The Circle of Vision

Rajesh K. Rajpal, MD

The eyes may be the window to your soul, but for ophthalmologists and optometrists, the eyes are the window to overall health. Rajesh K. Rajpal, MD, chief medical officer, global head of clinical and medical affairs, J&J Vision explains, “We can identify and see changes directly within the eye. For example, in diabetes, high blood pressure, or heart disease, we can look into the retina and see the blood vessels. It's really the only place in the body where you can do that. There are also many medical conditions within the eye that are impacted by genetic diseases.” Whether it’s a technology or a therapy and whether it’s working or not, the eyes can tell a lot about what’s going on inside a person.

There are many, many available treatments and solutions for eye-related conditions and diseases, and J&J Vision spans that spectrum of eye health, impacting over 40 million people a year across vision care and surgical vision. Rajpal oversees both the clinical and medical teams for the entirety of J&J Vision, which includes optometrists, who focus on vision care, and ophthalmologists who focus on surgical vision. The clinical science team is primarily focused on the development of clinical trial protocols, establishing the science behind why J&J Vision is approaching a new medical technology in a certain way. The teams are also very involved with professional societies including the American Academy of Ophthalmology, the American Society of Cataract and Refractive Surgery and the American Optometric Association.

As such, in addition to the doctors in the space, J&J Vision is part of the Johnson & Johnson MedTech segment (previously referred to as the Medical Devices segment) and is involved with various regulatory bodies globally. In the United States, FDA’s CDRH division regulates medical devices (and yes, contact lenses are a medical device, whose products must be reviewed and used with only a prescription). For example, a recent innovation in surgical vision is the VERITAS™ Vision System, which sought to address unmet needs in cataract surgery by offering a more consistent, stable and ergonomic option for cataract surgery. FDA granted 510(k) clearance and CE mark in 2021.

And in our world of advancing science and technology, there is increasing opportunity for innovations to be applied across the lifetime of one’s eye health, from contact lens wearers to cataract patients. A perfect example is J&J Vision’s OptiBlue™ light filter technology—which filters 60% of blue-violet light, the highest-level of blue-violet light filter in the industry. This technology is designed to meet the needs of consumers who are living more digitally intense lifestyles and spending more time on digital devices which leads to less blinking and ultimately dry and tired eyes. OptiBlue™ light filter technology can be found in the new ACUVUE® OASYS MAX 1-Day contact lenses which also include TearStable™ Technology. The new light filter technology can also be found in the new TECNIS Symfony™ OptiBlue™ intraocular lens for cataract patients.

To that end, Rajpal says it’s important that J&J Vision work to serve its optometry customers and ophthalmology customers not only because of product synergies, but also the large crossover of practitioner relationships.

“They are the same doctors, treating the same patients. The basis of our relationships have already been established through our commercial business that has been around for many years,” says Rajpal. “Our medical affairs teams work with these clinicians to educate them across these innovative products.”

Rajpal notes that in MedTech, because medical affairs is often the interface between the clinicians and the company, “It’s a recognition by most companies, and even by most clinicians, that the partnership between medical affairs and other aspects of the business—whether it's the commercial part, or research and development, or supply chain, all the various components—is really critical.”

Why industry?

Rajpal joined J&J Vision in his role April 2020. Here is his very abbreviated story of how he got there: “I was full-time in academics. Then I started a private practice group, which grew to multiple centers. And I stayed very involved academically in the private practice, continued voluntary faculty at academics, and then made the transition to industry.”

Today he still sees patients about once a week at that practice he founded in 1995, See Clearly Vision Group. He also maintains his position on the Clinical Faculty, Department of Ophthalmology at Georgetown and George Washington Universities.

But prior to this, of course, was what brought him into the field. Rajpal says he always had an interest in medicine growing up, and then became interested in technology in high school and through college. What he found in the ophthalmology specialty was the perfect blend of technology and caring for patients at all stages of their lives, in a very significant way…their important sense of sight.

“I found as I was going through training that it was very gratifying to be involved in that care and helping them achieve better vision or preserve their vision,” says Rajpal.

It was this same positive impact on patients that Rajpal sought out in clinical trials for his practice, to potentially, bring new products to market to help patients. And it was still yet a driver for his decision to enter industry.

“I felt that I could have an even greater impact if I was doing it on the industry side. And could guide industry on the needs from the clinical perspective and the patient perspective.” Rajpal explains.

And now, what does Rajpal have to say about his experiences? “I love the one-on one part of medicine and of doing surgery and seeing patients. And hearing how well they're seeing the next day. But I also love the impact of being involved in developing a treatment that's going to potentially help millions of patients.”

The clinician impact

Rajpal believes ophthalmologists and optometrists, by and large, are a happy and innovative bunch. “We have a significant number of clinicians who enjoy being involved in bringing new products to patients,” Rajpal remarks. “We generally have a fairly easy time finding investigators who are doing really good work, have a team of study coordinators, and are able to discuss with patients appropriately whether a clinical trial may be right for them. Generally, patients are pretty motivated also, because they're getting access to the latest technology.”

Besides a curiosity for education and innovation, it also is the nature of clinicians in this field to have skills and experiences that can easily fit into industry or lead organizations.

Rajpal says, “I do look at myself as a collaborative leader, working with teams, and creating consensus in terms of guiding where we go in the future. That aligns well with my clinical background. Clinicians in general work in teams. We lead the teams in a clinical practice. We put what’s best for the patient first, and we can impact innovation.”

Rajpal’s leadership tip to younger people finishing their residency or fellowship is to “first of all, have a really strong clinical background. That is critical. Because everyone wants to learn from your own experience on how you’ve actually managed patients or developed treatment plans.” He then advises to partner slowly by working in academia or academic centers, and when companies want insight, partner with them.

“They should contribute what they think is needed, and also learn their objectives from the partner,” says Rajpal. “And if you are interested to spend part-time in a role or go full time, be sure to maintain that clinical perspective. The education, ties into research, which ties into clinical value and patient benefits.” It’s the complete circle of innovation in vision.