Article Date: 9/1/2009

Jeffrey Gilbard, Creator of TheraTears
Practice pulse

Jeffrey Gilbard, Creator of TheraTears


Jeffrey P. Gilbard, M.D., the founder of Advanced Vision Research (AVR), which markets and distributes TheraTears, died last month due to complications related to a bicycle accident. He was 55.

Dr. Gilbard is known for his research that led to the treatment of dry eye disease.

“Jeff Gilbard was an innovative, gifted ophthalmologist and researcher, who made several important contributions to our profession,” says Edward Holland, M.D., director of Cornea Service at the Cincinnati Eye Institute. “He was the first person to understand the importance of tear film osmolarity, and his development of hypotonic artificial tears containing bicarbonate and potassium is a landmark event in the treatment of dry eye disease.”

Dr. Gilbard began his career-long interest in 1976 when, as a medical student, he met his first dry eye patient. This led to a summer research project into treating dry eye. In 1978, Dr. Gilbard became the youngest scientist to ever receive project grant funding from the National Eye Institute.

In discussing his early research with Ophthalmology Management (June 2004) — sister publication to Optometric Management — Dr. Gilbard said his hypotonic formulations “worked better than the other stuff that was out there, but the patients weren't coming back tap dancing. I knew something was missing.” After several more years of research, he found the solution: Living cells on the eye's surface need tear film because tear film supplies oxygen and electrolytes. The resulting solution became TheraTears.

Dr. Gilbard founded AVR in 1995 to market and distribute the new eye lubricant. His expertise as a researcher, together with his marketing and distribution strategies, led Thera-Tears to become one of the best-selling over-the-counter treatments for dry eye.

Dr. Gilbard is known for his holistic approach to dry eye care, which includes nutritional supplements. His research in this area resulted in TheraTears Nutrition, Macutrition and NutriDox — all to improve the ocular surface and to treat and prevent retinal disease.

Under Dr. Gilbard's leadership, AVR expanded to 11 products and numerous patents. And the company achieved sales records each year for the past 12 years.

Dr. Gilbard received his medical degree from Columbia University in 1979. He interned at Stanford University and served his residency at Harvard Medical School in the Massachusetts Eye and Ear Infirmary. He was a clinical assistant professor of Ophthalmology at Harvard Medical School and director of the Dry Eye and Ocular Surface Disease Clinic at the New England Eye Center.

The AVR executive team will continue to operate AVR: “That is what Jeff would want us to do, and there's no better tribute to him than to continue his work,” says Leigh Reynolds, AVR chief operating officer.

New Optometry Organization Debuts


■ On August 6, an elected board of directors took over from its anonymous beginnings, the newly formed American Optometric Society (AOS) “for the purpose of protecting optometry by returning to optometrists a meaningful voice by a representative organization.” The catalyst for its creation: The vote by the American Optometric Association (AOA) House of Delegates to develop a framework for board certification in the face of what the AOS characterizes as “overwhelming opposition” by optometrists.

“After the way the AOA handled the board certification issue, many optometrists feel the current leadership of the AOA has betrayed their trust and their profession. Somebody has to hold the AOA accountable for what they do,” says optometrist Pamela J. Miller, J.D., president/CEO of the AOS. Perhaps more than anything else, the AOS will work to restore trust in the AOA by returning it to the strong representative organization it once was.”

The association's mission is to mobilize a broad base of support to bring about change, according to its web site ( It doesn't seek to sue the AOA or any state optometric association — and would consider this only as “a last resort” — but rather strengthen the AOA by making it more representative and cohesive. Dr. Miller says that the board certification vote is just one of many issues the AOS intends to address within the profession. (The society's Web site includes its mission statement and additional information.)

AOA: channel concerns through state affiliations and the AOA

In commenting on the new organization, AOA president Randolf Brooks said: “The AOA would prefer that the energies expended in the formation of a new organization had been channeled into the state affiliates and the AOA, as we continue to fight for optometry's full inclusion in healthcare at the state and national level. Our ability to demonstrate that we provide quality care is critical to assuring that patients have continued access to their family optometrist in a non-discriminatory manner.”

As we go to press, the new organization is very much in its infancy stage. Its membership has elected seven directors to the board of the AOS. They are optometrists Larry Bickford, Tom Cheezum, Dickson Chen, Richard Driscoll, Art Epstein, Michael Rosenblatt and Pamela Miller, J.D. These directors continue to work on the Society's Web site, are currently discussing strategies for implementing the AOS mission and weighing options and developing ways to grow membership, which now stands at 1,300, according to the AOS Web site (accessed on Aug. 31, 2009).

Self-Service Kiosk May Boost O.D. Revenue


■ When EyeSite self-service kiosks, from SoloHealth, made their debut in Atlanta retail locations, such as Walmart, and regional malls in 2007, Atlanta optometrists who came in contact with the Robot-looking stands likely initially thought: “Danger, livelihood! Danger!” After all, the kiosks provide a free assessment of one's near and distance visual acuity in less than three minutes.

