Tackling the ‘trial-and-error’ approach to treating glaucoma
Dr Karl Matter | GR001476
27 February 2023
Through our Springboard Award scheme, we are supporting research led by Dr Karl Matter looking at how our genes can play a role in the development and progression of glaucoma. This could enable the development of innovative care strategies for glaucoma in the future.
The current treatments for glaucoma include eye drops, laser treatments and surgeries. However, we do not yet know which will work best for each individual patient, therefore necessitating a largely trial-and-error approach.
This means that many patients find that proposed treatments aren’t as effective, or they experience side-effects.
Many patients continue to lose vision even with the current best therapies available, meaning that there is a pressing need for new and more successful treatments.
What is glaucoma?
Glaucoma is an eye condition where 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 your 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
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.
Finding a solution
Glaucoma specialist, Dr Anthony Khawaja, recently led landmark studies identifying hundreds of genetic variants that are linked to glaucoma.
In this new project that we are funding, these findings will be taken into the lab to better understand how each genetic factor plays a role in glaucoma.
This interdisciplinary team based at the UCL Institute of Ophthalmology will comprise of Anthony, and Dr Karl Matter and Dr Maria Balda, who are both experienced in pre-clinical molecular cell biology research.
They will examine how these genetic variants affect the different cells which regulate eye pressure - a key risk factor for glaucoma.
From this, the aim is to gain a broader understanding of the gene-specific molecular processes involved in the development of glaucoma.
By pinpointing which parts of the eye are damaged as a result, personalised treatments could be developed for people with glaucoma in the future, based primarily on their genetic factors.
This is vital advancement of previous research which strives to enable the development of innovative care strategies for glaucoma in the future.
Identifying unexplored mechanisms that play a role in this condition will stimulate further research, enabling the development of new treatments to help prevent blindness.
Being able to know the precise cause of glaucoma in different people, the most effective treatment could be selected initially, preventing blindness and reducing unnecessary side-effects.
Enabling this personalised glaucoma care could also save the NHS the huge costs of unnecessary glaucoma appointments and treatments, and the economic impact of sight loss.
Dr Karl Matter