New Hope For Glaucoma

This entry was posted by Wednesday, 13 November, 2013
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Cartoon about glaucoma



We’re going to talk about something new in glaucoma research. I don’t want to raise false hopes since we’re a long way from a cure – we’re not even quite sure what’s going on with glaucoma even though it’s the second leading cause of blindness.  But we know more. And we can do more about it.


You may think glaucoma is what happens when the pressure in the front of your eye gets too high. That’s how it was generally understood until now.

Well many people who have glaucoma seem to have normal eye pressure. So now the thinking has shifted to the nerves of the eye. High ocular (eye) pressure isn’t a good thing. Definitely. So we want to keep that under control. If the pressure is too high, the nerves in the eye won’t get as much blood flow and, obviously, that’s bad. But, in glaucoma, even when the pressure is normal the nerves of the eye  deteriorate.

Why? This is the thing that’s not well understood. Maybe, in some people, those nerves are just defective in some way. Or maybe there’s something wrong with the way oxygen is transported to them. The interesting new direction that glaucoma research has taken is that in addition to keeping a handle on eye pressure, we’re also monitoring the condition of the optic nerve and developing stuff to protect it. Let’s look at both strategies, okay?

Pressure first.

Physicians do want to keep eye pressure down. If there are signs of glaucoma, they want to lower it. This is true even if it is already “normal”. This is often done with drops. Patients, unfortunately, aren’t very good at this stuff. They might take drops at first. But this is a lifelong commitment. Stuff happens. They forget. They get distracted. Whatever! And the eyes get worse.

The other thing is that it’s hard to get drops into your own eye. They land on the desk, on the cheek, on the Persian carpet. But not in the eye. That’s another problem. Historically, doctors find it very hard to get good results when they have to rely on their patients to get the job done.

Jerry Helzner, Senior Editor for Opthalmology Management, wrote about tiny implantable devices that can release medications very consistently to keep the pressure down. This is a really good idea. And it may save a lot of eyes.

Now nerves.

This is the new stuff. This is where we pull away from the focus only on pressure and start looking at how to protect the nerves too. In this interview from, Dr. Jeffery Goldberg (Bascom Palmer Eye Institute, University of Miami) talks about a different kind of  implant. This one continuously delivers  a therapeutic dose of “neurotrophic growth factor” into the eye. What’s different here is that the aim is at keeping nerves alive.  It’s been tested on animals . Now it’s in human trials.


 There are several “versions” of glaucoma. Here’s a fine article from the New York Times that explains more about the human eye and about how glaucoma develops.


There’s a lot more testing to be done and”breakthroughs” do have so many ways of disappointing once they do get to human trials. But moving to protect the nerves as well as lower pressure in the eye could change things for a lot of people who might, otherwise, lose their sight. If this doesn’t work out, something else will. Before we completely understand what’s going on with glaucoma, we will have better treatments.

If you think you might have glaucoma, please get your butt down to the doctor. You’ll be fine. But get on this. Early diagnosis and treatment is important, okay?

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The drawing? That’s one of mine. If you’re a regular reader, you probably recognize those two. They show up often.

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