Devices, systems, and methods for developing prescriptions for and/or treating presbyopia may use a combination of an alteration to the refractive tissues of the eye with changes in the response of the visual system. The visual system response may include using residual accommodation in a manner similar to that employed by latent hyperopes, a trained response of the pupil, trained psychophysics, or the like. Associated refractive prescriptions may be tailored to take advantage of the subsequent visual system response so as to mitigate presbyopia.