Vyzulta: A Breakthrough in Glaucoma Treatment

For the first time in over two decades, a new kind of glaucoma eye drop is changing what’s possible for patients.

If you or someone you care about has been diagnosed with glaucoma or high eye pressure (ocular hypertension), you know that managing intraocular pressure — the pressure inside your eye — is the cornerstone of treatment. Uncontrolled eye pressure can silently damage your optic nerve and lead to permanent vision loss. For years, patients and doctors had limited options. That changed in 2017 when the FDA approved Vyzulta (latanoprostene bunod), a first-of-its-kind once-daily eye drop that works in two ways simultaneously.

Why Is Vyzulta Called a Breakthrough?

The last truly new class of glaucoma medication — the prostaglandin analogues (PGAs), which include familiar names like latanoprost (Xalatan) and bimatoprost (Lumigan) — arrived in the mid-1990s. For more than 20 years after that, glaucoma treatment saw no major innovation in drug mechanisms. Vyzulta broke that drought.

Developed by Bausch + Lomb, Vyzulta is the first medication in its class: a nitric oxide-donating prostaglandin analogue. It combines two proven concepts — prostaglandin-based fluid drainage and nitric oxide — into a single drop taken once a day every evening.

Understanding Eye Pressure: A Simple Analogy

Think of your eye like a sink. A fluid called aqueous humor is constantly produced inside the eye — like a faucet that’s always running. That fluid needs to drain out through two pathways to keep the pressure balanced:

• The trabecular meshwork pathway — the primary drain, responsible for about 80–90% of outflow.
• The uveoscleral pathway — a secondary route that drains the remaining fluid.

In glaucoma, the trabecular meshwork becomes stiff and resistant, like a partially clogged drain. Traditional PGA medications primarily worked only on the secondary (uveoscleral) pathway — largely ignoring the main drain where the problem actually starts. Vyzulta addresses both.

How Vyzulta Works: Two Mechanisms in One Drop

When Vyzulta is applied to the eye, it breaks down into two active components:

• Latanoprost acid — a well-understood prostaglandin that increases drainage through the uveoscleral pathway. Doctors have decades of experience with latanoprost, and its safety profile is well established.
• Butanediol mononitrate — a nitric oxide-donating molecule that relaxes the trabecular meshwork, the eye’s primary drain, improving fluid outflow through the conventional pathway. Nitric oxide is also a natural vasodilator that may improve blood flow and oxygenation to the optic nerve.

This dual action is what sets Vyzulta apart. No previously approved single-molecule glaucoma therapy had targeted both pathways at the same time.

What the Clinical Trials Showed

Vyzulta was evaluated in multiple rigorous Phase 3 clinical trials, including the APOLLO, LUNAR, VOYAGER, and CONSTELLATION studies. The results were compelling:

• Patients using Vyzulta once daily for up to a year experienced reductions in eye pressure of 7 to 9 mmHg from baseline — greater than what was seen with latanoprost alone.
• Vyzulta outperformed twice-daily timolol (a long-standing standard of care) at all nine measured time points in the APOLLO and LUNAR trials.
• In the CONSTELLATION study, Vyzulta reduced nocturnal (nighttime) eye pressure by 2.5 mmHg below baseline — a period when timolol provided very limited or no statistically significant reduction.
• Vyzulta was also found to improve ocular perfusion pressure — the blood flow supplying the optic nerve — more than timolol, which may offer benefits beyond simply lowering pressure.

Why Once-Daily Dosing Matters

Glaucoma is a lifelong condition, and the effectiveness of any medication is only as good as the patient’s ability to take it consistently. Research has shown that when patients are required to use two or more eye drops, adherence drops significantly. With three or more medications, compliance can decline sharply. Vyzulta’s ability to replace the need for combination therapy in many patients — while delivering superior pressure reduction in a single once-daily dose — is a meaningful practical advantage.

Safety and Side Effects

Vyzulta’s side effect profile is consistent with other prostaglandin-based glaucoma drops. The most common side effects include:

• Eye redness (conjunctival hyperemia)
• Eye discomfort or pain at the instillation site
• Gradual changes in eyelash length, thickness, or color
• Possible gradual increase in brown pigmentation in the iris (the colored part of the eye) — this can be permanent
• Rare risk of macular edema (swelling in part of the retina) — notify your eye doctor promptly if you notice any vision changes

Systemic (whole-body) side effects are rare, as the drug’s concentration in the bloodstream is extremely low. Discontinuation due to side effects has been uncommon in clinical studies. Vyzulta is not approved for patients under 16 years of age.

Is Vyzulta Right for You?

Vyzulta may be a good fit if you:

• Are newly diagnosed with open-angle glaucoma or ocular hypertension and are starting treatment for the first time.
• Have been on a traditional prostaglandin analogue but have not achieved your target eye pressure.
• Are currently taking multiple glaucoma medications and want to simplify your regimen.
• Have cardiovascular concerns, as Vyzulta does not carry the systemic risks associated with beta-blocker glaucoma drops.

As with any prescription eye drop, Vyzulta requires a conversation with your ophthalmologist or optometrist. Your doctor will consider your full medical history, current medications, and target pressure goals before recommending the best treatment path.

The Bottom Line

Glaucoma is often called the “silent thief of sight” because vision loss happens gradually and without pain — until it’s too late. Staying on top of your treatment matters enormously. Vyzulta represents the first genuinely new approach to lowering eye pressure in a generation: one molecule, two mechanisms, one drop per day. For patients who have struggled to reach their target pressure on traditional therapies, or who want to simplify a multi-drug regimen, it offers a meaningful new option.

Talk to your eye doctor about whether Vyzulta is right for your situation. The most important step you can take is staying engaged in your care.

For inquiries about prescription medications, contact our team at Jason’s CanadaDrugstore.com by calling  1-800-226 3784 (CAN-DRUG) for assistance from our patient representatives or a licensed Canadian pharmacist.

This article provides medical information to help understand a condition or treatment plan but is not a diagnosis or treatment recommendation. Contact your doctor if you have concerns or symptoms. In case of emergency, call 911