Orasis Announces Qlosi Now Available to Prescribe for Presbyopia in US

Gretchyn Bailey

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Ponte Vedra, FL, April 7, 2025 – Orasis Pharmaceuticals, an ophthalmic pharmaceutical company delivering solutions to reshape vision possibilities, today announced that Qlosi™ (pilocarpine hydrochloride ophthalmic solution) 0.4%, a novel, corrective prescription eye drop for the treatment of presbyopia, or age-related blurry near vision, in adults is now available to prescribe in the U.S.

Qlosi’s proprietary EyeQ Formulation™ maximizes efficacy while minimizing side effects by balancing the lowest approved concentration of pilocarpine at a near neutral pH for optimal bioavailability, is preservative-free in single-use vials, and includes lubricants (HA & HPMC) for comfort. Patients have the flexibility of using one drop of Qlosi in each eye for improved near vision for a specific occasion or activity, and up to two drops per day for an extended effect, lasting up to eight hours.

“We are proud to deliver Qlosi, a solution that ushers in a new era in near vision correction and aims to empower patients, providing Qlosi Clear Moments through improved near vision,” said Elad Kedar, Chief Executive Officer of Orasis Pharmaceuticals. “Our goal has always been to improve near vision for the millions of people struggling with presbyopia, give them a break from readers, and provide eye care professionals with an additional option to optimize care for their patients.”

Presbyopia, the loss of ability to focus on near objects as a result of the natural aging process, affects more than 128 million people in the U.S. and cannot be prevented or reversed.1,2 Qlosi was shown to improve near vision by pupil modulation, resulting in a “pinhole effect” and an increase in the depth of field, increasing the ability to focus on near objects with no mean impact on distance vision. The FDA approval of Qlosi was based on results from the Phase 3 NEAR-1 and NEAR-2 clinical trials which met their primary and key secondary endpoints on Day 8.
“Qlosi is a breakthrough option for presbyopia patients, delivering functional near vision (20/40 near vision or better) in most patients, which is equivalent to a seven-point font such as the text that appears on a driver’s license. In addition, the combination of Qlosi’s efficacy and safety profile and EyeQ Formulation makes it a compelling solution for many of my early to moderate presbyopic patients who are looking for convenient options without compromising their activities,” said Paul Karpecki, OD, FAAO, Director of Cornea and External Disease for the Kentucky Eye Institute, and Associate Professor, University of Pikeville, Kentucky College of Optometry.

Patients can fill prescriptions via two pharmacy partners, BlinkRx and Medvantx, and receive free home delivery. Qlosi is available in single-use vials that can be taken on-the-go.

“The launch of Qlosi represents a potentially transformative moment, not just for many patients seeking alternatives to readers, but also for eye care professionals looking to expand their practice by incorporating innovative solutions to manage presbyopia,” said Jackie Garlich, OD, FAAO, Owner, Envision Optometry in Boston, Massachusetts. “I’m excited to integrate Qlosi into my practice and offer my patients a novel, discreet way to approach near vision care.”

For more information about Qlosi and Full Prescribing Information, visit www.QlosiECP.com, which includes resources for patients and eye care professionals on how to use Qlosi and the Qlosi Clear Start Kit that patients will receive with their first prescription. The Clear Start Kit will provide guidance on starting Qlosi twice a day for the first week and how to use it for occasional days or long-term to help patients achieve their best near vision.

About the Qlosi Clinical Development Program
The FDA approval of Qlosi was based on results from two pivotal, Phase 3 clinical trials, NEAR-1 and NEAR-2, which evaluated the efficacy, safety and tolerability of Qlosi in more than 600 adult patients with presbyopia. Both trials met their primary and key secondary endpoints on Day 8, achieving statistically significant 3-line or more gain in distance-corrected near visual acuity (DCNVA) and no loss of 1-line or more in distance visual acuity. In clinical trials, presbyopia patients achieved their best results when taking Qlosi consecutively over two weeks. All adverse events reported were in the single digits, with headache (6.8%) and instillation site pain (5.8%) being the most commonly reported treatment-related adverse events (TRAEs). The percentage of Qlosi participants who experienced a mild ocular TRAE was 96.1% while the percentage of Qlosi participants who experienced a moderate ocular TRAE was 3.9%.3

