64 MMP | Inside the Myopia Toolbox, Part 1: What Works, When, and Who Should Get It

66 MMP | Myopia News Monthly: LAMP Tapering, Stellest 2.0, Contrast Theory, and What We're Still Getting Wrong

Every month there’s more happening in myopia management than any one clinician can keep up with — new studies, new products, new debates. That’s exactly why we built this series. In this episode, I sit down with two practitioners who’ve been in the trenches of myopia management: Dr. Andrew Brauer of Eye Care Center of DuPage and Dr. Cary Herzberg, with 40+ years of myopia management experience. We go through the five most important stories from Q1 2026 — and we don’t hold back on the disagreements. 🎙️ Full episode + subscriber bonus: https://myopiamindset.substack.com 📧 Subscribe for weekly episodes, [https://myopiamindset.substack.com] articles, and exclusive bonus content In this episode: LAMP Study (8-year follow-up): The data is in — tapering atropine before stopping leads to less rebound than abrupt cessation. But is a quarter-diopter reduction enough to change how you manage discontinuation? And should we even be framing myopia management as something that ends? | Eight-Year Results of the LAMP Randomized Clinical Trial https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2846905 [https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2846905] Essilor Stellest 2.0: More plus, potentially twice the efficacy of the original. Andrew raises the concern nobody wants to say out loud about spectacle-only practices. | Next-Generation Spectacle Lens Aims to Strengthen Myopia Control in Children https://theophthalmologist.com/issues/2026/articles/march/next-generation-spectacle-lens-aims-to-strengthen-myopia-control-in-children/ [https://theophthalmologist.com/issues/2026/articles/march/next-generation-spectacle-lens-aims-to-strengthen-myopia-control-in-children/] Contrast Theory of Myopia: Dr. Ashley Tucker’s piece in Review of Myopia Management ties color vision research to myopic defocus. Is this a new mechanism — or just a new way of describing the one we already know? | When Color Vision Research Meets Myopia Control https://reviewofmm.com/when-color-vision-research-meets-myopia-control/ [https://reviewofmm.com/when-color-vision-research-meets-myopia-control/] Sight Glass DOT Lenses at NCC 2026: New data, 20% African American representation in the study, and the astigmatism question finally answered. | SightGlass Vision Presents Latest Findings on DOT Spectacles at NCC 2026 https://reviewofmm.com/sightglass-vision-presents-latest-findings-on-dot-spectacles-at-ncc-2026/ [https://reviewofmm.com/sightglass-vision-presents-latest-findings-on-dot-spectacles-at-ncc-2026/] European Delphi Consensus: Should myopia be classified as a progressive disease? Some colleagues still push back. Andrew and Cary explain why it’s not a question worth arguing. | Consensus on Evidence Gaps and Unmet Needs in Childhood Myopia https://reviewofmm.com/consensus-on-evidence-gaps-and-unmet-needs-in-childhood-myopia/ [https://reviewofmm.com/consensus-on-evidence-gaps-and-unmet-needs-in-childhood-myopia/] Whether you’re deep into myopia management or just building your program, this panel is your monthly check-in. 🎧 Listen now — and if you’re a paid subscriber, stay tuned for the bonus segment coming later this week. https://myopiamindset.substack.com [https://myopiamindset.substack.com] The Myopia Mindset is a weekly [https://myopiamindset.substack.com] podcast for optometrists, ophthalmologists, and eyecare professionals devoted to myopia management. New episodes every week.

65 MMP | "We've Lost 40 Years": Why Myopia Management Still Isn't Standard of Care | Myopia Awareness Week Special (Part 2)