Further scrutiny of the technology, however, revealed it's not designed to take the place of an eye exam, but rather prompt users to make a comprehensive eye exam appointment with a local eyecare practitioner (ECP) and look into purchasing recommended optical products.

Specifically, the kiosk doesn't provide a prescription, but rather a “Vision Test Report.” This report affords the user a percentage with an accompanying adjective to describe each eye's near and distance vision (e.g. “left eye: near: 93% excellent, far: 60% fair”), a brief recommendation for follow-up eyecare based on the vision screening results and/or user answers to eye health-related questions, eyecare product coupons from which the patient may benefit and a referral to one or more Eye-Site-affiliated local ECPs (visit It's this affiliation that may help optical manufacturers increase sales and ECPs book more appointments, SoloHealth says.

A user in the middle of her free vision screening on the EyeSite Kiosk.

“Approximately 3% of the people who sit down at the kiosk actually put in their information because they want to schedule an exam with an eye doctor, and that's out of more than 150,000 users,” says SoloHealth CEO and founder Bart Foster. “What we don't know is how many users wait three weeks to call the doctor themselves later. Those [users] are difficult to track.”

To become an affiliated practitioner, you must either lease one or more kiosks for one year, whereby you have complete control regarding the advertising content and referral listing, or be a part of the referral listing in an optical manufacturer-sponsored EyeSite kiosk. The cost for an ECPs to lease a kiosk is typically $200 per unit.

Thus far, consumers can find the EyeSite kiosks in 10 Atlanta retail locations. In addition, SoloHealth recently placed 30 EyeSite kiosks in Schnucks Markets in St. Louis. Transitions Optical, CIBA Vision and Optos, among other optical product manufacturers, are sponsoring these units. Also, the company is working on distributing the kiosks in at least three additional markets this year.

Mr. Foster says both retail establishment and ECP interest will dictate the further distribution of the kiosks.

“We have pre-approved retail locations in a number of markets. To gauge eyecare practitioner interest, the doctor page of our Web site provides a basic form that asks where SoloHealth should place the kiosks next,” he explains. “We use this information not only to inform ECPs of new locations, but also to decide what markets to go to next.” (Visit for more information.)

Vision Expo Leverages Social Media


■ You can keep up to date with International Vision Expo simply by going to your favorite social networking outlet.

The Expo now has a presence on Facebook (with 600 fans) Twitter (250 followers) LinkedIn and You-Tube. Through these social networking sites, Vision Expo will offer discounts, show specials, videocasts and discussion topics.

To access the Vision Expo profiles on any of the sites, simply search for “International Vision Expo.”

If you're not familiar with social networking, then you may want to attend one of the two social networking classes that will be held at Vision Expo West. Even those with a basic knowledge of social networking may want to consider the class “Cracking the Social Network Code to Generate New Business.” For more information, visit


• Ketorolac tromethamine ophthalmic solution 0.45% (Acuvail, Allergan Inc.) has received FDA approval for the treatment of pain and inflammation associated with cataract surgery. Patients should apply the preservative-free nonsteroidal anti-inflammatory drug on the affected eye twice-daily starting one-day pre-surgery, continued on the day of surgery and through the first two weeks of the post-op period, the company says. (Visit for more information.)

• The Akreos AO MICS intraocular lens, from Bausch & Lomb, is now available in the United States. The lens is spherical-aberration free and is designed for implantation through a 1.8mm incision, the company says.

• Scientists at the National Institute of Dental and Craniofacial Research, part of the National Institutes of Health (NIH), are currently developing a bait-and-bind diagnostic test called luciferase immunoprecipitation technology (LIPS), which so far has identified the SSB antibody — strongly associated with Sjogren's syndrome — correctly three out of four times and with perfect accuracy, the NIH says. Current standard blood tests detect SSB only about half the time, making the meaning of a negative result uncertain.

Oral or topical beta-blocker use appears to significantly predict a 10-year incidence of cataract surgery after adjusting for age, gender, blood pressure, intraocular pressure, myopia, diabetes, smoking and steroid use, According to a study in the July 23 issue of the British Journal of Ophthalmology.

Robert Breece, O.D., 59, a specialty contact lens design pioneer, died on August 10. He was president of MedLens Innovations.

Thom J. Zimmerman, M.D., Ph.D., 66, inventor of timolol maleate (Timoptic, Aton Pharma. Inc.), died after a brief illness.

◻ The October 12 episode of CSI: Miami will feature the Reichert AL200 Automated Lensometer, according to Reichert. Will star David Caruso be upstaged?

Optometry Giving Sight invites U.S. O.D.s to participate in this year's World Sight Day Challenge in October to help raise funds and awareness for eyecare service programs for people in countries without access to them. Visit,, or call (888) OGS-GIVE for more information.

CooperVision says that a recent U.S. District Court ruling involving Johnson & Johnson does not impact the supply of Biofinity or Avaira contact lenses or the servicing of customers who wear either of the lenses.

Optometric Management, Issue: September 2009