About Presbyopia
Presbyopia is the loss of ability to focus on near objects as a result of the natural aging process. It occurs mostly after the age of 40 when the crystalline lens of the eye gradually stiffens and loses flexibility.1 There are almost two billion people globally and more than 128 million people in the U.S. living with presbyopia.2,3 People with presbyopia experience blurred vision when performing daily tasks that require near visual acuity, such as reading a book, a restaurant menu or messages on a smartphone. Presbyopia cannot be prevented or reversed, and it continues to progress gradually. Many existing treatment options can be either cumbersome or invasive, presenting a significant unmet need for presbyopia patients. Presbyopia can be diagnosed during an eye exam conducted by an eye care professional.5

About Qlosi
Qlosi™ (pilocarpine hydrochloride ophthalmic solution) 0.4% is a novel corrective eye drop indicated for the treatment of presbyopia in adults. Qlosi’s EyeQ Formulation™ delivers the lowest effective concentration of pilocarpine approved in a preservative-free eye drop, with a near-neutral pH and dual lubricating agents to provide enhanced safety and patient comfort without compromising on efficacy.3,6,7,8 Qlosi improves near visual acuity by pupil modulation, resulting in a “pinhole effect” and an increase in the depth of field, thus increasing the ability to focus on near objects without negatively impacting distance vision. The most commonly reported treatment-related adverse events (TRAEs) were headache and instillation site pain, at rates of 6.8% and 5.8%, respectively.

About Orasis Pharmaceuticals
Orasis Pharmaceuticals is an ophthalmic pharmaceutical company delivering solutions to reshape vision possibilities. Orasis has developed Qlosi™ (pilocarpine hydrochloride ophthalmic solution) 0.4%, a novel, corrective prescription eye drop for the treatment of presbyopia, or age-related blurry near vision, in adults. Orasis is led by a collaborative team of industry executives and eye care professionals working to transform the standard of care for near vision correction. Orasis is funded by a diverse group of sophisticated and experienced life science and healthcare investors. Orasis has offices in the United States and Israel.

References
  1. Holden BA, et al. Global Vision Impairment Due to Uncorrected Presbyopia. Arch Ophthalmol. 2008;126(12):1731-1739. https://jamanetwork.com/journals/jamaophthalmology/fullarticle/420914
  2. U.S. Census Bureau. United States Census – Populations and People. Accessed April 7, 2025. https://data.census.gov/profile/United_States?g=010XX00US.
  3. Holland E, Karpecki P, Fingeret M, Smits G, Ignacio T, Lindstrom R. (n.d.-a). Efficacy and Safety of CSF-1 (0.4% Pilocarpine Hydrochloride) in Presbyopia: Pooled Results of the NEAR Phase 3 Randomized, Clinical Trials. Clinical Therapeutics. https://www.clinicaltherapeutics.com/article/S0149-2918(23)00478-2/fulltext
  4. Fricke TR, et al. Global Prevalence of Presbyopia and Vision Impairment from Uncorrected Presbyopia. American Academy of Ophthalmology. 2018;125(10):1492-1499. https://www.aaojournal.org/article/S0161-6420(17)33797-1/fulltext.
  5. WebMD. Presbyopia: Symptoms, diagnosis, and treatment. Accessed April 7, 2025. https://www.webmd.com/eye-health/eye-health-presbyopia-eyes.
  6. Qlosi™ (pilocarpine hydrochloride ophthalmic solution) 0.4%. Prescribing Information. Orasis Pharmaceuticals; 2023.
  7. U.S. Food and Drug Administration. Orange Book: Approved Drug Products with Therapeutic Equivalence Evaluations. Accessed April 7, 2025. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm.
  8. Holland E, Karpecki P, Fingeret M, et al. Efficacy and Safety of CSF-1 (0.4% Pilocarpine Hydrochloride) in Presbyopia: Pooled Results of the NEAR Phase 3 Randomized, Clinical Trials. Clinical Therapeutics. 2024;46(2):104-113.
 
