Presbyopia (the need for reading glasses or “cheaters”) is the age-related loss of the ability to see up close. It generally becomes noticeable after age 40 and then continues to get worse after that. It is caused by the gradually loss of flexibility of the lens, which is located inside the eye, behind the pupil. If someone over 40 or 45 is corrected for good distance vision, whether this correction is from LASIK, PRK, glasses, contact lenses, or birth, it is normal for this reason to have more and more difficulty with reading or with seeing your phone. There have been several surgical solutions for presbyopia, including monovision and blended vision as well as presbyopic lens implants with cataract surgery. One exciting option that is still not yet approved by the FDA in the United States is called “presby-LASIK”, or LASIK in which the cornea is sculpted with a shape that can see both near and far simultaneously regardless of age. Presby-LASIK always has been considered an optical trade-off in which some distance is sacrificed to improve the close. Various laser manufacturers have developed proprietary approaches to this complex re-shaping. Recently, at the annual meeting of the American Society of Cataract and Refractive Surgery, Dr. Robert Ang gave a presentation of impressive results with the Bausch and Lomb Technolas approach to presby-LASIK, called “Supra-Cor.” Dr. Ang showed that, at 6 months post-operative in a subjective questionnaire, 93% of patients said they could read newspaper headlines without glasses and 89% said they could read text messages on their phones without glasses. 96% were satisfied to the point that they would recommend the procedure to their friends. This data is very good. Nonetheless, the FDA continues to have some legitimate reservations about potential trade-offs involving contrast resolution and night vision and this technology is not approved for use in the United States. I think with further refinements of computer modeling, the ideal presby-LASIK shape will become better understood and that this will some day be an important tool for us in refractive surgery.