This article was originally published in a sponsored newsletter.
Cary Herzberg is a true pioneer in the field of myopia management. This is the second part of an interview about his 50-year journey.
How have the demographics of your patient population evolved over the years?
Dr. Herzberg: The changes didn’t happen until relatively recently. Initially, the practice had mostly a white population (as we were on the south side of Chicago), some Italian, some Polish. They were very nice and used to invite us over for meals after work. Relationships with patients were much closer than they are today.
All of a sudden, in the 1980s, I started to see a trend that I couldn’t explain. Until then, once patients got past the college, they didn’t come back in until they were in their 40s as their prescriptions didn’t change. You would have to beg them to come in for their medical exam.
In the early ’80s, that all changed, and these patients started coming every six months. It coincided with the introduction of the desktop computer. Their vision was changing, and we also saw obesity increasing. We associated the myopia progression with the work changes. At that time, [it was generally believed] that myopia was all genetics, but clinicians knew that couldn’t be the entire story. Blaming genetics for myopia frees [practitioners] from the responsibility of doing anything; it’s all going to happen anyway.
So, when did you see the next change?
Dr. Herzberg: It was when my patient base became mostly Asian. I had become much more active with the National Eye Research Foundation (NERF), and…the Asian patients were drawn to the founder, Newton Wesley, OD. I think they found us through the grapevine. I would say something to one patient in our office, and then everybody knows. This spread the word for us.
I found that Chinese patients were much more open to a discussion about myopia control than any other ethnic base with whom I worked. I didn’t have to do a lot to convince them about orthokeratology (ortho-k). They wanted to do something about their child’s myopia, and they knew about ortho-k. This was the early part the ’90s before the scientific literature emerged. We were correcting myopia for a meaningful way during the day. Of course, the [U.S. Food and Drug Administration] approvals for overnight wear came in the early 2000s, but by then I already had a robust ortho-k myopia control practice.
How much of your practice was orthokeratology?
Dr. Herzberg: About 90% of my practice was ortho-k. The rest of it was mostly specialty sclerals. I was also a pioneer in sclerals and other kinds of specialty lens fitting. I had a patent on a scleral ortho-k design in 2006, so I have had a second act in the last 20 years or so.
So, when did you step away from your practice and start an easier life?
Dr. Herzberg: That was three years ago. I merged my practice with another doctor, whom I’d worked with for more than six years. We now have a combined practice where I work only occasionally. If you’re retiring, you have to find someone to take over for you. We’re trying to figure out the retirement puzzle. I’m too active in this field to just stop cold turkey, so I do work with a lot of young doctors, especially with ortho-k. They still want to hear from me, so it’s a great exchange of ideas.
