What Yuvezzi brings to the optometrist's clinical toolkit with Dr Derek Cunningham

As pharmacologic options for presbyopia continue to evolve, new therapies are expanding how optometrists approach near-vision correction and patient counseling. In this Q&A, Derek N. Cunningham, OD, FAAO, discusses Yuvezzi (carbachol and brimonidine tartrate ophthalmic solution) 2.75%/0.1% in light of its recent FDA approval and explores how it may fit into everyday clinical practice. The conversation covers candidate selection, mechanism of action, patient education, and how drops can be integrated alongside traditional spectacle correction as part of a personalized presbyopia treatment strategy.

How does Yuvezzi uniquely expand the average optometrist’s tool kit for presbyopia treatment?

Derek N. Cunningham, OD, FAAO: This product consists of 2 new molecules in the presbyopia class. They both have a long track record of use in eye care, but they have never been used in the presbyopia drop class to date. It is another option to customize your prescribing options to the needs of the patient.

What is the ideal candidate for Yuvezzi and how can optometrists best discuss the new drop with their patients?

Cunningham: As this is a relatively new and unknown treatment option to patients, general awareness is always key. Almost all presbyopic patients are potential candidates and all should at least be aware these are a potential option. The only exception is patients with existing retinal pathology or high myopes (including previous high myopes); we do not have sufficient data on these groups and as with all drops in this class, these patients are not considered candidates.

Generally, any suitable presbyopic patient is a good candidate and the only way to know if they will be successful is for them to try the product.

In what ways do Yuvezzi’s method of action set it apart from other drops for presbyopia?

Cunningham: The combination of carbachol and brimonidine tartrate may have a synergistic effect of constricting the pupil and prolonging the duration. There may also be an added effect of increased tolerability and comfort with this combination as compared to some other products in this class.

As drop options for presbyopia expand, do you see patients wanting to shift away from glasses? If not, how can both glasses and drops be integrated into a patient’s treatment plan?

Cunningham: If anything we have seen the opposite. These drops either provide patients with temporary relief from, or even enhanced vision with spectacles. We rarely see patients giving up on glasses that use these drops, rather they appreciate the quality/proper correction with spectacles as opposed to the visual freedom they enjoy with the drops. One correction provides perspective and a better appreciation for the other. There are benefits and compromises with both correction options and we often hear patients request "a really good pair of specs for when they are locked in doing a lot of stationary demanding tasks and drops for when they are active."