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Dr. Thomas Aller, Optometrist, Inc., 380 West Portal Avenue, Ste B, San Francisco, CA (2026)

10/06/2026

Well, this was fun.

I recently sat down with Matthew Herzberg for The Myopia Mindset podcast for a conversation about how I somehow ended up spending much of the last 40+ years trying to slow myopia progression.

It started with a fairly simple problem: the textbooks told me myopia was largely genetic and should stop progressing around age 16.

My patients apparently hadn't read the textbooks.

That eventually led to fitting bifocal contact lenses on myopic children, a clinical trial whose results seemed too good to be believed, patents, and a chance encounter with Brien Holden at an annual party during an American Academy of Optometry meeting. We escaped the noise into a hallway, talked for about two hours, shook hands — and began a collaboration that would have an enormous influence on the rest of my career.

We get into all of that in this podcast, including some stories I haven't told very often.

But we also spend a lot of time talking about where myopia management goes from here.

My continuing argument is that we need to stop making myopia management seem harder than it is.

Not every optometrist needs to become a myopia specialist. But every optometrist can do something.

And, yes, this is also the podcast in which I explain why:

“Even a monkey can control myopia (by 40%)” 🐒

We also get into one of my more irreverent observations from an International Myopia Conference: so many seemingly different optical strategies were slowing myopia that I speculated you could probably sneeze on a spectacle lens, let the randomly deposited droplets create little areas of plus power, and produce a pretty strong anti-myopia signal.

To be clear, no lenses were actually sneezed upon in the advancement of myopia science. 🤧

There are also discussions of treating before myopia even begins, COVID lockdowns as an accidental myopia experiment, spectacle compliance, the dangers — or perhaps benefits — of “dabblers,” and why contact lens companies may still be too timid with their optical designs.

It was a wide-ranging, occasionally irreverent conversation and I had a great time doing it.

Thanks to Matthew Herzberg and The Myopia Mindset for inviting me and for putting together such a thoughtful look at both the history and future of myopia management.

And if “Even a Monkey Can Control Myopia” sounds suspiciously like a song title, it is. 🐒🎶 That and some of my other slightly unconventional takes on myopia have now found their way onto my *Myopia Warrior* album. Apparently, researching myopia for 40 years wasn't enough.

https://myopiamindset.substack.com/p/thomas-aller-myopia-control-pioneer

Forty years ago the textbooks said myopia was genetic and stopped at 16. Dr. Thomas Aller's patients didn't read them — so he started a field instead.

09/22/2026

The third and final installment of Charles Morris's retrospective on the landmark Brien Holden “50% myopia by 2050” paper is now out, and I think Charles saved his best title for last:

“Written to Be Proven Wrong.”

Most landmark scientific papers are written with the hope that their conclusions will stand the test of time. The Holden paper was different. The projection that 4.76 billion people — nearly half the world — would be myopic by 2050 was a warning. Success would mean that we acted strongly enough to make the prediction wrong.

Ten years later, Tim Fricke has gone back to the model, and unfortunately the basic 2050 projection still stands.

That isn't vindication. It's a challenge.

This final installment brings the story back to Brien, who died in 2015 and never saw the paper published, much less the extraordinary impact it would have on our field.

I particularly liked Naidoo's answer when Charles asked what Brien would think today:

“He’d be saying, ‘Guys, we were right about the numbers, but that means we have to work harder to prevent those numbers from being what we claim they’d be.’”

Exactly.

We now have something Brien didn't have: multiple effective interventions, an enormous evidence base, regulatory approvals, growing professional consensus and, most recently, AMA support for formally recognizing myopia as a disease and for insurance coverage and reimbursement of evidence-based treatments to slow progression.

So the next decade should be less about proving that myopia control works and more about making sure it actually reaches children.

As Charles concludes:

“Being right was never the achievement. Holden and his team left us a warning and 24 years to prove it wrong.”

A fitting conclusion to an excellent three-part series.

Thanks to Charles Morris for taking this on, to Review of Myopia Management for giving him the space to do it properly, and to Tim Fricke, Monica Jong, Kovin Naidoo and Serge Resnikoff for helping revisit their paper that changed our field.

👉 Part 3: “Written to Be Proven Wrong”
https://reviewofmm.com/written-to-be-proven-wrong/

In the final part of this three-part article series, Charles Morris explains why the landmark BHVI paper was written to be proven wrong.

09/14/2026

Part 2 of Charles Morris’s 10-year retrospective on the landmark Brien Holden “50% myopia by 2050” paper is now out — and I seem to have considerably more to say in this installment. 😊

Charles titled this one “We Have the Tools. We Just Haven’t Made the Decision.” That pretty well summarizes an argument I’ve been making for much of my career.

We’ve spent decades establishing that myopia progression can be slowed. We now have effective spectacle lenses, soft contact lenses, orthokeratology and pharmacological approaches. We have an enormous evidence base and, increasingly, regulatory approvals.