The market is filling up with the newer formularies as compared to Vuity, How many ODs have been turned off? I wonder. Any answers form the crowd? The newer formularies do have less side effects and last longer but is this enough? Time will tell. I hope there is an interest in at last trying the newer drugs
 
The market is filling up with the newer formularies as compared to Vuity, How many ODs have been turned off? I wonder. Any answers form the crowd? The newer formularies do have less side effects and last longer but is this enough? Time will tell. I hope there is an interest in at last trying the newer drugs
Since Vuity worked basically not at all in my office, the bar has been set very low.
 
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vuity = essentially useless.

I expect this to be the same. And it’s a prescription. $500 a bottle? Or is this another one of those ridiculous scan this QR code or text code 867-5309 to get another code to give to the pharmacist who will not do anything with it?
 
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The key to success with Miotic in order of importance by the patient IMHO

1). Satisfactory near acuity for all or 99% of daily tasks
2). Cost that is not prohibitive to use daily
3). Limited or no side effects that make you feel it is not worth the hassle for improved near acuity
4). Time of effective treatment is convenient to get through a full day whether it be work or otherwise

Opinions???
 
An interesting factoid I think on Vuity: as of March 2023, VUity (pilocarpine hydrochloride ophthalmic solution 1.25%) had been prescribed to over 120,000 patients, resulting in 190,000 prescriptions being filled.

This leads me to believe very few refilled it more than once and even that was just over 50%
 
The key to success with Miotic in order of importance by the patient IMHO

1). Satisfactory near acuity for all or 99% of daily tasks
2). Cost that is not prohibitive to use daily
3). Limited or no side effects that make you feel it is not worth the hassle for improved near acuity
4). Time of effective treatment is convenient to get through a full day whether it be work or otherwise

Opinions???
IF all those turn out to be true, especially point 2, it would be a home run.
 
This qualifies as an advertorial. Did I miss the disclaimer somewhere? Shilling at this level deserves disclosure.

SERIOUSLY

"Qlosi is a breakthrough option for presbyopia patients, delivering functional near vision (20/40 near vision or better) in most patients, which is equivalent to a seven-point font such as the text that appears on a driver’s license. In addition, the combination of Qlosi’s efficacy and safety profile and EyeQ Formulation makes it a compelling solution for many of my early to moderate presbyopic patients who are looking for convenient options without compromising their activities,” said Paul Karpecki, OD, FAAO, Director of Cornea and External Disease for the Kentucky Eye Institute, and Associate Professor, University of Pikeville, Kentucky College of Optometry."
 
This qualifies as an advertorial. Did I miss the disclaimer somewhere? Shilling at this level deserves disclosure.

SERIOUSLY

"Qlosi is a breakthrough option for presbyopia patients, delivering functional near vision (20/40 near vision or better) in most patients, which is equivalent to a seven-point font such as the text that appears on a driver’s license. In addition, the combination of Qlosi’s efficacy and safety profile and EyeQ Formulation makes it a compelling solution for many of my early to moderate presbyopic patients who are looking for convenient options without compromising their activities,” said Paul Karpecki, OD, FAAO, Director of Cornea and External Disease for the Kentucky Eye Institute, and Associate Professor, University of Pikeville, Kentucky College of Optometry."
Ya think? I remember when the very same author promoted a product called Flouromeme (spelling?) about a decade ago.It was a combination of Fluorescein and Lissamine green. It was god awful. Got all over the place, The bottle clogged the first time you used it. Yet he said in a journal ad how great it was. Well where is it now?
 
This qualifies as an advertorial. Did I miss the disclaimer somewhere? Shilling at this level deserves disclosure.

SERIOUSLY

"Qlosi is a breakthrough option for presbyopia patients, delivering functional near vision (20/40 near vision or better) in most patients, which is equivalent to a seven-point font such as the text that appears on a driver’s license. In addition, the combination of Qlosi’s efficacy and safety profile and EyeQ Formulation makes it a compelling solution for many of my early to moderate presbyopic patients who are looking for convenient options without compromising their activities,” said Paul Karpecki, OD, FAAO, Director of Cornea and External Disease for the Kentucky Eye Institute, and Associate Professor, University of Pikeville, Kentucky College of Optometry."
Well, it's a quote in a press release. I'm not sure what you would expect a KOL quote to say.