It’s Myopia Awareness Week — and we’re releasing the bluntest episode we’ve ever recorded. Awareness weeks tend to be glossy. This one isn’t. Dr. Cary Herzberg has been doing this work for forty-five years, and Part 2 of our panel opens with him asking a question that should sit uncomfortably with the profession: it’s 2026, we have FDA-approved tools, and we’re still trying to convince colleagues to start. What happened to those forty years? We had to split this conversation in two. Part 1 was the toolbox [https://myopiamindset.substack.com/p/inside-the-myopia-toolbox-part-1]. This is the part that got real. In Part 2, Dr. Cary Herzberg lays down four decades of frustration: optometry has had the data, the products, and the patients in the chair since the early 1980s — and is still, in 2026, asking how to get colleagues to start. Dr. David Ng counters with a hopeful sign — parents are now walking into exams asking, unprompted, about their child’s hyperopic reserve. Then he drops a warning that should get every U.S. ECP’s attention: counterfeit “myopia” spectacle lenses are already showing up in Canadian opticals at $100 a pop, with no efficacy data and unidentifiable origin. Inside this episode: – Cary on what optometry has gotten wrong since the 1980s genetics-only era — and what he thinks “real” board certification in myopia would look like – Dave’s red-flag report on counterfeit myopia spectacle lenses showing up in Canada (and why he expects it in the U.S.) – Dr. Jennifer Lyerly on a 2022 Vision Monday survey claim that 70% of U.S. ODs were “doing myopia management” — most of them, somehow, with progressives – The structural problems: 15-minute exam slots, PE-backed practices, debt-loaded new grads, and the national boards as a curriculum gatekeeper – Why ODs still don’t refer to other ODs — and what the AAOMC’s brand-new P2P program is trying to do about it – The closing trio of pitches to new grads: Jennifer’s compassion frame, Dave’s “come spend a day with me,” and Cary’s Newton Wesley line — make a legend of yourself If you missed Part 1, start there — we walk through the modalities, the data, and the “where do I even start” question. [https://myopiamindset.substack.com/p/inside-the-myopia-toolbox-part-1]This is the follow-up. If this episode hit, share it. Myopia Awareness Week is the one week of the year a non-clinical friend or family member might actually click on something like this. Forward it to a parent. Send it to the OD you know who's been "thinking about getting into myopia management" for three years.

64 MMP | Inside the Myopia Toolbox, Part 1: What Works, When, and Who Should Get It

Twenty years ago, the myopia toolbox had one drawer: ortho-K. Today, U.S. optometrists have FDA-approved soft contacts, an approved spectacle lens, off-label low-dose atropine, and a steady drip of next-generation options coming through Health Canada first. So how do you actually decide what to put a kid in? In Part 1 of this two-part panel, Matthew sits down with Dr. Jennifer Lyerly (True Vision Eye Care, Defocus Media), Dr. David Ng (Bayview Vision Care & The Myopia Clinic, AAOMC board member), and Dr. Cary Herzberg (co-founder and past president, AAOMC) to walk through the modern myopia toolbox in real, chair-side terms. What’s inside this episode: – How each panelist actually decides between MiSight, ortho-K, atropine, and Stellest based on lifestyle, age, and progression – The new MiSight IQ data David is watching — and the 100%-control claim coming out of a Malaysian ortho-K + red-light cohort – Why Jennifer says you do not need axial length to get started, and which single piece of equipment actually is non-negotiable (hint: only one modality requires it) – A real cautionary story from a state board complaint filed against an OD who never mentioned myopia management – Cary’s “throw the gauntlet down” pitch for SYD-101 and the case for moving from myopia management to myopia prevention Part 2 drops next week — that’s where things get heated. Becomes a Subscriber on Substack: https://myopiamindset.substack.com/ [https://myopiamindset.substack.com/]

