The LiGHT trial
Glaucoma is when damage to the optic nerve causes sight loss, usually caused by the pressure inside your eye rising too high. We’re helping to fund the LiGHT Trial, a revolutionary project that’s exploring new ways of treating glaucoma.
Glaucoma can affect people throughout their lives, from birth to old age.
Current treatments for glaucoma aim to reduce pressure that has built up in the eye, either with surgery, laser treatment or eye drops.
These treatments are effective to an extent, but not all glaucoma sufferers are receptive to the same treatments. Eye drops, for example, can cause irritation and unpleasant side effects, which means they are not always suitable for long term use.
What is glaucoma?
Glaucoma is a when damage to the optic nerve causes sight loss. It is usually caused by the pressure inside your eye rising too high.
Your eye is full of fluid, which helps it to keep its shape and function properly. If too much fluid builds up inside the eye, the pressure rises and squeezes the optic nerve at the back of the eye.
This can cause damage to your optic nerve - a bundle of over a million nerve fibres that carry signals between your eye and your brain.
Pressure might build up in the eye when:
- fluid is stopped from draining away;
- extra fluid is produced after an eye injury or infection - this is called ‘secondary glaucoma’;
- there is an abnormality in the shape of the eye in children - this is called ‘congenital glaucoma’.
Glaucoma tends to develop slowly over many years. As there is currently no cure for glaucoma, treatment focuses on early diagnosis, careful monitoring and regular treatment to help prevent further sight loss.
9 in 10
Over 90 per cent of people diagnosed with glaucoma today who get the treatment they need will retain useful sight for the rest of their lives
It is not currently possible to repair the optic nerve once it has been damaged, so any vision lost to glaucoma cannot be recovered. If left untreated, glaucoma can lead to blindness.
There are usually no symptoms of a rising pressure in the eye until sight loss occurs, so regular eye tests are the best way to help spot the condition early.
The LiGHT Trial
The LiGHT Trial is examining quality of life in patients who start treatment with traditional medicines (like eye drops) compared to those who are treated with both a form of therapy called selective laser trabeculoplasty (SLT) as well as traditional medicines.
It aims to find out if initial treatment with SLT is more effective than using traditional medication alone.
Setting up the trial
- The trial involved 700 patients who had been newly diagnosed with glaucoma or ocular hypertension (an increase in pressure in the eye that doesn’t cause damage to the optic nerve).
- Each person had to fill in questionnaires about experiences with glaucoma and quality of life.
- The participants were treated on one of two pathways - either with traditional medicine, or with a combination of SLT and traditional medicine.
- Researchers monitored the participants across a three year period to understand how their experiences differed.
Key findings and outcome
The results from the study showed that the pathway using a combination of SLT and traditional medicines was more effective than traditional medicines alone.
The patients on this pathway required fewer reactive procedures that often are necessary with glaucoma, such as surgery or cataract extractions.
The findings from the LiGHT Trial could also bring significant cost reductions for the NHS.
The NHS could save up to £1.5 million per year in direct treatment costs for newly diagnosed patients
If new treatment pathways are also effective for previously diagnosed patients, the NHS could save up to £250 million per year
These results could revolutionise the way glaucoma is treated across the world.
After the initial trial, lead investigator Professor Gus Guzzard managed to secure funding to extend the LiGHT trial for another three years (until 2020).
Since then, two new studies have also been set up - the China LiGHT Trial and LiGHT Bio Bank.
These additional projects will allow the researchers to monitor quality of life over a longer period, ensuring a more robust dataset. Extending the project will also strengthen expertise within the glaucoma research community and generate collaborations to take glaucoma research further.
Moorfields Eye Charity is facilitating this study with a number of other organisations, such as National Institute for Health Research Health and Technology Assessment Programme (NIHR HTA) and UCL.
Chief executive of Moorfields Eye Charity Robert Dufton said, “We are excited by the results from this trial and the potential to improve treatment options for patients with glaucoma.
Moorfields Eye Charity is committed to investing in world leading glaucoma research and is supporting the next phase of this work, to extend the trial for a further three years.