Also note the references at the bottom of the release. Karpecki is listed as an author on a safety study.


References
  1. Holden BA, et al. Global Vision Impairment Due to Uncorrected Presbyopia. Arch Ophthalmol. 2008;126(12):1731-1739. https://jamanetwork.com/journals/jamaophthalmology/fullarticle/420914
  2. U.S. Census Bureau. United States Census – Populations and People. Accessed April 7, 2025. https://data.census.gov/profile/United_States?g=010XX00US.
  3. Holland E, Karpecki P, Fingeret M, Smits G, Ignacio T, Lindstrom R. (n.d.-a). Efficacy and Safety of CSF-1 (0.4% Pilocarpine Hydrochloride) in Presbyopia: Pooled Results of the NEAR Phase 3 Randomized, Clinical Trials. Clinical Therapeutics. https://www.clinicaltherapeutics.com/article/S0149-2918(23)00478-2/fulltext
  4. Fricke TR, et al. Global Prevalence of Presbyopia and Vision Impairment from Uncorrected Presbyopia. American Academy of Ophthalmology. 2018;125(10):1492-1499. https://www.aaojournal.org/article/S0161-6420(17)33797-1/fulltext.
  5. WebMD. Presbyopia: Symptoms, diagnosis, and treatment. Accessed April 7, 2025. https://www.webmd.com/eye-health/eye-health-presbyopia-eyes.
  6. Qlosi™ (pilocarpine hydrochloride ophthalmic solution) 0.4%. Prescribing Information. Orasis Pharmaceuticals; 2023.
  7. U.S. Food and Drug Administration. Orange Book: Approved Drug Products with Therapeutic Equivalence Evaluations. Accessed April 7, 2025. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm.
  8. Holland E, Karpecki P, Fingeret M, et al. Efficacy and Safety of CSF-1 (0.4% Pilocarpine Hydrochloride) in Presbyopia: Pooled Results of the NEAR Phase 3 Randomized, Clinical Trials. Clinical Therapeutics. 2024;46(2):104-113.
 
Well, it's a quote in a press release. I'm not sure what you would expect a KOL quote to say.

Also note the references at the bottom of the release. Karpecki is listed as an author on a safety study.


References
  1. Holden BA, et al. Global Vision Impairment Due to Uncorrected Presbyopia. Arch Ophthalmol. 2008;126(12):1731-1739. https://jamanetwork.com/journals/jamaophthalmology/fullarticle/420914
  2. U.S. Census Bureau. United States Census – Populations and People. Accessed April 7, 2025. https://data.census.gov/profile/United_States?g=010XX00US.
  3. Holland E, Karpecki P, Fingeret M, Smits G, Ignacio T, Lindstrom R. (n.d.-a). Efficacy and Safety of CSF-1 (0.4% Pilocarpine Hydrochloride) in Presbyopia: Pooled Results of the NEAR Phase 3 Randomized, Clinical Trials. Clinical Therapeutics. https://www.clinicaltherapeutics.com/article/S0149-2918(23)00478-2/fulltext
  4. Fricke TR, et al. Global Prevalence of Presbyopia and Vision Impairment from Uncorrected Presbyopia. American Academy of Ophthalmology. 2018;125(10):1492-1499. https://www.aaojournal.org/article/S0161-6420(17)33797-1/fulltext.
  5. WebMD. Presbyopia: Symptoms, diagnosis, and treatment. Accessed April 7, 2025. https://www.webmd.com/eye-health/eye-health-presbyopia-eyes.
  6. Qlosi™ (pilocarpine hydrochloride ophthalmic solution) 0.4%. Prescribing Information. Orasis Pharmaceuticals; 2023.
  7. U.S. Food and Drug Administration. Orange Book: Approved Drug Products with Therapeutic Equivalence Evaluations. Accessed April 7, 2025. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm.
  8. Holland E, Karpecki P, Fingeret M, et al. Efficacy and Safety of CSF-1 (0.4% Pilocarpine Hydrochloride) in Presbyopia: Pooled Results of the NEAR Phase 3 Randomized, Clinical Trials. Clinical Therapeutics. 2024;46(2):104-113.
Exactly!
My bad for not realizing press releases don't require disclosures. And that there was even a forum called PRESS RELEASES until just now.
 