63 MMP | Why the FDA Said No to a Drug That Could Save Kids' Eyes

A Texas ophthalmologist sits down to explain the lifetime risks of myopia to a 6-year-old's mom — and mid-sentence realizes the mom, still in her 20s, has already had retinal detachments in both eyes from her own untreated nearsightedness. That's the gap this episode is about: the gap between what we know myopia does to people, and what the FDA's drug division decided was "not clinically meaningful" when it rejected SYD-101 — Sydnexis's stable, low-dose atropine drop — last fall. Dr. Cary Herzberg, a 40-plus-year ortho-K/myopia management pioneer, walks through the STAR study, the fast-progressor data Sydnexis dropped at AAPOS, and why a drug that's approved in Europe is still locked out of American practices. We get into how the FDA's own request to add older patients dragged the headline numbers down, what 47.9% / 37.6% / 28.0% actually means for a kid, and what an everyday optometrist, ophthalmologist, or parent can do this week to push back. What We Cover In This Episode: Sydnexis & SYD-101 — the company and the 0.01% low-dose atropine drop that this episode is about. https://sydnexis.com/ [https://sydnexis.com/] Sydnexis Press Release Data Presented At AAPOS — https://www.businesswire.com/news/home/20260323823740/en/Sydnexis-Announces-New-Data-from-Phase-3-STAR-Trial-of-SYD-101-Presented-at-2026-AAPOS-Annual-Meeting [https://www.businesswire.com/news/home/20260323823740/en/Sydnexis-Announces-New-Data-from-Phase-3-STAR-Trial-of-SYD-101-Presented-at-2026-AAPOS-Annual-Meeting] The STAR study — Sydnexis’s 3-year, 847-patient pediatric myopia trial across the U.S. and Europe. https://sydnexis.com/resource/evidence-from-the-star-study-a-novel-low-dose-atropine-eye-drop-slows-the-progression-of-pediatric-myopia/ [https://sydnexis.com/resource/evidence-from-the-star-study-a-novel-low-dose-atropine-eye-drop-slows-the-progression-of-pediatric-myopia/] https://iovs.arvojournals.org/article.aspx?articleid=2804883 [https://iovs.arvojournals.org/article.aspx?articleid=2804883] Washington Post article — A drug for myopia could help millions of kids. The FDA is keeping it off the shelves (by David G. Hunter) https://www.washingtonpost.com/opinions/2026/02/10/fda-myopia-drug-trial/ [https://www.washingtonpost.com/opinions/2026/02/10/fda-myopia-drug-trial/] Inside Health Policy article — Pediatric Myopia Drug is Latest In String of Unexpected FDA Rejections (by Jessica Karins) https://insidehealthpolicy.com/inside-drug-pricing-daily-news/pediatric-myopia-drug-latest-string-unexpected-fda-rejections [https://insidehealthpolicy.com/inside-drug-pricing-daily-news/pediatric-myopia-drug-latest-string-unexpected-fda-rejections] American Association for Pediatric Ophthalmology and Strabismus (AAPOS)— https://www.aapos.org/home [https://www.aapos.org/home] The LAMP study — https://pubmed.ncbi.nlm.nih.gov/30514630/ [https://pubmed.ncbi.nlm.nih.gov/30514630/] Stellest spectacle lenses — https://www.essilorluxottica.com/en/newsroom/press-releases/essilor-stellest-fda/ [https://www.essilorluxottica.com/en/newsroom/press-releases/essilor-stellest-fda/] American Academy of Orthokeratology and Myopia Control (AAOMC) — https://aaomc.org/ [https://aaomc.org/] Petition to classify pediatric progressive myopia as a disease — Urgent Call for U.S. Children to Have Access to an FDA-Approved Low-Dose Atropine https://www.change.org/p/urgent-call-for-u-s-children-to-have-access-to-an-fda-approved-low-dose-atropine-68d0a62c-8058-48bb-ab09-9c586d3a3ff6?recruiter=1397201700&recruited_by_id=25f73080-d542-11f0-94d3-2b1ed6b14439&utm_source=share_petition&utm_campaign=petition_dashboard&utm_medium=copylink [https://www.change.org/p/urgent-call-for-u-s-children-to-have-access-to-an-fda-approved-low-dose-atropine-68d0a62c-8058-48bb-ab09-9c586d3a3ff6?recruiter=1397201700&recruited_by_id=25f73080-d542-11f0-94d3-2b1ed6b14439&utm_source=share_petition&utm_campaign=petition_dashboard&utm_medium=copylink] WHO projection — https://www.sciencedaily.com/releases/2016/02/160217113308.htm [https://www.sciencedaily.com/releases/2016/02/160217113308.htm]

62 MMP | pt1 - How a Top Children's Hospital Built a Myopia Program That Treats Every Kid

What does it look like to build a full-spectrum myopia management program inside one of the country’s top pediatric hospitals — and what can every optometrist learn from it? 🔗 Subscribe on Substack [https://myopiamindset.substack.com/] - video podcasts + articles + exclusive bonus content 📸 Instagram [https://www.instagram.com/myopiamindset/] / TikTok [https://www.tiktok.com/@myopiamindset] / Linkedin [https://www.linkedin.com/in/matthew-herzberg-a6a15163] - connect + daily insights In Part 1 of this special episode of the Myopia Mindset podcast, host Matthew Herzberg sits down with Drs. Magda Stec, Noreen Shaikh, and Shelby Johnson from the ophthalmology division at Ann and Robert H. Lurie Children’s Hospital in Chicago [https://www.luriechildrens.org/]. The doctors take us inside a program that’s been building for nearly eight years — starting with low-concentration atropine and evolving into a full toolbox that includes MiSight, Ortho-K, Biofinity toric multifocal, and now FDA-approved Stellest lenses. You’ll hear how Lurie’s philosophy of offering myopia management to every patient — including those on public aid — came together, and how the division created a collaborative culture where ophthalmologists, optometrists, nurses, and pediatricians all speak the same language. The panel also covers what a solid baseline workup looks like, how to approach pediatricians for cross-referrals, and how they navigate the conversion conversation with parents in a time-efficient way. If this episode fires you up about myopia management, subscribe — Part 2 drops soon and covers confidence-building, staff training, and whether Stellest glasses will finally blow open the category for optometrists everywhere.