The race to replace reading glasses

Overview

For 240 years, the solution to presbyopia—the gradual loss of near-vision that affects nearly everyone over 45—has been essentially the same: put lenses in front of your eyes. Benjamin Franklin invented bifocals in 1785. Today, two billion people worldwide rely on reading glasses. On January 29, 2026, the Food and Drug Administration approved YUVEZZI (carbachol and brimonidine tartrate ophthalmic solution), the first dual-agent eye drop for treating this universal condition, marking a pivotal moment in pharmacological presbyopia treatment.

In This Story

3 Videos

2 People

5 Orgs

FDA Approves Brimochol PF, Fourth Drop Enters Market

2 Context

Vuity Launch and Market Reality Check (2021-2022)

Key Indicators

2 billion

Global presbyopia cases

Number of people worldwide affected by age-related near-vision loss

8-10 hours

Duration of effect

How long YUVEZZI improves near vision after a single dose, compared to 6 hours for Vuity

$235M

Launch financing

Total capital raised through Series B equity ($85M) and credit facility ($150M) to support commercialization

72,000+

Treatment days monitored

BRIO II conducted the longest safety study in presbyopia drop history with no treatment-related serious adverse events

Interactive

Exploring all sides of a story is often best achieved with Play.

Benjamin Franklin

(1706-1790) · Enlightenment · wit

Fictional AI pastiche — not real quote.

"I observe with some amusement that my bifocals, which cost nothing but a bit of glass-grinding ingenuity, have held their ground against the march of progress for two and a half centuries—whilst these modern alchemists now promise to sell drops at no doubt considerable expense to achieve what a penny's worth of curved glass accomplishes admirably. Perhaps in another 240 years, they shall rediscover that the simplest solution to a universal problem need not extract twenty billion dollars from those it serves."

Ever wondered what historical figures would say about today's headlines?

Debate Arena

Two rounds, two personas, one winner. You set the crossfire.

People Involved

Henric Bjarke

Chief Executive Officer, Tenpoint Therapeutics (Leading commercial launch preparations following FDA approval)

Ben Bergo

President and Chief Business Officer, Tenpoint Therapeutics (Leading commercial preparation for potential launch)

Organizations Involved

Tenpoint Therapeutics

Biotechnology Company

Status: Preparing commercial launch of FDA-approved YUVEZZI in Q2 2026

Global clinical-stage biotech developing treatments for age-related eye conditions including presbyopia, cataracts, and geographic atrophy.

U.S. Food and Drug Administration

Federal Regulatory Agency

Status: Approved YUVEZZI as fourth presbyopia eye drop

Federal agency responsible for approving new drugs, including presbyopia treatments, for the U.S. market.

AbbVie (Allergan)

Pharmaceutical Company

Status: Marketing first-approved presbyopia drop Vuity

Major pharmaceutical company that launched Vuity, the first FDA-approved presbyopia eye drop, in late 2021.

Janus Henderson

Investment Management Firm

Status: Co-led Tenpoint's $85M Series B financing

Global asset management firm that co-led Tenpoint Therapeutics' Series B financing round in January 2026.

Hercules Capital

Specialty Finance Company

Status: Provided $150M credit facility to Tenpoint

Leading specialty financing provider focused on innovative venture capital-backed companies, provided senior secured term loan to Tenpoint.

Timeline

FDA Approves YUVEZZI as First Combination Presbyopia Drop
Regulatory

FDA approves carbachol and brimonidine tartrate ophthalmic solution 2.75%/0.1% (branded as YUVEZZI, formerly Brimochol PF), the first dual-agent eye drop for presbyopia treatment in adults.
January 29th, 2026
Tenpoint Secures $235 Million in Financing
Corporate

Company closes $85 million Series B financing led by Janus Henderson, EQT Nexus, Hillhouse, and British Business Bank, plus $150 million senior secured term loan facility with Hercules Capital to accelerate YUVEZZI commercialization.
January 29th, 2026
FDA Decision Day for Brimochol PF
Regulatory

PDUFA target date for FDA to announce approval or rejection of the first combination therapy presbyopia eye drop.
January 28th, 2026
CEO Presents at J.P. Morgan Healthcare Conference
Corporate

Henric Bjarke presented at the 44th Annual J.P. Morgan Healthcare Conference in San Francisco, highlighting Brimochol PF ahead of the January 28 FDA decision deadline and discussing commercial launch preparations for first half 2026.
January 13th, 2026 • 10:00 PST
FDA Approves Third Presbyopia Drop
Regulatory

Vizz (aceclidine 1.44%) becomes the first aceclidine-based presbyopia treatment approved in the U.S., offering up to 10 hours of effect.
July 31st, 2025
FDA Accepts Brimochol PF Application
Regulatory

FDA accepts NDA and sets January 28, 2026 as target decision date. Agency indicates no advisory committee meeting will be held.
June 3rd, 2025
Tenpoint Submits NDA for Brimochol PF
Regulatory

Company files New Drug Application with FDA seeking approval for the first combination presbyopia eye drop.
April 2025
Qlosi Launches in U.S. Market
Commercial

Orasis Pharmaceuticals commercially launches its lower-dose pilocarpine drop after securing funding in late 2024.
April 2025
BRIO-II Confirms 12-Month Efficacy
Clinical Trial

Topline results from the largest presbyopia drop study (629 participants, 70,000+ dosing days) show sustained efficacy with no loss of effect over a year of daily use.
January 2025
Tenpoint and Visus Therapeutics Merge
Corporate

The two clinical-stage biotechs combine to create a focused ophthalmic company, accelerating Brimochol PF toward commercialization.
December 11th, 2024
FDA Approves Second Presbyopia Drop
Regulatory