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Here, I hope this helps.....From a link from an article he wrote called

"Stop Punishing Doctors​

It’s time to reform healthcare—where it truly needs it."

Paul M. Karpecki, OD, FAAO

2021 Disclosures:
Akorn
Alcon Labs
Aldeyra
Allergan/Abbvie
Azura Pharmaceuticals
Bausch + Lomb
BioTissue
BlephEx
Bruder Healthcare
Bruno Pharmaceuticals
Cambium Pharmaceuticals
Dompe
Eyedetec
Eyegate
Eyevance
Healthe
iCare USA
Imprimis
Ivantis
Johnson & Johnson Vision
Kala pharmaceuticals
KEPLR Vision
Konan Medical
LeGrande
LenTechs
Maculogix
Mallinckrodt
Mati Therapeutics
Neurolens
Novaliq
Novartis
Oasis Medical
Ocuphire
Ocular Sciences
Oculus
OcuMedic
Omega Ophthalmics
Orasis
Osmotica
Oyster Point
Percept
RegenerEyes
Reichert
Rendia
RxSight
Science Based Health
Sentiss Pharmaceuticals
Sight Sciences
Silk Technologies
Sun Pharmaceuticals
Surface Pharmaceuticals
Tarsus Medical
TearClear
TrueVision Systems
Visant Medical
Visus
Vital Tears
 
I agree that Vuity was an absolute flop. I am hoping to at least get trials. I have some patients that are willing to try anything.

BlinkRx faxed over pricing this morning. I am guessing patients can only get at cash price if they have no insurance which is rare.

1744825722583.png
 
Here, I hope this helps.....From a link from an article he wrote called

"Stop Punishing Doctors​

It’s time to reform healthcare—where it truly needs it."

Paul M. Karpecki, OD, FAAO

2021 Disclosures:
Akorn
Alcon Labs
Aldeyra
Allergan/Abbvie
Azura Pharmaceuticals
Bausch + Lomb
BioTissue
BlephEx
Bruder Healthcare
Bruno Pharmaceuticals
Cambium Pharmaceuticals
Dompe
Eyedetec
Eyegate
Eyevance
Healthe
iCare USA
Imprimis
Ivantis
Johnson & Johnson Vision
Kala pharmaceuticals
KEPLR Vision
Konan Medical
LeGrande
LenTechs
Maculogix
Mallinckrodt
Mati Therapeutics
Neurolens
Novaliq
Novartis
Oasis Medical
Ocuphire
Ocular Sciences
Oculus
OcuMedic
Omega Ophthalmics
Orasis
Osmotica
Oyster Point
Percept
RegenerEyes
Reichert
Rendia
RxSight
Science Based Health
Sentiss Pharmaceuticals
Sight Sciences
Silk Technologies
Sun Pharmaceuticals
Surface Pharmaceuticals
Tarsus Medical
TearClear
TrueVision Systems
Visant Medical
Visus
Vital Tears
When you endorse everything you endorse nothing IMHO
 
When you endorse everything you endorse nothing IMHO
I very much doubt Qlosi is a "breakthrough option". How much hype have we heard from the EyeCare sector over the years.

Is shill too unkind to use for one of our more accomplished colleagues? I don't know him personally but by all appearances.

Shill (Noun):
A person who feigns enthusiasm or interest to persuade others, often for personal gain or to drive up prices.
 
I very much doubt Qlosi is a "breakthrough option". How much hype have we heard from the EyeCare sector over the years.

Is shill too unkind to use for one of our more accomplished colleagues? I don't know him personally but by all appearances.

