Center/Research Area Affiliations

• Cornea Center of Excellence

Biography

Dr. Greiner has contributed to the discovery, naming, and elucidation of two pathological disorders of the ocular surface: giant papillary conjunctivitis (GPC) and lid wiper epitheliopathy (LWE), as well as the etiology of keratoconus and a cure for filamentary keratitis. Additionally, Dr. Greiner and his collaborators developed a patented, long-acting oil-in-water eye drop for the treatment of evaporative dry eye disease. Currently, at Schepens Eye Research Institute of Mass Eye and Ear, he is working on a number of projects addressing dry eye disease and meibomian gland dysfunction (MGD), including: 

1. The identification and treatment of LWE in both the upper and lower eyelids and its association with dry eye symptoms
2. Developing techniques to quantitatively and qualitatively assess the tearfilm, particularly the lipid layer
3. The validation of the long-term therapeutic benefits of thermal pulsation system treatment and manual lid expression for MGD

Early Career

Dr. Greiner joined the Howe Laboratory at Massachusetts Eye and Ear in 1974 for postdoctoral training under Dr. Leo Chylack in the field of cataract development. This was followed by an additional postdoctoral fellowship at the Eye Research Institute (ERI) with Drs. Mathea Allansmith and Claes H. Dohlman to explore ocular surface diseases, particularly those related to allergy and contact lens wear. During that time, Dr. Greiner began a lifelong collaboration with optometrist/scientist Dr. Donald Korb, a leader in the field of contact lens-associated ocular surface disorders, while simultaneously completing his OD degree from the New England College of Optometry. The collaboration with Drs. Allansmith and Korb resulted in the discovery of the condition known as Giant Papillary Conjunctivitis (GPC) as well as treatment options for this disorder.

In 1978, as a medical student at Midwestern University in Chicago, Dr. Greiner founded and became co-director of an NIH-funded research laboratory and began his ongoing collaboration with physicist Dr. Thomas Glonek to apply magnetic resonance spectroscopic (MRS) techniques to the study of the biochemistry of ocular tissues in health and disease. He continued this research program, as well as the long-distance collaboration with Dr. Allansmith at ERI, after graduating from medical school and while completing an internship in Internal Medicine at Cook County Hospital in Chicago and a residency in Ophthalmology at Georgetown University Medical Center with Dr. Michael Lemp.

Dr. Greiner returned to Boston in 1986 as a Clinical Fellow in Cornea with Drs. Kenneth Kenyon and Claes Dohlman at Mass Eye and Ear. During this time, Dr. Greiner collaborated with Drs. Glonek and Korb to develop a patented eye drop to provide exceptional long-term (24 hr) relief from dry eye symptoms. Currently, Dr. Greiner serves as Director of an ophthalmology practice with subspecialty in cornea and external diseases and continues his research focus on dry eye diseases through ongoing collaborations with investigators in multiple disciplines. His research goal is to expand our basic understanding of ocular surface and dry eye diseases and to develop highly efficacious treatments for these conditions.

Education

MS, Purdue University (1974)

PhD, University of Toledo and the Medical University of Ohio (1975)

OD, New England College of Optometry (1978)

DO, Midwestern University, Chicago College of Osteopathic Medicine (1982)

Postgraduate Training

Postdoctoral Fellowship in Research and Teaching, Howe Laboratory of Ophthalmology, Massachusetts Eye and Ear (1975-1976)

Research Fellowship, Cornea Research, Schepens Eye Research Institute (1976-1978)

Internship, Department of Internal Medicine, Cook County Hospital (1982-1983)

Residency, Department of Ophthalmology, Georgetown University Medical Center (1883-1986)

Clinical Fellowship, Cornea Service, Massachusetts Eye and Ear (1986-1988)

Honors

2017: Dr. E.O. Martin Award (medal), American Association of Physician Specialists

2015: Distinguished Career of Excellence in Ophthalmology, Hallmark Health System

2003: Physician of the Year, American Academy of Specialists in Surgery

2001: Achievement Award, American Academy of Ophthalmology

1998: Distinguished Practitioner (medal), National Academies of Practice

1976: National Research Service Award, National Eye Institute

Identification and Characterization of Lid Wiper Epitheliopathy

Lid wiper epitheliopathy, a pathology of the distal eyelid, was first observed to occur in the upper eyelid margin. It was best observed with sodium fluorescein and Lissamine green vital staining in patients with dry eye conditions associated with meibomian gland dysfunction. Initial observations revealed that the greater the dysfunction, the greater the degree of vital staining. More recently, this epitheliopathy has been reported to occur not only in the upper eyelid, but also in the lower eyelid. This phenomenon is perplexing, especially when considering the upper and lower eyelid movements during blinking are very different. The association of this phenomenon and dry eye diseases is becoming more established, although this condition occurring in the lower eyelid remains unclear. Observational studies in patients with various degrees of dry eye disease are underway. It is expected that observational information should assist in revealing the etiology.

Thermal Pulsation System for Dry Eye Disease

Dr. Greiner found that a single treatment with a thermal pulsation system has long-term (nine-month) therapeutic benefits for patients with meibomian gland dysfunction, and subsequent studies demonstrate even longer term effects. His observational studies have led him to study why such long-term effects occur. The relationships among the signs and symptoms of dry eye disease have been shown to correlate with improvement of dry eye conditions following thermal pulsation system treatment, but there remain many signs that do not correlate with the treatment and the long-term results. Dr. Greiner's studies aim to discover why such correlations are not always present and why the signs and symptoms of conditions of dry eye disease are not always related.

Lipid Layer Thickness in Dry Eye Secondary to Meibomian Gland Dysfunction

Interferometric methods are used to measure the lipid layer thickness in both asymptomatic subjects and subjects with dry eye symptoms. Subject selection is made based not only on symptomatology, but also using meibomian gland assessment scores and other scored signs that are related to meibomian gland dysfunction since meibomian gland function can be related to the status of the tear film lipid layer. Presently, there is no accurate way of measuring the lipid layer since it is a dynamic layer that overlays the underlying aqueous layer of the tear film, which is in constant flux. Although current techniques can measure the lipid layer thickness over the cornea inferiorly, Dr. Greiner is interested in assessing changes in the lipid layer thickness over the visual axis in normal and disease states.

Current work is in collaboration with Dr. Marshall Doane, who has spent his career measuring ocular surface tear film phenomena.

Current Members of Dr. Jack V Greiner’s Laboratory

Clinical Coordinator and Laboratory Administrator

• Paula J. Oliver, AS

Research Associate

• Cynthia A. M. Greiner, PhD

Research Assistant

• Michael Lindsay, BS

Research Assistant

• Deidra, Soto, BS

Alumni

More than 24 trainees have worked in Dr. Greiner’s laboratory.