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Subspecialties Professional Development, Cataract, COVID-19, Imaging & Diagnostics

Making An Impact

Could you talk about your career journey and some of the highlights so far?

During my ophthalmology training, I liked the technological aspects of some sub-specialties. I was drawn to anterior segment – corneal and refractive – surgery. The bonus here is you get to have a real impact on patients undergoing cataract and LASIK surgery. Vision can improve relatively quickly in these patients; it’s rewarding to interact with patients when they can  – quite literally – see how quickly they are recovering.

My other passions are teaching, educating, and research. At Georgetown University I was fortunate to get involved with early clinical trials for laser technology. A real highlight was helping colleagues get certification on refractive surgery, in PRK or LASIK. I saw that working with industry is a great way of developing new technology. So, after transitioning to private practice and building up a network of refractive laser centers – which was very new at the time – I continued to research and collaborate with industry on new technologies. I’m proud to say we built a reputation of being able to take on complex cases.

All the while I was still involved in clinical trials. I joined Avedro as Chief Medical Officer (CMO); the company was seeking FDA approval for cross-linking for keratoconus. I was one of the principal investigators on the study that led to FDA approval, and, in the long-term, reimbursement – which is essential for commercialization. After an IPO, we were acquired by Glaukos and I moved to J&J Vision. By continuing to practice and be a part of industry, I’ve had the privilege of helping more people through the scale of J&J Vision, which spans the entire eye health continuum from myopia management to contact lenses and dry eye, as well as cataract and refractive surgery.

Have any role models or mentors helped to shape the path you’ve taken?

At every stage of my career this has absolutely been the case. My mentors were the first ophthalmologist I worked most closely with; I modeled my career after them in many ways.Ophthalmologists tend to be very optimistic, positive people who make great teachers. Two who come to mind are my medical school advisor, Robert Weiunber, an excellent corneal specialist, and the head of my fellowship program, Peter Laibson.

I loved seeing them at work – how they spoke to patients, how they educated them, and of course, they were excellent surgeons. When I went into the business side of eye care, there were fewer role models, but there are many intelligent and creative people guiding the development of new technology and products. I’ve also worked with some great people in finance, who helped to teach me about building a company and the importance of developing the right team. My current position at J&J Vision now allows me to act as a mentor to colleagues who have also come into industry from an academic or clinical background.

How can industry meet the challenge of both chronic and preventable eye conditions?

At J&J, we continue to build on our 130-year legacy by pioneering in platforms, creating new categories, and elevating the existing ones. Innovating products is what we do, but our commitment to patient outcomes is the why. The quest for improved outcomes is what drives each innovation, product, and partnership.

Part of our responsibility in the business world is to develop technology that is accessible. This is true from a cost perspective – We need to make sure our breakthroughs are widely affordable wherever possible, and be proactive in the prevention of diseases. Myopia is a good example – it’s a growing epidemic that leads to so many other eye diseases, but it is preventable. At J&J Vision we’re creating solutions with contact lenses like ACUVUE Abiliti that help prevent myopia progression.

When it comes to the economics of treatment, we’re developing a phacoemulsification machine, for example, which makes cataract surgery more efficient. We know cataract is one of the leading causes of preventable blindness, so if we can make treatment affordable worldwide then we can transform global eye health.

Our commitment to patient outcomes and presbyopia correction is reflected by advances in our TECNIS PC-IOL Portfolio Powered by InteliLight. These lenses are designed to provide the best contrast and low-light performance across the presbyopia-correcting IOL category with a combination of three proprietary technologies. We are also making significant investments in refractive surgery, like the recent debut of our ELITA Femtosecond Laser which represents a generational leap in corneal refractive technology.

The J&J Vision R&D team regularly meets with optometrists and ophthalmologists to share our insights, learn the ever-evolving needs of patients and get feedback on our innovations during development. The industry has a responsibility to be involved in education and raising awareness. This can be achieved partially through academic research centers and clinical trials, making sure residents and fellows have access to technology. We must also encourage closer collaboration between optometrists and ophthalmologists. Both can partner successfully to help build better systems of care for patients – what could be more important than that?

Do you have any advice for new ophthalmology residents?

I am fortunate to speak frequently with residents, fellows, and students. I always tell them to “find and follow your passion.” Eye care is so gratifying for both physician and patient – the feeling you get when you help someone see their loved ones clearly is so powerful. So, if you want to be a clinician, learn all you can. If you want to be the best surgeon, make sure you get the experience. If you enjoy technology, get involved in research and partner with industry. We partner with AAO, ASCRS, YoungMD Connect, and other organizations to offer opportunities such as educational workshops and events. I encourage those in training or clinicians who are interested in learning more about industry to engage with our clinical and medical affairs team through programs like these. That said, you also have to have something outside of work, so focus on your family and friends – because if you are happy and content outside of work, you will be the best doctor you can be.

What do you see on the horizon in terms of the detection and management of keratoconus?

In some ways keratoconus is similar to myopia – it has significant effects on a younger population. Those with irregular or asymmetric astigmatism must be watched very closely. Early detection is so important and today we have much better technology in topography and tomography to look at curvature and thickness of the cornea. But access is key – especially in a global setting. Eventually, telehealth and virtual testing that will allow early and remote diagnosis will be invaluable. In terms of treatment, there’s a lot of discussion around removing or not removing the epithelium – or some hybrid of those two approaches. But removing the epithelium as an in-office procedure is only widely available in the USA. There are other types of cross-linking products on the way – aside from riboflavin or UV light – and it’ll be interesting to see how they develop. Another option will be targeted treatment – really homing in on the most impacted area of the cornea. In the long term, with early detection, and more targeted treatment, we should see a decrease in the number of corneal transplants.

Outside of ophthalmology, what do you enjoy doing?

I love spending time with my family. One of the best things we do together is travel. Visiting other parts of the world is really fun and a hobby of mine. It’s a great way of learning about different cultures and spending quality time connecting through new experiences.

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