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TearLab taps social media for dry eye awareness

December 6, 2011 by · Leave a Comment 

During the past six months, TearLab (NASDAQ:TEAR;TSX:TLB) has initiated a series of social media campaigns as part of an innovative strategy to increase the awareness of dry eye disease (DED) with both patients and doctors.

Elias Vamvakas

The program is also designed to demonstrate how its diagnostic test for dry eye can change the paradigm of dry eye management in the doctor’s practice by developing a new practice model, which not only benefits patients, but also creates a new revenue center.

“We are ecstatic with the initial results of our social media strategy,” CEO Elias Vamvakas says in an exclusive interview with “As far as we can tell, we are the first to coordinate and maximize as many elements on the web: the company, the doctor, the patient and the medical community, all in an effort to improve care for dry eye patients.”

TearLab has developed the first point-of-care device that quantitatively measures a patient’s tear osmolarity to diagnose the severity of DED, which can have a dramatic impact on a patient’s ophthalmologic health and quality of life. Essentially, osmolarity gives doctors a meaningful measure of the health and stability of the tear film, an important element in stabilizing and fine tuning quality of vision.

For patients complaining of burning and irritated eyes, blurred vision and/or excessive tearing, the TearLab test is a fast (less than 60 seconds) and efficient (50 nanoliters of fluid) way to test tear osmolarity for both the diagnosis of dry eye disease and the measurement of response to therapy.

Tear film stability is critical in a number of clinical settings. Beyond general health, the stability of one’s tear film is critical for patients having cataract surgery, laser vision correction and glaucoma treatment. It’s even critical in contact lens fitting as 50% of contact lens wearers develop contact lens-induced dry eye (CLIDE) within five years of wearing lenses.

Currently, the main test for dry eye is the Schirmer test. This test involves placing a strip of filter paper over part of the eye (conjunctival sac) for up to five minutes. Less than the normal amount of wetting, on repeated examinations, indicates decreased tear production. Unfortunately, this test misses detecting many patients with dry eyes.

Prior to the arrival of TearLab’s Osmolarity Test, eye doctors lacked a meaningful diagnostic tool for DED, which affects some 30 million people in the U.S. alone. “The result was that eye doctors didn’t consider it to be a real disease,” Mr. Vamvakas recalls. “As the outcome of having long-term dry eye is rarely a serious sight-threatening issue, dry eye has often been treated as a nuisance or inconvenience. Typically, clinicians suggested patients take a variety of eye drops until they found one that worked on their symptoms.”

That was the biggest challenge Mr. Vamvakas faced in trying to get the TearLab device into the market.

“The first thing we had to do was convince doctors that TearLab could be a valuable part of their practice. A quantitative measure for the disease would allow both doctors and patients to understand both the disease and treatment efficacy to a much better extent. It was also important for them to understand that DED presented a tremendous practice growth opportunity  in an environment where practice revenues were constantly being impacted from reduced levels of reimbursement and companies like Wal-Mart or online providers [are] continuing to take market share of  glasses, contact lenses and over the counter therapies,” he recalls.

The other major challenge was finding a way to connect patient experiences and their desire to deal with their condition in a way that doctors could understand the real impact to their quality of life.

“So, we decided to go at this completely differently and build an online community using social media,” Mr. Vamvakas remembers. “By enabling communication between patients and doctors, we felt that doctors would understand how important treating dry eye properly is to their patients and the profound impact they would have to their care. In addition, by putting together tools for patients to seek out doctors who were experts in this area, it would become obvious that doctors, who weren’t focused in this area, would lose out on a great opportunity.”


Mr. Vamvakas’ marketing strategy took flight in June, when TearLab launched its Accredited Dry Eye Center (ADEC) program to help doctors establish a practice for high quality dry eye care using advanced ophthalmic diagnostic techniques and treatments.

TearLab’s social media group headed by Tracy Puckett, TearLab’s VP of Marketing, now works with ADEC participants to modernize their websites for social media, promoting direct consumer interaction on Facebook, Twitter, LinkedIn and other blog sites, including TearLab’s That website was launched at the end of August to educate patients, provide them the ability to communicate with doctors and ultimately drive them to doctors who are committed and focused on treating DED.

