January 15, 2026
By Sherman Tung, OD, FAAO, FCCSO, FIAOMC, IACMM
Photo Credit: Getty Images
Hiring new staff for a myopia management program is exciting, but it also makes most practice owners nervous. Payroll rises immediately, while the return shows up later. Many of us try to stretch our existing team as long as possible, but if you wait until you are overwhelmed, patient experience declines and the program stalls.
After developing my own myopia program, I realized that staffing decisions tend to follow predictable stages. When hiring is tied to clear signals instead of instinct, the process becomes more intentional and far less stressful. Before reaching any of these stages, however, there is an essential first step.
Stage 0: Do Everything Yourself First
This stage cannot be skipped. You cannot train someone effectively until you have gone through the entire process yourself. I block one weekend afternoon or one weekday afternoon and perform every part of the myopia consultation. I present options in the same order each time, beginning with orthokeratology, then soft multifocal or dual focus lenses, then anti-myopia glasses, and finally atropine.
If the patient is moving forward with orthokeratology, I take the topography, guide insertion and removal training, and review the contract. If the patient is prescribed soft multifocals, I follow the same steps. When a child cannot manage contact lenses, I walk them to optical to select the right spectacles. If the patient is prescribed atropine only, I personally review side effects and expected results.
A solo doctor does not need to do this entirely alone. Having a staff member sit in and document the visit is incredibly helpful. If they can record the flow accurately, they begin to understand it, and their questions often help refine your messaging. These notes can eventually become your training guide.
You are ready to move to Stage 1 when your weekend block consistently fills or you are starting three to five new myopia patients per week. At that point the workload becomes difficult to sustain by yourself.
Stage 1: Hire Your First Part-time Myopia Ambassador
Your first ambassador is usually part-time. A weekday or Saturday afternoon block works well. College students are often ideal because they learn quickly, can work weekends and handle structured protocols well.
Many doctors wonder if they can cross-train existing staff such as opticians or pre-testers. I tried this myself. Although my team members were capable, adding the extra responsibility affected their primary roles. Pulling your strongest optician into myopia for even half a day can weaken your optical department. Cross-training can work, but only with clear boundaries about which hours are dedicated to myopia and what gets shifted off their original workload.
Stage One is about building consistency. You have a process, demand is growing and now you have someone supporting the program—even if it starts with only one afternoon a week.
Stage 2: When Myopia Becomes a Weekday Priority
You enter Stage Two when myopia management begins to take up regular weekday time. The signs are easy to spot. You may find yourself spending more than 30 minutes a day explaining myopia control during routine exams. You may also see five to 10 new inquiries each week through phone calls, emails, or parents who bring up the topic in the chair. Another clear sign is if you are signing up one new OrthoK patient each week.
This is when your ambassador needs weekday hours. Instead of repeating the same explanation multiple times a day, you can transition families to your ambassador for a structured consultation, either the same day or later in the week.
During Stage Two, clarity around responsibilities becomes essential. Your ambassador should be able to explain OrthoK, soft multifocals, atropine and spectacles using consistent scripts and visuals. They should also review fees, logistics, expectations and timelines. You focus on diagnosis and the clinical plan while they focus on communication and education.
This shift saves significant time and improves consistency.
Stage 3: Build a Two-Person System
You typically reach the point where you need two people when the volume becomes too much for one ambassador to manage effectively. This usually happens when you are fitting about two new OrthoK patients per week, or when your clinic has around 100active myopia patients. Another indicator is consistently signing up 20 new myopia management packages per month. At that stage, the workload naturally splits into two roles: one person focused on parent communication and coordination, and the other focused on clinical training and education.
This division prevents bottlenecks and keeps the program running smoothly. At this stage, parents often know your ambassadors by name and develop strong relationships with them.
Training Your Ambassadors
Fortunately, you do not need to create all the training materials yourself. Programs such as the AAOMC Certified Myopia Navigator and education from the Myopia Summit offer structured paths. Internally, I prefer a mix of observation and simple checklists. New ambassadors should shadow your Stage 0 consultations and gradually take over portions of the visit while you debrief afterwards.
On slower days, ambassadors can update scripts, prepare educational materials, audit charts for potential candidates, or follow up with families who postponed their decision.
Final Thoughts
Hiring for myopia management will always feel like a leap, but it becomes easier when decisions are based on measurable triggers instead of intuition. Full weekend consultations, three to five new starts per week, more than 30minutes per day spent explaining myopia, one new OrthoK patient per week and a consistent flow of inquiries are clear signs that it is time to expand your team.
By moving through the stages intentionally and defining roles clearly, you create smoother clinic flow, more confident staff and families who feel supported. The long-term growth of a myopia program depends not only on clinical expertise, but on the strength and structure of the team behind it.
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Sherman Tung, OD, FAAO, FCCSO, FIAOMC, IACMM, graduated from Illinois College of Optometry. As a Fourth Year ICO externship preceptor, he is dedicated to mentoring future optometrists. A former president of BC Doctors of Optometry and recipient of the 2019 Optometrist of the Year award, Dr. Tung is celebrated for his contributions to advancing optometric standards. In addition to his role as co-chair for the accreditation team at the AAOMC (American Academy of Orthokeratology and Myopia Control), he owns and operates his private practice, Eyelab, Doctors of Optometry, in Vancouver, BC, Canada, where he continues to provide exceptional eye care services to the community. Find him on Instagram: @helloeyelab |
