Coming to Washington, DC, Alper built a large private practice of ophthalmology, while maintaining a continuing role in clinical research and teaching at the Washington Hospital Center and George Washington University, particularly in neuroophthalmology and orbital disease. For much of this career, he was recognized as one of the most astute and distinguished clinicians in the entire Washington area. He immediately recognized the unique merits of the just-emerging technology of computerized tomography and published in early 1973 what was probably the first study of its use in orbital disease. In the 1960s, he cofounded, organized, and led a monthly teaching program in neuroophthalmology, bringing area ophthalmologists, neurologists, neurosurgeons, and neuroradiologists together in discussions that became and remain the main feature of advanced neuroophthalmologic education for the entire Washington, DC, medical community. He published more than 50 articles, book chapters, and book reviews during his active 41-year career, as well as participated in more than 100 formal lectureships and visiting professorships, a total made more impressive by his simultaneous private practice. In 1975, he was admitted to membership in the American Ophthalmological Society with a thesis describing changes in the anterior segment of the monkey eye after trigeminal nerve sections.