UK 2026 private Vizz aceclidine costs a projected £70–£110 per single preservative-free bottle per eye per month (about 30 days of once-daily dosing), or approximately £800–£1,200 per year for ongoing bilateral therapy. Vizz contains aceclidine 1.44%, a predominantly pupil-selective miotic that contracts the iris sphincter to a sub-2mm pupil. This pinhole extends the depth of focus and improves uncorrected near vision in adults with age-related presbyopia, with the distinctive advantage of acting mainly on the pupil rather than the ciliary muscle — so it sharpens near vision without the myopic shift (blurred distance vision) that can affect older pilocarpine drops. Near vision improvement begins within roughly 30 minutes and is projected to last up to 10 hours from a single morning dose. The effect is fully reversible as the pupil returns to baseline.
Vizz aceclidine prices
Vizz is a private prescription medicine in the UK and is priced per single preservative-free bottle dispensed under a private prescription written by a UK-registered ophthalmologist or an optometrist with an independent prescribing qualification. The total cost of therapy includes the per-bottle drug acquisition cost, the pharmacy dispensing fee, a consultant presbyopia assessment to confirm candidacy and exclude other causes of near vision loss, and a follow-up review at 4–6 weeks.
The first tolerability review is typically included in the assessment. The annual cost of ongoing Vizz therapy should be weighed against the one-off cost of a definitive presbyopic procedure: 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.
Weighing daily drops against a one-off procedure? A consultant presbyopia assessment gives you a like-for-like comparison of Vizz versus surgery for your eyes.
Book a presbyopia assessmentWhat is Vizz and how does aceclidine work?
Vizz is the first FDA-approved aceclidine-based ophthalmic solution, developed by LENZ Therapeutics for the temporary improvement of near vision in adults with age-related presbyopia. Aceclidine is a new chemical entity for presbyopia: a cholinergic miotic that is predominantly pupil-selective, meaning it acts mainly on the iris sphincter to constrict the pupil rather than strongly stimulating the ciliary muscle. The result is a small, sub-2mm pupil that produces a robust pinhole effect — extending the depth of focus and sharpening near vision — while largely avoiding the accommodative spasm and myopic distance blur that can accompany pilocarpine-based drops.
The mechanism is the optical pinhole: a smaller pupil increases depth of focus, allowing the presbyopic eye to focus near print without changing the natural lens or cornea. Vizz sits in the same therapeutic class as pilocarpine-based Vuity and the carbachol-brimonidine combination drop Brimochol PF / Yuvezzi, but is distinguished by its pupil-selective single-agent aceclidine chemistry and its sub-2mm aperture. Vizz is a pharmacological aid for age-related presbyopia only and does not treat cataract, refractive error or structural eye disease.
What is included in your Vizz 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 and counselling on Vizz 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 evaluation and dilated fundoscopy to exclude retinal pathology.
- Private prescription and dispensing — a written private prescription for Vizz dispensed through the supplying pharmacy under the supervision of a UK-registered prescribing ophthalmologist, with explicit once-daily dosing instructions.
- Drop technique counselling — in-clinic instillation technique, written aftercare covering timing of the daily dose, contact lens compatibility and dim-vision and headache expectations, plus a clinical advice line for the first 30 days.
- 4–6 week tolerability review — a consultant review confirms tolerability, near vision benefit and side-effect profile. Patients not benefiting are counselled on alternatives 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 if you would prefer a one-off definitive correction.
What does the evidence say about Vizz?
Vizz received FDA approval in 2025 as the first aceclidine-based treatment for presbyopia, supported by a phase 3 clinical programme in adults with age-related presbyopia. Across the pivotal trials, a significantly greater proportion of patients treated with aceclidine achieved a clinically meaningful three-line or greater improvement in distance-corrected near visual acuity compared with vehicle, with a duration of effect projected at up to 10 hours from a single daily dose and, importantly, without a clinically significant loss of distance vision.
