Refractive surgery has now been around for almost thirty years. The advances in technology over the period has been astounding. An area of vision that is being given considerable attention deals with patients who have lost the ability to focus up close. Various surgical strategies dealing with both the cornea and lens of the eye are helping individuals over forty see both distance and near. Depending on the individual and the type of near work being performed, a particular surgery and device will be used. It is important to know that at this time there are limitations as to having the patient be able to see perfectly at all distances. However, these surgeries are a great advancement compared to what was available to patients just a few years ago.