Investigating the genetics of glaucoma to find new treatments
Professor Gus Gazzard | GR000071, GR000072
Glaucoma is a very common eye condition that affects around 70 million people worldwide. We’re co-funding a research trial called Laser in Glaucoma & Ocular Hypertension Trial (LiGHT) that investigates types of personalised therapy for people suffering with glaucoma.
Glaucoma is an eye condition in which the optic nerve (nerve of sight) becomes damaged.
In its early stages, people often don’t notice glaucoma. Howver, when it becomes advanced it may cause significant - or even severe - loss of vision.
If left untreated, the condition will gradually get worse over time for most patients. This usually happens quite slowly.
The damage caused by glaucoma is irreversible, so the aim of treatment is to slow down the rate of damage.
Ocular hypertension is the medical name for high pressure in the eye-ball. Having ocular hypertension does not mean that you have glaucoma but it puts you at greater risk of getting it. The risk of getting glaucoma is greater when there is higher pressure in the eye and so most eye doctors treat ocular hypertension when this is the case.
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 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
Over 90% 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.
Finding a solution
At the moment, nearly all patients who have glaucoma or ocular hypertension are given eye drops to lower the pressure in the eye. Once started, these are usually continued for life.
However, not all patients like to take eye drops. An alternative treatment involves gentle laser therapy to the front of the eye - this is called Selective Laser Trabeculoplasty (SLT).
This laser treatment is not experimental. It is a therapy that is in common use, but it is not used everywhere.
Laser in Glaucoma & Ocular Hyper Tension (LiGHT) trial
The Laser in Glaucoma & Ocular Hypertension Trial (LiGHT) is a large multicentre randomised controlled trial that has been co-funded by Moorfields Eye Hospital and the UCL Institute of Ophthalmology. It investigating the effect of starting treatment of glaucoma either with laser or eye-drops.
The study is also collecting blood samples for DNA extraction and conducting quality of life questionnaires of participating patients. This is in order to establish a large and robust dataset which will include precise clinical data, as well as data on the patient’s genetics, response to treatments and quality of life.
This research project brings together glaucoma with genetics.
It works towards the provision of better patient care and quality of life by developing new, personalised treatment for glaucoma and ocular hypertension.
In addition, it will aim at better, more efficient intraocular pressure control, in turn reducing financial impact on the NHS.
Research project grants
Professor Gus Gazzard