June 12-18th is National Glaucoma Awareness Week, which this year is focusing on eye pressure and glaucoma. It is estimated that there are 64 million people with glaucoma worldwide, and 600,000 in the UK, with half undetected. It is really important that you have a regular eye health check as if detected early glaucoma can be managed and useful sight can usually be maintained throughout life.
St Paul’s is heavily involved in the treatment of this condition so here is a very brief outline of what glaucoma actually is and a summary of the some of the research we are doing in the field right now.
What is glaucoma?
Ideally the eye maintains a constant pressure by continuously producing fluid, aqueous humour, while at the same time draining an equal amount of that fluid out of the eye through the trabecular meshwork. In the most common type of glaucoma, primary open-angle glaucoma, the drainage system becomes blocked and pressure in the eye increases, damaging the optic nerve and leading to irreversible sight loss if left untreated.
At St Paul’s Eye Unit, and in collaboration with the University’s Department of Eye & Vision Science (DEVS), we are developing novel ways of diagnosing and treating this debilitating condition.
New ways to diagnosis glaucoma
We are currently trialling a contact lens developed in collaboration with biomechanics from the Department of Engineer at the University. As the wearer blinks a pressure sensor within the lens is squeezed, allowing a reading to be taken of the pressure within the eye itself. The data is then wirelessly communicated to an external controller for analysis. It is hoped that the lens will measure the pressure within the eye over a 24-hr period, giving a much more dynamic picture of eye pressure than a snapshot test in a clinic. This work is being funded by the National Institute for Health Research i4i programme.
One strand of our current research, co-funded by Fight for Sight and The International Glaucoma Association,focuses on gene therapy. Glaucoma patients get scarring in the eye drainage system or following surgery, so using the latest gene sequencing technology, staff at St Paul’s and DEVS are targeting that scarring process. We are working to increase the levels of anti-scarring genes using gene therapy. This project will provide significant insight into the molecular changes that cause glaucoma in the trabecular meshwork, and allow us to develop a new class of disease-modifying therapeutics.
Another current clinical trial, funded by Allergan, focuses on how treatments are administered. It involves the injection into the eye of a tiny pellet carrying a drug called Bimatoprost (Lumigan). This will allow precise and longer term delivery of treatment in a minimally invasive fashion which has both clinical and patient care benefits.