Good Vision

It's 7 p.m. on a Monday and Alexander Eaton has just seen his last patient of the day.

Eaton, the founder and medical director of Retina Health Center in Fort Myers, locks the front door. But the day hasn't ended as he turns his attention to entrepreneurial ventures that could change medicine.

Eaton's most promising device has the potential to improve on the syringe, the ubiquitous device in every medical setting. He's developed a tiny sleeve that wraps around the needle and guards against infection, a simple idea that's garnering international attention from peers, professional journals and medical manufacturers.

To state the obvious, the market is huge: Eaton estimates 5 billion injections worldwide annually. For his specialty, it's more than 1 million injections.

But that's not the only project Eaton has going on in his entrepreneurial incubator in Fort Myers. Upstairs, Chinese scientist Guangjun Gao is working on an imaging system that would provide doctors like Eaton more information on the functional state of retinal tissue in the eye.

Gao, formerly a research scientist at the National Astronomical Observation of China, is testing the hardware and software on pigs' eyes. “We're seeing things no one's seen before,” Eaton marvels.

Meanwhile, Eaton's colleague, Hussein Wafapoor, is developing a Web-based patient referral system called DoctorAccessNow.com. The idea is to streamline the way patients are referred to other doctors to reduce the administrative hassles.

While the prospect of commercial success is real, Eaton says the thrill of developing new products is what drives him and his colleagues. “For me, it's the scientific excitement,” he says.

One key to creating an entrepreneurial culture is to bring team members into the process and constantly engage them. Wafapoor says he and Eaton might exchange ideas any time it strikes them. “In the hallway, he comes up to me and says, 'I have this idea,'” Wafapoor says. “It happens spontaneously.”

Edward Kennedy, the director of U.S. retina business with Bausch + Lomb, says Eaton has all the qualities of an entrepreneur. “He's smart, articulate and he's a tinkerer,” Kennedy says.

A better syringe
When Kennedy says he saw a presentation by Eaton on improving the syringe, it was a sort of slap-in-the-forehead moment. “It's one of the simplest things in the world. Why didn't I think of that?” Kennedy remembers thinking. “It's common sense, it's patient care and it's looking for a better clinical delivery every day.”

As an eye surgeon, Eaton has a particular challenge when he uses a syringe needle in the eyeball. To keep the patient from blinking, he's had to use a tool called a speculum to keep the eyelids apart.

Blinking while a surgeon inserts a syringe into the eyeball risks infection on the needle from the lashes, eyelids or even from the breath of the surgeon. So Eaton created a tiny retractable sleeve that covers the needle so that even if a patient blinks it greatly reduces the chances of needle contamination. He calls it the Guarded Injection Device and it eliminates the need for a speculum.

Besides patient safety, the sleeve helps doctor practices be more efficient because they don't have to spend time sterilizing the speculum. In initial tests, Eaton found that the staff saved five minutes between patients by eliminating this step. “He's got a very good marketing message on top of the clinical message,” Kennedy says.

In addition, Eaton and his colleagues found that they could insert a needle more quickly and more comfortably for the patient. The needle insertion time was reduced by 20%, according to an article to be published this month in the industry publication Retina Today.
“We tried to keep things simple,” says Eaton, who came up with his syringe idea while he was involved in clinical trials for a drug that required many injections.

In fact, many of today's miracle drugs for treating eye conditions come in the form of drugs that have to be injected into the eyeball on a monthly basis. Because the eye doesn't have much blood flow, it is particularly susceptible if infected.

Eaton formed a company called I-Tech JV Development Co. to conduct ongoing clinical trials, obtain patents and ultimately win approval from the U.S. Food and Drug Administration. “We've had discussions with some equipment manufacturers,” Eaton says, declining to elaborate for competitive reasons.

At this point, it's hard to say when the syringe sleeve will be available. “We're pretty far along,” Eaton says.

Fact is, this is a hugely competitive business on an international scale. “We're not just competing with the guys across the street,” Eaton says.

Eaton acknowledges that part of his job is to market the product. For example, he recently returned from a symposium in Italy where he presented his findings. “You have to build interest in the product,” he says.

“Injections are the fastest-growing thing in ophthalmology,” says Kennedy. Most syringe-related products on the market are designed to protect health care workers from accidental stabbing. “This is the first one that I know of that's geared to patients,” Kennedy notes. “His device is very simple: It protects patients.”

Besides Wafapoor, other partners include Robert Avery of California Retina Consultants and retinal researchers Dave Booth and Dyson Hickingbotham. Eaton says this kind of collaboration is essential because of the complexity of bringing a medical device to market. For example, Booth and Hickingbotham have been crucial partners for the engineering of the device. “It's really all about the team,” says Eaton, who has found his collaborators by networking among his peers.

Collaborators also help spread the expense and time for development, though Eaton says he's reluctant to bring in outside investors. “If I have investors, I have to deal with them and the technology,” he says. It's easier to work with scientific collaborators. “We make the decisions,” he says. “We don't have a board; we move very quickly.”

Still, Eaton recognizes that unanticipated obstacles are a part of product development that can boost the cost of development. “You have to expect that it's going to take longer than you think,” he says.

An entrepreneurial culture
Many eye-care providers participate in clinical trials for drug and device manufacturers, but it's rare that one is as entrepreneurial as Retina Health Center.

Eaton, a trim man who was raised in New York City and enjoys skiing and mountain climbing, says the potential profits from a blockbuster product isn't his main goal. “I'm trying to develop stuff to help my patients,” he says. “For me, seeing patients is incredibly rewarding.”

But make no mistake: This isn't an ordinary medical practice.

In addition to long hours after the doors close, Eaton and his colleagues toil through the weekend on various projects. “I get complaints from my wife,” chuckles Wafapoor. “I'm working on the website right now to finish the last details.”

When they don't have the expertise, Eaton and Wafapoor seek out the right person. For example, they recruited Gao, a Ph.D. from China who is working on developing a computer-assisted imaging system that is more powerful than what is on the market.

Wafapoor says he and Eaton complement each other's styles. “I'm very careful on the costs,” says Wafapoor.

Despite running a busy practice, Eaton and Wafapoor always find time to think of new ways to improve what they do. “It makes the day go easier,” Wafapoor says. “It makes it more interesting and exciting to be in the field.”