Qlosi (pilocarpine 0.4%) receives FDA approval, offering a lower-concentration alternative to Vuity with fewer reported headaches.
October 2023
Brimochol PF Hits Phase 3 Endpoints
Clinical Trial

BRIO-I pivotal trial demonstrates the carbachol-brimonidine combination outperforms both monotherapy and placebo in improving near vision.
May 2023
FDA Approves First Presbyopia Eye Drop
Regulatory

Vuity (pilocarpine 1.25%) from Allergan/AbbVie becomes the first FDA-approved pharmacological treatment for presbyopia, marking a new therapeutic category.
October 29th, 2021
Benjamin Franklin Invents Bifocals
Historical

American inventor describes his bifocal glasses in a letter to George Whatley, establishing the optical solution that would dominate presbyopia treatment for 240 years.
May 23rd, 1785

Scenarios

FDA Approves Brimochol PF, Fourth Drop Enters Market

Discussed by: Ophthalmology Times, company investor communications, industry analysts

The FDA grants approval based on strong Phase 3 data showing 8-10 hour duration, 85% response rate, and favorable safety profile. Tenpoint launches in first half of 2026 as planned, positioning the combination therapy as a premium option for patients seeking longer-lasting relief without multiple daily doses. The approval validates the dual-mechanism approach and intensifies competition among presbyopia drop makers.

FDA Issues Complete Response, Requests Additional Data

Discussed by: Pharmaceutical regulatory analysts, industry observers

The FDA declines to approve the application in its current form, requesting additional clinical data or manufacturing documentation. This would delay potential launch by 6-18 months and require Tenpoint to address specific agency concerns. Such outcomes are not uncommon for first-in-class combination products.

Approval Granted But Market Adoption Struggles

Discussed by: Ophthalmology Management, Review of Ophthalmology, prescribing physicians

Brimochol PF wins approval but encounters the same market headwinds that limited Vuity's success: high out-of-pocket costs, insurance coverage gaps, and competition from inexpensive reading glasses. Physicians report improved patient satisfaction compared to earlier drops, but the presbyopia eye drop category remains a fraction of its projected potential.

Brimochol PF Becomes Category Leader, Reshapes Market

Discussed by: Healthcare equity analysts, ophthalmology conference presentations

The combination drop's superior duration and tolerability profile drives rapid market share gains against Vuity, Qlosi, and Vizz. Strong physician recommendations and word-of-mouth lead to broader acceptance of pharmacological presbyopia treatment. Tenpoint's success attracts acquisition interest from major pharmaceutical companies seeking ophthalmology pipeline assets.

YUVEZZI Overcomes Market Headwinds, Drives Category Growth

Discussed by: Ophthalmology Management, industry analysts

The combination therapy's superior 8-10 hour duration and improved tolerability profile address the specific limitations that hampered Vuity adoption. If Tenpoint prices competitively and secures favorable insurance coverage, the $235 million in financing provides runway to invest in physician education and direct-to-consumer marketing. Strong early adoption could validate the pharmacological presbyopia treatment category and expand the total addressable market beyond early adopters.

Price Premium Limits Market to Affluent Early Adopters

Discussed by: Healthcare market analysts, payer organizations

YUVEZZI launches at a price point above Vuity's $79 monthly cost, positioning as a premium option justified by longer duration and combination mechanism. Without broad insurance coverage, the market remains constrained to affluent patients and former LASIK recipients willing to pay out-of-pocket for vision freedom. The $235 million financing sustains operations but the presbyopia drop category continues to underperform projections.

Historical Context

Vuity Launch and Market Reality Check (2021-2022)

October 2021 - December 2022

What Happened

AbbVie's Allergan launched Vuity as the first FDA-approved presbyopia eye drop with massive consumer awareness campaigns. Initial enthusiasm was high—128 million Americans theoretically represented the target market. Ophthalmologist Steven Dell called the launch "masterful" with unprecedented category awareness.

Outcome

Short Term

Prescriptions peaked early then declined as patients encountered headaches, 6-hour duration limits, and the $79 monthly cost not covered by insurance.

Long Term

The experience taught the industry that efficacy alone isn't sufficient—duration, tolerability, and price all matter for patient adoption. Subsequent drops (Qlosi, Vizz) were designed to address Vuity's specific limitations.

Why It's Relevant Today

Brimochol PF's clinical development explicitly targeted Vuity's weaknesses: the combination therapy offers 8-10 hour duration versus 6, brimonidine reduces the redness side effect common to miotics, and the preservative-free formulation improves tolerability. The real test is whether these improvements translate to better commercial performance.

LASIK's Transformation of Refractive Surgery (1999-2010)

1999-2010

What Happened

Laser-assisted in-situ keratomileusis (LASIK) went from experimental procedure to mainstream vision correction, with millions of Americans choosing surgery over glasses or contact lenses. The procedure's adoption accelerated as technology improved, prices dropped, and patient testimonials spread.

Outcome

Short Term

LASIK became a $2+ billion annual market in the U.S. by the mid-2000s, fundamentally changing how refractive errors were treated.

Long Term

A generation of LASIK patients now entering presbyopia age have perfect distance vision but still need reading glasses. These patients are considered ideal candidates for presbyopia drops—they've already embraced technology-based vision solutions and have higher disposable income.

Why It's Relevant Today

Presbyopia drop companies specifically target former LASIK patients, who represent motivated customers accustomed to investing in vision freedom. If combination drops like Brimochol PF prove effective, this demographic could drive adoption in ways that early drops haven't achieved.