A patient from San Luis Obispo asked me about a blog I had previously posted on an exciting new drop that possibly could cure presbyopia, the age related loss of the ability to see up close. Presbyopia typically starts at age 40 and is due to the lens becoming progressively stiffer as it loses its ability to flex to see up close. The drop, called EV06, works by dissolving into lipoic acid and chlorine after it is absorbed into the eye. Both are naturally occurring substances. The lipoic acid is absorbed into the lens and is reduced to dihydrolipoic acid, which can help break the disulfide bonds that are stiffening the lens. I just came back from the largest meetings of the year of LASIK surgeons, the annual meeting of the American Society of Cataract and Refractive Surgery (ASCRS). A Phase 1/2 FDA clinical study update of EV06’s clinical progress was presented involving 50 patients who used EV06 in both eyes and had their near vision measured using both eyes together. Meaningful improvement was seen as early as 8 days and continued for over the 3 months of the study. By 3 months, 84% of patients gained 1 line of near vision on a near-card eye chart and just over 50% gained more than 2 lines. The drops were stopped and the patients were then followed for 7 months with the effect mostly persisting the entire time, with only a slight decline. Distance vision was unaffected. As preliminary data, this was very exciting, but the effect of the drop, while not trivial, was not huge. It may be that combining a relative improvement in lens function with a small degree of LASIK or PRK monovision (blended vision) or even a corneal inlay may give a more significant improvement in near vision performance. This is an exciting technology with significant potential, but the dosing still needs to be worked out and the improvements so far do not show a complete “cure” of presbyopia.