BLOG: TearLab takes it behind closed doors
How long has it been? It seems like my entire career, but I know it’s not that long.
I first heard about tear osmolarity (TO) from Paul Koch. Like always, Paul was way ahead of the curve, using a research lab TO machine and putting punctal plugs in everyone who had elevated levels. Must have been the early ’00s, already well into my dry eye disease journey. SkyVision was so early in the TO game that we jumped through the hoops necessary to use the TearLab unit not only before it was approved for insurance payment but before it was CLIA waived. We actually became an intermediate level lab so that we could test our patients.
Over the years, I have vacillated between “raving fan” and “loyal opposition” when it came to TearLab and TO. Some of my very earliest writing was on the topic. I felt then, and continue to feel now, that TO is not a binary “normal vs. abnormal” metric, but rather one that guides both diagnosis and treatment, whether it is high or low. As such, it is an integral part of a comprehensive DED clinic. Indeed, TO made its way into the most recent DEWS definition of DED.
TearLab announced that it is being taken private in a 100% sale of assets (and debt) to a private equity fund specializing in health care companies that have a commercial product already on the market. TearLab was always a bit of an outlier, a tiny company with a single product that went public while it was trying to grow. That always seemed strange to me. The specter of the share price always lurked in the background when TearLab was in the conversation.
Not anymore. TearLab now has the luxury of moving forward with the much hoped for expansion of its unique “lab on a chip” technology without the intense interest of the stock market. In my opinion, this is a good thing. TearLab and Accelmed now get to make strategic decisions and, more specifically, decide how and when to disclose those decisions, with a singular focus, without the need to explain themselves to the market.
TearLab as we know it will still likely function pretty much as it has been, at least until we get some kind of decision from the FDA on the expanded Discovery platform. Also, this may not be the end of the “action” involving TearLab. Maybe as a private company with access to capital it will go from prey to pursuer in the market for products in its space. Alas, this could also be a pretty short relationship. Heaven knows — well, heaven and about 300 or 400 ophthalmologists who are now private equity employees know — private equity companies are DNA-driven to extract the best return at the earliest opportunity.
I am agnostic regarding the ownership of TearLab and the TO technology. TO is fundamental to DED care, and it would be tragic if the ability to test for it went away. Here’s hoping that TearLab and its new owners keep pushing point-of-care ocular surface disease testing forward. Discovery is publicly known (European data) to have objective MMP-9 measurement capability. Add in IgG, maybe another inflammatory marker and perhaps adenoviral antigen testing, and you literally have a one-stop in-office red eye test. Remember, we are all red eye doctors. We should all be cheering for the “new” TearLab to succeed.
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