And just as this article appears, there has been an important development that may help remove one of the largest remaining barriers: the American Medical Association has adopted policy supporting the formal classification of myopia as a disease and comprehensive insurance coverage and reimbursement for evidence-based treatments that slow progression in children and adolescents.

That distinction matters. If progressive myopia is treated as a disease rather than simply a refractive error requiring another pair of glasses, it becomes much harder to justify treating interventions that reduce its progression as elective or non-medical care.

Myopia management is still too often treated as a specialty service rather than something every practitioner can and should participate in.

I particularly appreciate that Charles captured an important distinction I’ve tried to make: **not every practitioner needs to become a myopia specialist.** Generalists can screen, educate parents and initiate straightforward treatment. More experienced practitioners can manage additional modalities, while specialists remain available for the difficult cases.

Lower the barriers and we treat more children.

Charles also resurrected one of my less academically phrased observations from years of lecturing:

“Even a monkey can control myopia by 40%. It’s really that simple.” 🐒

Fortunately, he explains what I mean.

Forty percent isn't where we should aspire to finish. It's roughly where we can start with interventions that are already readily available. We can do considerably better.

Perhaps my favorite line remains the simplest:

“We have the tools. We just haven’t made the decision.”

The AMA decision may be an important step toward finally making that decision.

Thanks again to Morris and Monarch for putting this series together, and to of Myopia Management for deciding that Charles’s original 6,000-word retrospective deserved three articles rather than a red pencil.

👉 Part 2: **“We Have the Tools. We Just Haven’t Made the Decision.”**
https://reviewofmm.com/we-have-the-tools-we-just-havent-made-the-decision/

In part two of this three-part article series, Charles Morris shares how having the right tools for myopia hasn't changed the industry.

09/01/2026

I’m honored to have been appointed to the 2026–2027 Advisory Panel of the Global Myopia Awareness Coalition (GMAC), joining an exceptional international group of clinicians, researchers, educators, and advocates.

This appointment has a particularly satisfying full-circle quality. In 2018, as a founding advisor to Treehouse Eyes and a consultant to the Brien Holden Vision Institute, I was invited to participate in one of GMAC’s formative meetings and help engage industry colleagues in the effort. Many of those around the table represented organizations with which I had collaborated in research and consulting. I’m delighted to return now as a member of GMAC’s Advisory Panel.

Close to 40 years ago, I began investigating whether bifocal contact lenses might slow myopia progression. At the time, myopia control was far outside mainstream clinical thinking. It is gratifying to see how far the field has come—and how much serious work is now being directed toward helping parents understand that childhood myopia is not simply a matter of needing stronger glasses.

I look forward to helping GMAC communicate the science clearly, encourage earlier action, and increase awareness of the lifelong importance of slowing myopia progression.

Thank you to for the appointment and to for sharing the announcement. Congratulations to my fellow Advisory Panel members:

Olga Prenatrenat
Dahlmann-Noor
García Rubio
Flitcroft
Kate Giffordfford
-Lian Foo

https://reviewofmm.com/gmac-announces-2026-2027-advisory-panel/

The Global Myopia Awareness Coalition (GMAC) announced its 2026-2027 advisory panel, bringing together industry leaders.

08/31/2026

Ten years ago, one of the most influential papers in the history of myopia management was published: Professor Brien Holden and colleagues’ projection that nearly half of the world’s population — 4.76 billion people — would be myopic by 2050 https://www.aaojournal.org/article/S0161-6420(16)00025-7/fulltext

Sadly, Brien died before the paper was published and never got to see the extraordinary impact it would have. It helped transform myopia from something largely viewed as a refractive inconvenience into a global public-health issue and became one of the papers that helped organize an entire field.

Author Charles Morris of who helped introduce Paragon CRT lenses to the world, decided that the paper’s 10th anniversary deserved more than a mere retrospective. Charles went back to several of the people who were there — Monica Jong, Kovin Naidooo, Serge Resnikoff and Tim Fricke — and asked not only whether the prediction still holds, but what we have actually done about it.

I was pleased to help Charles connect with some of them and honored that he also included quite a bit of my perspective. I may have been somewhat less diplomatic than the others. 😊
My basic argument hasn’t changed much: "We have the tools to bend the curve. We just haven’t made the decision to use them broadly enough."

Charles originally wrote about 6,000 words. Rather than cutting it down, the editors at decided it deserved to run as a three-part series. I think they made the right decision.

It is a thoughtful tribute to Brien, but more importantly, it asks exactly the question Brien would probably be asking us today:
"If we were right about 2050, what are we going to do to make the prediction wrong?" I'm pretty sure he would have phrased it just a bit less diplomatically!
👉 Part 1: “Half the World by 2050”
https://reviewofmm.com/half-the-world-by-2050/

Ten years ago, eyecare leaders at BHVI wrote a paper that determined half the world would be myopic by 2050.

08/06/2026

I'm pleased to share my latest article in , published as part of a sponsored series with .