Shill (Noun):
A person who feigns enthusiasm or interest to persuade others, often for personal gain or to drive up prices.
Paul is a very bright guy and an excellent clinician. I lectured with him also at the same event and he is truly a nice guy. But he does "like" a lot of products and endorses them. One I highlighted that had no redeeming qualities so it does give me pause
 
I live not all that far from Ponce De Leon Springs.......I tried splashing some of that water from his "fountain of youth" in my eyes and all I got was a wet face......still needed my +1.50 for near.......later + 2.25.

I had a Grandchild born two days ago and it dawned on me she may still be alive in the year 2100.......maybe by then "Bones" from StarTrek will give her (thinking she'll be Plano for most of her life) a scan and she'll never need to use lenses for presbyopia...

until then, time marches on........but we who are dust do not.

Capitalism reigns so that soon there will be an even "better" drop - not just this one ..........for about $399 for a 3 ml bottle with no generic by people that promise you the 'fountain' that will replace a device that slows light down before it hits your eye.

Please - because I do care about the rest of you - don't hold your breath waiting for the next "miracle cure"

Extra Extra Pinball Wizard in a miracle cure

Think about it..........refractive index is really a measure of the speed of light going through that medium.....so as Life has continued to 'get away from you' with age and one can't keep up with all kinds of things in life.....one can't even keep up with the light that goes from a page of print held at Harmon's distance....so by putting Plus in front of the eye it's not only focused BUT SLOWED....such that one can more properly resolve the print/light.

Later.....life goes on even faster and our lenses get thicker which slows light more so.
 
Stanley physics does state that a lens with a higher index than air does slow light. This fact is negligible in how a plus lens works. It is the bending of a convex lens that does the work. Slowing down although calculate-able is so negligible as to be discounted entirely

As we get older again the index may increase but again it is the opacification that blurs light not the infinitely small change in light speed
 
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So you can discount as negligible something that is in the realm of nano (or even less) seconds....really? I'll guess lightning's effect on human tissue - because it's only nanoseconds, is negligible too. After all it's only light.....but in another form

It is true that the light is slowed - and of course altered in its various rays courses too (which I understand all too well) - but the fact remains it is slowed.

Do prove that the major factor is the convergence............and ........come on....where's your sense of humor?.....I"m just egging you on with this slows the light down stuff.......but it is true. I have no intent of trying to prove to anyone the major factor is slowing.....who knows?.. maybe five Centuries from now it might be taught that way after the Theory of Relativity is taught in Kindergarten

I've been saying such for years.....not to my Patients but to other ODs at meetings......they say I'm nuts.....which I don't deny, but I say to them I'm not wrong either.

How y'all doing at keeping up with Life? ....you too moderator.....
no wrinkles? no joint pain?......does the joint experience pain when one lights the joint up?

Challenge > keeping ahead of Life. .....good luck
 
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For fun I asked Gpt to figure this out.

Speed of light in vacuum: 299,792,458 m/s299,792,458 m/s

  • Speed of light in +5 lens (n = 1.5): ≈199,861,639 m/s≈199,861,639 m/s
  • Time to travel through 5 mm lens: ≈0.02501 ms≈0.02501 ms
  • Extra time caused by slowing in the lens: 0.00833 milliseconds. 0.00833 milliseconds
 
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For fun I asked Gpt to figure this out.

Speed of light in vacuum: 299,792,458 m/s299,792,458 m/s

  • Speed of light in +5 lens (n = 1.5): ≈199,861,639 m/s≈199,861,639 m/s
  • Time to travel through 5 mm lens: ≈0.02501 ms≈0.02501 ms
  • Extra time caused by slowing in the lens: 0.00833 milliseconds. 0.00833 milliseconds
You beat me to it. I’ll stand with my answer. No need to discuss this anymore.might as well add a thousand meter Plano piece of glass to really slow the light. Lol
 
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You beat me to it. I’ll stand with my answer. No need to discuss this anymore.might as well add a thousand meter Plano piece of glass to really slow the light. Lol
I'm pretty much in agreement, but you did incorrectly the use word "infinitely", as there IS a measurable finite change. I do get your point, as it is negligible for all practical purposes.
 
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You beat me to it. I’ll stand with my answer. No need to discuss this anymore.might as well add a thousand meter Plano piece of glass to really slow the light. Lol
Well, there's another thought experiment for you.