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. 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 yourselfIf you missed Part 1, start there — we walk through the modalities, the data, and the “where do I even start” question. 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.