A patient in my Santa Barbara office asked me today whether there were any advances in treating presbyopia, the age related loss of the ability to see up close. She was looking for a solution to avoid reading glasses after LASIK. Presbyopia occurs because the lens of the eye, which sits inside the eye and behind the pupil, gets stiffer with age and is unable to focus up close. Current options to treat presbyopia include using LASIK or PRK to create either monovision or blended vision in which the non-dominant eye is set for a degree of close focus while the dominant eye is set for distance focus. This option works well for many patients, but is a trade-off in which some distance is sacrificed to improve close vision. PresbyLASIK is another option under development that uses the excimer laser to create a multi-focal cornea to see both near and far simultaneously. Other surgical options include corneal inlays such as the Raindrop or Kamra and also refractive lens exchange with presbyopia correcting intraocular lenses. Recent research has shown that the root cause of the age-related lens stiffening may be “cross-linking” of the lens with disulfide bonds. A small company called Encore Vision currently is working on an eyedrop to treat presbyopia called EV06 which dissolves these disulfide bonds in an effort to actually restore flexibility to the lens. The EV06 drop goes through the cornea and, once in the eye, breaks down into lipoic acid and chlorine which are both naturally occurring substances. The lipoic acid, in turn, goes into the lens and is reduced to dihydrolipoic acid, which is the active ingredient causing the breakdown of the disulfide bonds. A small Phase I-II study of 75 patients has shown extremely impressive results. Benefit in near vision was seen as early as 2 weeks and continued for the 3 month duration of the study. Further study will be necessary to make sure the results do not wear off. The drop has enormous potential. In the future, vision correction for patients over 40 could involve setting both eyes for distance with customized wavefront LASIK or customized wavefront PRK for excellent distance vision (as we do today) and the use of these drops to maintain close vision as well.