Legend has it that individuals who walk through a moongate are blessed with good fortune and a joyful and prosperous future. Credit: Captain-tucker

For me, it all began with a moongate. While a graduate student at Dartmouth Medical School (Hanover, US) in the mid-1970s, one of my mentors, the internationally renowned corticosteroid endocrinologist, the late Emeritus Professor Allan Munck, organised an exclusive meeting of approximately 25 steroid hormone experts from around the world in a mansion behind a moongate in Bermuda. Although, being a graduate student, I was not invited, I thought the meeting was an amazing idea. I dreamed that if I ever became a faculty member, I would also like to organise a medical research conference behind a moongate in Bermuda and invite people from all over the world.

My dream came true in November 1992. After requesting input from many global colleagues, I organised the first International Conference on the Lacrimal Gland, Tear Film and Dry Eye Syndromes: Basic Science and Clinical Relevance. This three-day conference was held in the Southampton Princess Resort, located behind a moongate in Bermuda, attracted 175 participants from all over the world and resulted in a 729-page Proceedings book¹. As part of this conference, I had asked Professor Michael Lemp to give a presentation about clinical trials and dry eye. He was so appalled at the lack of information that he proposed “an academic-clinical practice-industry-governmental effort to develop a consensus” for clinical trial design to evaluate treatments for dry eye. This led to Prof Lemp's organisation of the NEI Industry Workshop with Professor Anthony Bron and Dr Daniel Nelson.

One more outcome was that many people wanted another conference. Consequently, I organised a sequel, also held in Bermuda, in November 1996. This three-day meeting involved 230 participants and resulted in a 1,051-page book². The success of this second Bermuda conference, in turn, led to my organisation of the third conference in Maui in November 2000, attended by 310 participants and resulting in a 1,385-page book³.

Just some of the TFOS ambassador attendees at the TFOS meeting in Rome in 2019

The present

One of the most remarkable achievements of these conferences is that they led to the formation in November 2000 of the non-profit organisation the Tear Film & Ocular Surface Society (TFOS). TFOS is a global community whose mission is to advance the research, literacy and educational aspects of the scientific field of the tear film and ocular surface throughout the world. TFOS has achieved, and continues to achieve, its mission by organising international TFOS conferences (Puerto Rico, 2004; Taormina, Sicily, 2007; Florence, Italy, 2010; Taormina, 2013; Montpellier, France, 2016; Cernobbio, Italy, 2020; Venice, Italy, 2024), awarding more than 225 young investigator awards, publishing authoritative white papers, organising scientific symposia and sessions in congresses of other global eye societies, presenting US Congressional briefings, hosting networking nights, producing educational campaigns and videos and creating a worldwide TFOS ambassador programme and an affiliate – TFOS China.

Most of the TFOS DEWS II steering committee in March 2015 at the TFOS meeting in San Francisco

Perhaps the best known TFOS initiatives are the international TFOS Workshops, including those focused on dry eye disease – DEWS, DEWS II and DEWS III – meibomian gland dysfunction and contact lens discomfort, as well as one entitled ‘A Lifestyle Epidemic: Ocular Surface Disease’. These global workshops involved the efforts of between 60 and 160 scientific and clinical experts, with each requiring two to three years to complete and all leading to the publication of major reports.

Through these activities TFOS has helped to promote increased international awareness of external eye diseases, enhance governmental funding for tear film and ocular surface research, stimulate the development of therapeutic drugs and diagnostic devices and influence the design and conduct of clinical trials of novel treatments for ocular surface disorders. TFOS has a distribution to many hundreds of thousands of basic scientists, clinical researchers and industry representatives throughout the world.

TFOS DEWS III leadership group: Prof Wei Chen, Drs Victor Perez and David Sullivan (author), Profs Lyndon Jones, James Wolffsohn, Fiona Stapleton and Jennifer Craig and Dr Murat Dogru

I have had the privilege to organise many of these initiatives, including the white papers, ambassador programme and workshops. However, none of these TFOS achievements would have been possible without the commitment of hundreds of experts from around the world. Of all these people, I would like to give very special thanks to my daughter Amy Gallant Sullivan. During the past 23 years, she has served as the TFOS executive director and been responsible for so many aspects of TFOS, including the fundraising, management, branding, communication, business development, event coordination and legal matters. Her outstanding efforts have significantly helped promote global awareness of TFOS as the premier organisation for advancing the research, literacy and educational aspects of the scientific field of the tear film and ocular surface.

Organisers of the TFOS Lifestyle Workshop, Dr David Sullivan and his daughter Amy Gallant Sullivan, TFOS executive director, in the Church of the San Domenico Palace in Taormina, Sicily, where the meeting was held

The future

I stepped down as chair of the TFOS Board of Directors in August this year, passing the gavel to Professor Jennifer Craig. A TFOS founding member, Prof Craig has been extraordinarily active in TFOS over the past 16 years and has served as a leader in many TFOS Workshops.

Legend has it that individuals who walk through a moongate are blessed with good fortune and a joyful and prosperous future. This moongate experience has certainly brought good fortune to TFOS and, under Prof Craig’s guidance, may it continue to lead to a joyful and prosperous future for tear film and ocular surface research throughout the world.

References

1. Abelson MB, Knight E. (1994). Dry Eye Therapy: Evaluation of Current Directions and Clinical Trials. In: Sullivan, D.A. (eds) Lacrimal Gland, Tear Film, and Dry Eye Syndromes. Advances in Experimental Medicine and Biology, vol 350. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-2417-5_75
2. Mathers WD, Lane JA. (1998). Meibomian Gland Lipids, Evaporation, and Tear Film Stability. In: Sullivan DA, Dartt DA, Meneray MA. (eds) Lacrimal Gland, Tear Film, and Dry Eye Syndromes 2. Advances in Experimental Medicine and Biology, vol 438. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-5359-5_50
3. Dursun D, et al. (2002). Experimentally Induced Dry Eye Produces Ocular Surface Inflammation and Epithelial Disease. In: Sullivan DA, Stern ME, Tsubota K, Dartt DA, Sullivan RM, Bromberb BB. (eds) Lacrimal Gland, Tear Film, and Dry Eye Syndromes 3. Advances in Experimental Medicine and Biology, vol 506. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-0717-8_91

Dr David Sullivan is the founder and immediate past chair of the board of directors of the Tear Film & Ocular Surface Society (better known as TFOS).