Jeffrey P. Gilbard, MD: Dry eye pioneer, product developer remembered

Key Points

Fellow ophthalmologists and business partners are mourning the loss of Jeffrey P. Gilbard, MD, 55, whose career was filled with innovative ideas and solutions for treating dry eye disease. The founder, chief executive officer, and chief scientific officer of Advanced Vision Research (AVR), Woburn, MA, died Aug. 12 following complications from a bicycling accident.

Peter J. McDonnell, MD, director, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, praised Dr. Gilbard's ability to "understand laboratory work, understand patient care, and understand and work with industry.

A pledge to help

While Dr. Gilbard was a medical student at Columbia University in 1976, he encountered a patient with dry eye, whom he pledged to help.

"She thought her condition was helpless. I thought this is ridiculous. Here we are doing heart transplants, and we can't treat dry eye," Dr. Gilbard was recorded as saying in an interview posted on the company's Web site ( http://www.theratears.com/).

In 1978, Dr. Gilbard received funding from the National Eye Institute (NEI) to research the causes and treatment of dry eye and became the youngest recipient of an NEI grant. After he concluded an internal medicine internship at Stanford University Medical Center, Palo Alto, CA, he completed his ophthalmology residency at MEEI. He opened his laboratory and began what would become an 18-year research project on dry eye.

Tear film osmolarity

Dr. Gilbard's work led to a better understanding of tear film osmolarity and a realization that a loss of water in the tears makes them hyperosmotic. The result was the launch of lubricant eye drops (TheraTears) in 1995, which were developed to lower the high-salt concentration, balance the electrolytes in the eye, and offer a lubricant to relieve irritation.

He later developed related products, including a vitamin supplement (TheraTears Nutrition), with omega-3 oils (including flaxseed and fish oils), that supports healthy tear production, and an eyelid cleanser (SteriLid) to remove bacteria that can lead to blepharitis and exacerbate dry eye.

Marguerite B. McDonald, MD, clinical professor of ophthalmology at New York University School of Medicine, praised Dr. Gilbard's work in bringing vitamins into the eye-health arena.

"[He] can be credited with drawing ophthalmologists' attention to the importance of omega-3 fatty acid nutritional supplements in the treatment of dry eye disease," she said.

In addition to his research, Dr. Gilbard was equally passionate about discussing with colleagues the science behind his products.

"His love of teaching was very obvious from the many physicians at his company's booth [at trade shows]," said Ernest W. Kornmehl, MD, a dry eye specialist who practices in the Boston area and an associate medical editor of Ophthalmology Times. "He loved to educate people about dry eye. He appreciated that it was a significant chronic problem that was very bothersome to patients and could affect their life adversely in terms of comfort and their quality of life. Being the curious person he was, he delved into the subject matter and was observant enough to make an important contribution."

Dr. Gilbard's curiosity extended beyond the laboratory but often related to his work. For example, he loved to learn languages, especially if he knew he would be speaking about his findings in another country. He spoke French and Italian rather fluently and was learning German, Japanese, and Spanish, said Leigh Reynolds, who shared an office with Dr. Gilbard as AVR's chief operating officer.

When Reynolds joined the company 11 years ago, its sales were about $1 million a year. Today, the company has 13 full-time employees, numerous outsourced employees, and sales top $20 million, she said.

"Part of what gives me comfort is that there are very few people in this life who achieve their dreams," added Neil D. Donnenfeld, senior vice president of global sales and marketing and brother of refractive surgeon Eric D. Donnenfeld, MD. "That's what he set out to do, and that's what he did."

Reynolds and Donnenfeld said they pledged to continue Dr. Gilbard's work and are planning to launch an improved version of the company's original dry eye drops in the first quarter of 2010.