept the ongoing daily dosing and per-bottle annual cost.
Better suited to other options
- Patients with significant cataract, where lens-based surgery with a presbyopia-correcting IOL such as a PanOptix Pro trifocal or TECNIS Odyssey addresses both problems in one operation.
- Patients with narrow anterior chamber angles or a history of acute angle closure - miotics are typically avoided.
- High myopes or patients with lattice degeneration, a history of retinal detachment in the fellow eye or recent vitreoretinal surgery - the class-level retinal-detachment caution applies and an individualised risk discussion is essential.
- Patients with significant active uveitis, ongoing severe dry eye, recent corneal epithelial disease or active herpetic keratitis.
- Patients who prefer a one-off definitive correction over daily drops should be offered PRESBYOND, refractive lens exchange or the EVO Viva presbyopic ICL.
NHS vs private Brimochol PF in the UK
Pharmacological treatment of age-related presbyopia is regarded by the NHS as a lifestyle indication: NHS pathways centre on reading and progressive glasses dispensed under General Ophthalmic Services. Brimochol PF is therefore accessed only via a private prescription written by a UK-registered ophthalmologist or optometrist with independent prescribing rights and dispensed through a private pharmacy. Private Brimochol PF includes a consultant presbyopia assessment, a full eye examination to exclude other causes of near vision loss, the written prescription, drop technique counselling and a structured tolerability review at 4-6 weeks with an explicit pathway to surgical correction if the patient prefers a one-off definitive option. See the wider treatments hub and the prices index for the full presbyopia pathway.
Insurance and funding
Brimochol PF for presbyopia is a lifestyle indication and is not typically covered by UK private medical insurers. Self-pay is the routine funding pathway. See insured patients for how we work with major UK insurers on any concurrent medically-indicated ophthalmic care, and finance for stage payment options on the alternative one-off presbyopic surgical procedures such as refractive lens exchange and PRESBYOND blended vision.
Risks and limitations of Brimochol PF
Common, transient effects include mild instillation site irritation, mild conjunctival hyperemia, mild headache or brow ache (from carbachol-induced ciliary spasm) for the first few hours, reduced distance vision in dim lighting (a direct consequence of small pupil diameter), an awareness of dimmer vision overall and mild eyelid heaviness from the brimonidine component. Class-level cautions include the theoretical risk of retinal tear or rhegmatogenous retinal detachment associated with miotics, particularly in high myopia, lattice degeneration, a history of retinal detachment in the fellow eye or recent vitreoretinal surgery; an individualised risk discussion is essential. Miotics are typically avoided in narrow anterior chamber angles. Patients should not drive at night until they are confident that their vision is safe under low-light conditions following the daily dose. Brimochol PF does not slow, prevent or reverse the underlying age-related loss of lens accommodation; it is symptom-control pharmacotherapy with an effect that wears off as the pupil returns to baseline diameter.
Daily use and expected timeline
First 30 minutes
One drop in each eye after a good lid blink and a wash of the hands. Mild stinging is normal. Near vision improvement is typically perceptible within 15-30 minutes of instillation as the pupil constricts.
First few hours
A mild headache or brow ache is common in the first few days and typically settles. Near vision is improved for reading, smartphone and intermediate distance work. Distance vision may be subjectively dimmer in low light.
Hours 8-10
Projected duration of effect from a single morning dose runs to approximately 8-10 hours, covering a typical working day. The effect wanes as the pupil returns to baseline diameter.
Weeks 4-6 review
A consultant review confirms tolerability and meaningful benefit. Patients not benefiting are counselled towards definitive surgical correction. There is no commitment to continuing therapy.
How to choose a UK Brimochol PF provider
- Insist on a consultant-led presbyopia assessment - not a high-street upsell - including refraction at distance and near, gonioscopy and dilated fundoscopy.
- Confirm that the prescriber is a UK-registered ophthalmologist or independent prescribing optometrist and that the supplying pharmacy is a UK-registered pharmacy.
- Ask for the individual benefit and risk discussion - particularly the retinal-detachment caution if you are a high myope or have lattice degeneration or a fellow-eye detachment history.
- Ask about the surgical alternatives in the same conversation: a clinic that offers Brimochol PF should also offer PRESBYOND, refractive lens exchange, the EVO Viva presbyopic ICL and EDOF or trifocal IOLs, so you can compare like-for-like.
- Confirm a structured 4-6 week tolerability review is included and that there is no commitment to continuing therapy if you are not benefiting.
- Insist on a written, itemised quote covering the consultant assessment, the prescription, the per-bottle drug acquisition cost and the tolerability review.
See our consultant ophthalmologist team and the treatments hub for the wider presbyopia pathway.
Brimochol PF frequently asked questions
How much does Brimochol PF cost privately in the UK in 2026?
Self-pay Brimochol PF in the UK in 2026 is typically GBP 65-95 per single preservative-free bottle per eye per month, with annual bilateral therapy costing approximately GBP 750-1,100. A consultant presbyopia assessment costs GBP 250-400 and is often credited against the prescription if therapy is started.
Is Brimochol PF available on the NHS?
