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

Dr. Jennifer Lyerly, Dr. Dave Ng, and Dr. Cary Herzberg on choosing between MiSight, ortho-K, atropine, and Stellest — and why you don't need a $40,000 biometer to start.

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.

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