The most commonly reported adverse reactions were mild and transient: instillation site irritation (around 20% of patients), dim vision (around 16%), headache (around 13%), and conjunctival or ocular hyperemia (around 7–8%). The majority of adverse reactions were mild, transient and self-resolving. As with all miotics, the class-level theoretical risk of retinal tear or rhegmatogenous retinal detachment is acknowledged, and patients at higher risk — high myopia, lattice degeneration, a history of retinal detachment in the fellow eye or recent vitreoretinal surgery — require an individualised risk discussion and a dilated peripheral retinal examination before starting. Vizz is symptom-control pharmacotherapy and does not slow, prevent or reverse the underlying loss of lens accommodation that causes age-related presbyopia.
Vizz vs other presbyopia options
Presbyopia can be managed pharmacologically, optically or surgically. Vizz is one of the UK pharmacological options alongside pilocarpine-based Vuity and the carbachol-brimonidine combination drop. Definitive surgical options include PRESBYOND blended vision, refractive lens exchange, presbyopia-correcting IOLs and the EVO Viva presbyopic ICL.
| Option | Mechanism | Best for | Key trade-off |
|---|---|---|---|
| Vizz (aceclidine 1.44%) | Pupil-selective single-agent miotic, sub-2mm pupil, once daily, preservative-free | Early to moderate presbyopia wanting a daily drop with minimal distance blur | Ongoing daily cost, dim vision in low light, no anatomical correction |
| Vuity (pilocarpine 1.25%) | Single-agent pilocarpine miotic with pH-shift vehicle, once or twice daily | Early to moderate presbyopia preferring the longer real-world track record | Possible myopic distance shift; twice-daily dosing in some patients |
| Brimochol PF / Yuvezzi | Carbachol + brimonidine fixed combination, once daily, preservative-free | Patients wanting a dual-agent drop with extended duration and less redness | Ongoing daily cost; transient headache and brow ache |
| PRESBYOND blended vision | Bilateral micro-monovision LASIK with a custom blend zone | Presbyopes 40–55 wanting distance, intermediate and most near from a one-off procedure | Corneal surgery with 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+ wanting a one-off correction that also removes future cataract | Intraocular surgery with its own risk profile |
| Light Adjustable Lens | Photo-tuneable monofocal IOL adjusted in clinic after surgery | Presbyopes wanting a customised post-op refractive or blended-vision target | Requires multiple post-op UV adjustment sessions |
Are you a candidate for Vizz?
Good candidates include adults aged roughly 40–55 with early to moderate age-related presbyopia and good (or well-corrected) distance vision, an open anterior chamber angle on gonioscopy, no significant cataract, and a healthy or only mildly dry ocular surface, who want a non-surgical daily option and accept the ongoing per-bottle cost. Better suited to other options are patients with significant cataract (where a presbyopia-correcting IOL addresses both problems at once), narrow angles or a history of acute angle closure, high myopes or those with lattice degeneration or a fellow-eye retinal detachment history, and anyone who would prefer a one-off definitive correction such as PRESBYOND or refractive lens exchange.
NHS, insurance and funding
Pharmacological treatment of age-related presbyopia is regarded by the NHS as a lifestyle indication, so Vizz is accessed only via a private prescription 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 one-off surgical alternatives.
Vizz aceclidine frequently asked questions
How much does Vizz cost privately in the UK in 2026?
How is Vizz different from Vuity?
Does Vizz blur my distance vision?
How long does Vizz last each day?
What are the common side effects of Vizz?
Is Vizz available on the NHS?
Is there a risk of retinal detachment with Vizz?
Can I use Vizz with contact lenses?
Does Vizz treat cataract or correct distance refractive error?
Where can I book a private Vizz consultation in the UK?
Methodology and sources
Pricing is taken from a 2026 UK private pharmaceutical and ophthalmology tariff review across UK-registered prescribing ophthalmologists, independent prescribing optometrists and supplying private pharmacies, and is presented as a typical projected self-pay range per bottle and per year, inclusive of consultant assessment, prescription, dispensing and tolerability review. Clinical statements are drawn from the LENZ Therapeutics Vizz (aceclidine 1.44%) prescribing information and phase 3 clinical programme, the published safety profile of the miotic class, NICE guidance on presbyopia and Royal College of Ophthalmologists guidance on presbyopia and refractive surgery. Page last reviewed 12 June 2026 against the live URL set on eyesurgeryclinic.co.uk.