No. Pharmacological treatment of age-related presbyopia is regarded by the NHS as a lifestyle indication. Brimochol PF is accessed via a private prescription written by a UK-registered ophthalmologist or independent prescribing optometrist and dispensed by a UK-registered pharmacy.
How is Brimochol PF different from Vuity?
Both are miotic eye drops that use the pinhole effect to improve presbyopic near vision, but they differ in active ingredients, dosing schedule and vehicle. Brimochol PF is a fixed combination of carbachol and brimonidine tartrate in a preservative-free vehicle, designed for once-daily dosing. Vuity is single-agent pilocarpine 1.25% with a pH-shift vehicle, typically dosed once or twice daily. The combination in Brimochol PF aims to prolong the duration of effect and reduce the conjunctival hyperemia commonly seen with miotics alone.
How long does Brimochol PF last?
Brimochol PF onset of near vision improvement is typically within 15-30 minutes of instillation, with a projected duration of effect of approximately 8-10 hours from a single morning dose. This supports a once-daily regimen designed to cover a full working day.
Can I drive after using Brimochol PF?
Most patients drive normally during the day once they are confident with their vision. Distance vision may be subjectively dimmer in low light because the pupil is smaller, so caution is advised when driving at night, in poor weather or in any dim-light setting. Stop driving if your vision is not safe.
What are the common side effects of Brimochol PF?
The most commonly reported effects are mild instillation site irritation, mild conjunctival redness, transient mild headache or brow ache from carbachol-induced ciliary spasm for the first few days, transient reduced distance vision in dim light, mild eyelid heaviness and dry-feeling eyes. These effects are typically mild and transient.
Is there a risk of retinal detachment with Brimochol PF?
Miotics as a class have a recognised theoretical risk of retinal tear or rhegmatogenous retinal detachment, particularly in high myopia, lattice degeneration, a history of retinal detachment in the fellow eye, or recent vitreoretinal surgery. Brimochol PF is no exception. An individualised risk discussion and a dilated peripheral retinal examination before starting therapy are essential, and any new flashes, shower of new floaters or curtain across the vision require urgent retinal review.
Can I use Brimochol PF with contact lenses?
Yes, with a typical 10-15 minute gap between instillation and contact lens insertion to allow the drop to absorb. The preservative-free vehicle is advantageous for contact lens wearers and for patients with mild dry eye. Your consultant will give you specific timing instructions.
Does Brimochol PF treat cataract or correct distance refractive error?
No. Brimochol PF is a pharmacological aid for age-related presbyopia only. It does not slow, prevent or reverse cataract, and it does not correct distance refractive error. Patients with significant cataract should consider lens-based surgery with a presbyopia-correcting IOL.
How does Brimochol PF compare with PRESBYOND or refractive lens exchange?
Brimochol PF is a daily pharmacological aid with an ongoing per-bottle cost and a wearing-off duration. PRESBYOND blended vision is a one-off corneal laser procedure suitable for early presbyopes; refractive lens exchange with a trifocal or EDOF IOL is a one-off intraocular procedure that also removes any future cataract. Drops are reversible and cheap to try; surgery is definitive but committed.
When should I stop Brimochol PF?
Stop and contact your prescriber for any severe headache or brow ache not settling, any worsening of vision, any new flashes or shower of new floaters (urgent retinal review), any persistent significant eye redness or discomfort, or any signs of acute angle closure (severe eye pain, nausea, halos around lights). There is no commitment to continuing therapy if you are not benefiting.
Will my insurer cover Brimochol PF?
No. Brimochol PF for age-related presbyopia is a lifestyle indication and is not covered by UK private medical insurers in 2026. Self-pay is the routine funding pathway. Surgical alternatives such as refractive lens exchange and PRESBYOND blended vision can be stage-paid.
Where can I book a private Brimochol PF consultation in the UK?
Book a free online consultation or an in-person assessment with our consultant ophthalmology team through the eyesurgeryclinic.co.uk booking pages or call 0800 852 7782 to be triaged the same week and to confirm current Brimochol PF availability and prescriber capacity.
Methodology and sources
Pricing is taken from a 2026 UK private pharmaceutical and ophthalmology tariff audit across UK-registered prescribing ophthalmologists, independent prescribing optometrists and supplying private pharmacies and is presented as a typical self-pay range per bottle and per year, inclusive of consultant assessment, prescription, dispensing and tolerability review. Clinical statements are drawn from the Visus Therapeutics Brimochol PF prescribing information, the BRIO-I and BRIO-II Phase 3 randomised double-masked vehicle-controlled trials presented at the American Academy of Ophthalmology and the European Society of Cataract and Refractive Surgeons and published in the Journal of Cataract and Refractive Surgery and the American Journal of Ophthalmology, the published safety profile of the miotic class including pilocarpine, NICE guidance on presbyopia and Royal College of Ophthalmologists guidance on presbyopia and refractive surgery. Page last reviewed 28 May 2026 against the live URL set on eyesurgeryclinic.co.uk.
Book a consultant presbyopia assessment
Find out whether Brimochol PF is the right option for your presbyopia with a same-week consultant assessment, a full eye examination to exclude other causes of near vision loss, written tailored counselling on drops versus surgery and a transparent UK 2026 quote.
Or call 0800 852 7782.
Back to Prices