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Pilocarpine Eye Medication: Uses, Side Effects & More

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Oilocarpine ophthalmic is a miotic medication that is mainly prescribed to treat glaucoma. It can also be prescribed to treat ocular hypertension and, more recently, presbyopia. 

This medication is used to manage the high pressure in the eye related to glaucoma and ocular hypertension as well as to shrink the pupil for blurry vision related to presbyopia. It can help to lower the amount of fluid in the eye. 

Pilocarpine is a prescription eye medication taken as an eye drop.

Uses for Pilocarpine Eye Medication

Pilocarpine eye medication, or pilocarpine ophthalmic, is commonly used as a prescription eye drop medication to treat glaucoma, typically open-angle glaucoma. 

Open-angle glaucoma is an eye disease that causes high eye pressure. Without treatment, it can lead to lost vision and blindness. Once glaucoma causes damage, it cannot be reversed, but treatments, such as medications, can help to slow progression of the disease, lower eye pressure, and minimize further damage. 

Prescription medications, such as pilocarpine ophthalmic, are the most common treatment method for glaucoma to lower eye pressure and minimize damage to the optic nerve. Pilocarpine ophthalmic can also be used to treat ocular hypertension, which also causes increased pressure in the eye. 

Pilocarpine eye medication allows excess fluid to drain from the eye to help reduce eye pressure. It can also be used after some types of laser surgery and during an eye exam to constrict the pupil.

Recently, pilocarpine (in the form of the brand name Vuity) has been approved to treat presbyopia by reducing the pupil size to decrease blurry vision in older adults. Presbyopia is a condition impacting the lens of the eye as it ages, which makes it hard to focus on objects or writing up close. Vuity is an FDA-approved medication to treat age-related blurry near vision.

How to Use Pilocarpine Ophthalmic

Pilocarpine ophthalmic is a prescription eye drop that comes in 1%, 2%, and 4% solutions that are to be placed directly into the eyes. Vuity is a 1.25% solution. 

When used to treat glaucoma or ocular hypertension, pilocarpine ophthalmic is generally administered into the eyes up to four times per day, while Vuity is put into the eyes once per day to treat glaucoma. When used prior to laser surgery, pilocarpine eye medication is placed into the eye or eyes 15 to 60 minutes before the procedure. 

Pilocarpine eye medication should be used exactly as directed by your doctor and the prescription labeling. 

Follow these steps to use pilocarpine eye medication eye drops:

  1. Wash your hands thoroughly with soap and warm water.
  2. Tilt your head back, and pull the lower part of your eyelid away from your face.
  3. Using your other hand, get the dropper tip as close to your eye as possible without touching it.
  4. Look up.
  5. Gently squeeze the dropper to release one drop into the pocket formed in your lower eyelid.
  6. Close your eye for two to three minutes with your head down while trying not to blink or squeeze your eye.
  7. Put your finger on the tear duct to apply gentle pressure for two minutes.
  8. Use a tissue to wipe up any excess liquid from your face. 
  9. Repeat in the other eye.
  10. If placing more than one drop in the same eye, wait at least five minutes before reapplying.


Pilocarpine eye medication and Vuity can make it difficult to see well in the dark or dim lighting. This can impact night vision and make it temporarily unsafe to drive at night. You will need to use caution when driving at night or performing activities that could be dangerous in low lighting. 

This medication can also cause temporary issues with changing focus between near and far objects. This can make driving and operating machinery potentially hazardous. 

You should not use pilocarpine ophthalmic or Vuity if you are allergic to the medication or any of its components or ingredients.

You will need to remove contact lenses before applying pilocarpine eye medication, and wait at least 10 minutes before putting them back in. Do not touch the dropper to your eye. Always wipe the dropper after use, and be careful not to contaminate it in any way. Store it with the lid tightly closed. 

Report any potential side effects of the medication that you notice to your health-care or eyecare professional.

Side Effects of Pilocarpine

All medications have potential side effects. The most common with pilocarpine eye medication are headaches and eye redness. Other side effects can include the following:

  • Dim vision, especially in low lighting
  • Blurry vision
  • Stinging or burning in the eye
  • Itching or eye discomfort
  • Swelling of the eye
  • Tearing up

If you experience more serious side effects, such as sudden loss of vision, sweating, nausea, vomiting, or diarrhea, you should call your doctor right away.

How Long Does It Take to Start Working?

It is important to remember that pilocarpine eye medication is not a cure for glaucoma or hypertension, and Vuity will not completely stall presbyopia. The medication instead is meant to slow the progression of these conditions and improve related symptoms. 

Typically, you will notice symptom improvement within 15 to 30 minutes after taking the medication. Eye fluid will drain to lower eye pressure for glaucoma and ocular hypertension. Pupils will constrict and blurry near vision related to presbyopia will usually improve in this time frame.It can take up to a full month before the eye medication reaches its full potential. It is important to keep taking pilocarpine eye medication exactly as directed even if you feel better. It is meant to keep working to slow progression of eye conditions and diseases that often progress slowly.

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