By 2050, nearly half the world's population is expected to be myopic, with around a billion people projected to progress to high myopia — a leading cause of irreversible vision loss later in life. Children face a narrow window in which to intervene, while the eye is still growing, before those structural changes become permanent. Yet despite the scale of the problem, there is still no FDA-approved drug that slows myopia progression in children, a gap underscored just last month when the FDA declined to approve an atropine eye drop for the same use.

My guest today is Thomas Ruggia, President and CEO of Theialife, a late-stage biotech developing an oral therapy for pediatric myopia derived from a natural caffeine metabolite. Tom joins Theialife after 25 years in ophthalmology leadership, including roles at Johnson & Johnson, Alcon, Novartis, and most recently as CEO of Samsara Vision. We'll talk mechanism, evidence, and the road to Phase 3.

01:49 Meet Thomas Ruggia

06:50 How progressive myopia develops in children and why it's misunderstood

15:55 ND10's mechanism of action

19:51 20 years of Danish compassionate-use data vs. a randomised trial

26:44 Why no FDA-approved pharmacologic therapy exists yet

37:57 Theialife's pipeline beyond myopia

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To dive deeper into the topic: 

• Innovation in ophthalmology: How biotechs are reshaping the treatment of eye diseases
• Can gene therapy treat vision loss?
• Europe’s Ophthalmology Scene Stays Hot for Biotech Funding