While my previous article reflected on nearly 40 years of myopia research, this one focuses on something much more practical: what I've learned after prescribing NaturalVue Enhanced Multifocal 1 Day contact lenses in everyday clinical practice for more than a decade.

Research tells us whether a treatment can work. Clinical practice teaches us how to make it work for real patients—with different prescriptions, different lifestyles, and different visual demands.

In this article, I discuss why I see NaturalVue Enhanced Multifocal as a lens built for real life, and some of the clinical characteristics that have made it an important part of my approach to slowing myopia progression. Many patients can find it to be a lens that is also built for a whole life, myopia control early, continued good vision with near vision comfort in the middle, and presbyopia with aging.

If you'd like to read it, here's the link:

https://reviewofmm.com/why-i-see-naturalvue-enhanced-multifocal-as-a-lens-built-for-real-life/

Dr. Thomas Aller shares why NaturalVue Enhanced Multifocals are lenses built for real life and a wide range of patients.

07/30/2026

It's always interesting to look back and realize how a career evolves.

Close to 40 years ago, I began investigating whether bifocal contact lenses could slow myopia progression. It didn't take long before I became convinced the answer was **yes**.

The decades since have been spent trying to understand *why* they work, optimizing optical designs, gathering the evidence, and helping convince a once-skeptical profession that myopia management could become part of everyday clinical care.

My latest article for (published as part of a sponsored series with Visioneering Technologies) became a reflection on that journey—and why I've been prescribing NaturalVue Enhanced Multifocal 1 Day contact lenses for more than ten years.

One of my favorite memories was my first conversation with Dr. Sally Dillehay with Visioneering Technologies . They knew me as someone with a long history of developing new optical designs, and I assured her I wasn't interested in reverse engineering their lens into another patent. I simply wanted to know whether it could help my patients. Fortunately, she trusted me.

Over the years, I've come to appreciate not only the uniqueness of the NaturalVue optical design, but also the outstanding people I've had the opportunity to collaborate with and the company's commitment to making these lenses available through eye care professionals.

If you're interested in how that journey unfolded, I hope you'll enjoy the article:

https://reviewofmm.com/how-i-came-to-myopia-management-and-why-i-prescribe-naturalvue-enhanced-multifocal-1-day-contact-lenses/

Dr. Thomas Aller explains how he came to myopia management why he prescribes NaturalVue Enhanced Multifocals.

07/20/2026

One of the biggest challenges in myopia management isn't deciding whether to treat—it's explaining why and demonstrating whether treatment is working. I was pleased to collaborate with Pascal Bl**er of and on an article in Review of Myopia Management on the value of growth curves in myopia care. The article https://reviewofmm.com/use-and-assessment-of-growth-curves-in-myopia/ describes how growth curves can help practitioners assess risk, choose treatment strategies, and communicate progression using intuitive color-coded eye growth charts.

It also highlights the free tools available on Myopia.Care, including:
• Eye Length Growth Curves
• Annual Eye Growth assessment
• MyAppia progression forecasting
• Risk assessment resources

These tools can make conversations with parents much more visual and evidence-based. Financial disclosure, I'm a board member of myopiacare.com and my intellectual property is licensed to them and through them to for the Lenstar Myopia Biometer.
https://myopiacare.com/

Send a message to learn more

05/05/2026

My latest article for Optometric Management magazine, "The Myopia Toolkit" just published. In it, I argue that all eye care practitioners must manage myopia effectively. The trajectory of progressive myopia all around the world with an alarming level of vision threatening conditions associated with excessive axial elongation cannot be meaningfully altered if we depend only on myopia control specialists. To paraphrase Nike, optometrists must choose to just do something. Now with a spectacle lens finally authorized by the FDA, there is practically no reason for any optometrist or ophthalmologist to decline to offer a treatment for myopia. Doctors who aspire to provide the most efficacious treatment for their individual patient should practice at the level of their competence and refer to colleagues if their patients require specialty care. The late great Brien Holden once argued that by merely controlling myopia in a population by 50%, practically so easy even Earl Smith's rhesus monkeys could do it (at least according to some of my lectures) there may never be -6.00D myopes. With broad use of our ever expanding "Myopia Toolkit" that strikes me as a very reasonable goal.

Thomas Aller, OD, provides in-depth overviews of each myopia management option—pharmacologic therapy, soft contact lenses, orthokeratology, spectacle lenses, and environmental and behavioral interventions—so clinicians can not only provide the right option to each patient, but also address the l...

04/15/2026

John Sailer, formerly with Jobson and former Editor in Chief with Review of Myopia Management has embarked on some new ventures, starting with a series of publications on myopia management entitled, Myopia Masterclass. This looks to be a monthly series of 10 issues covering all aspects of myopia management and worth a look. The second issue, Determining which patients to treat is my current favorite, because I am quoted, but the whole series should be on your must read list. https://insightmediagroup.com/.../myopia-masterclass.../

The first article in The Myopia Masterclass series explores how to identify and prioritize candidates for myopia management.

Dr. Thomas Aller, Optometrist, Inc.

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