“The strategy is to have be the focus of the social media marketing strategy and raise the website and associated linked websites on search engines to the top of the page, ultimately converting interest in the site’s content into a desire to find an expert dry eye doctor,” Mr. Vamvakas points out.

He says, “By having websites dominate Google searches [and having] thousands of fans on Facebook, LinkedIn, Twitter and YouTube would be equivalent of spending millions of advertising dollars in traditional print and radio media, all for the benefit of local ADEC doctors and their communities. Together, we can accomplish what no one individual can accomplish on their own.”

The key to the strategy’s success is interlinking authoritative sites, web links and online references. “The effect of interlinking all of the major website properties managed by TearLab, including, and, with thousands of doctors’ websites would very powerful,” he contends. He adds, “This online presence would not only serve to raise search engine ratings nationally but, in most cases, catapult individual doctors’ websites to the top in their individual markets.”

Ms. Puckett says 67 medical practices have already enrolled in the ADEC program, giving them access to all of the company’s marketing resources. has 77 regular users, including subscribers to its forum and blog, and 276 likes on Facebook.

“That may not sound like a lot, but it’s a fantastic early result for a site that has been up for only two months,” she points out. According to Ms. Puckett, the website also averages two questions a week for a TearLab virtual doctor, which shows “people are interacting with us.”

TearLab’s website for professionals,, has 2,650 subscribers comprised of doctors who receive an email alert with each new posting in order to “keep the conversation going about DED,” Ms. Puckett adds.

Mr. Vamvakas, a co-founder and the CEO of TLC Laser Vision until 2004, says he was attracted to the dry eye sector, because 30% of people who visit an eye doctor complain of dry eye symptoms, and there were very few ways of diagnosing the disease.

The only FDA-approved drug for DED is Allergan’s Restatis, with annual sales of around $500 million. In addition, there are some two dozen DED drugs working their way through clinical trials.

Restasis, however, can take up to six months to show it works, stings the eye when administered and is an expensive medication, resulting in a high dropout rate. “If there was an objective test to show patients that Restasis is working, they’d stick with it. It’s like cholesterol. You don’t feel any different taking a pill, but if your blood test shows your cholesterol went down, you’re happy staying on the medication,” Mr. Vamvakas adds.

TearLab Osmolarity: What's your number?

“So, I looked at it as a perfect storm; it’s a huge disease, there was no diagnostic out there, and there are many potential treatments coming down the road,” he says. “What I hadn’t counted on was the fact that doctors were reluctant to treat the disease.”

But the tide is turning.

Osmolarity testing for DED is now making impressive inroads with U.S. eye doctors. For example, an article entitled “Tear Osmolarity in the Diagnosis and Management of Dry Eye Disease”, which appeared in the May 2011 issue of the prestigious American Journal of Ophthalmology, ranks as the second most frequently downloaded AJO article (on Science Direct) published from January to August this year.

In initiating coverage of TearLab last week, analyst Matt Dolan of Roth Capital Partners writes that, based on conversations with clinicians, “tear osmolarity is becoming increasingly accepted as an important metric in evaluating DED patients, with some suggesting it should be standard of care.”

Mr. Vamvakas, in a presentation at the Piper Jaffray Healthcare Conference last week, estimated that the potential U.S. market for routine osmolarity examinations is $1.8 billion a year. That’s based on 50,000 ophthalmologists and optometrists seeing an average of six dry eye patients a day and testing both eyes with a $12 per treatment card for the TearLab osmolarity device.



Editor’s note: Yesterday, TearLab announced receipt of a communication from the FDA indicating that, based on a supervisory review of the Company’s appeal, the Agency has granted its petition for a waiver under CLlA for its osmolarity test.  The waiver will be issued after TearLab submits labeling acceptable to the Agency. Mr. Vamvakas said in a statement that a CLIA-waiver will now allow the osmolarity test to start growing to its potential.



Bottom line: Mr. Vamvakas states, “Our objective is to make TearLab, the device, a valuable tool for doctors and to make TearLab, the corporation, a valuable partner for doctors to build their practice and increase their revenue.”

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