Glaucoma plugs could stop the need for drops

A trial of a new method of delivering glaucoma medication by using a slow release punctum plug has started.

Glaucoma usually requires patients to permanently take drops once or twice a day to reduce pressure inside the eye. Patients often find it difficult to remember to take the drops or hard to get them int the eye and methods which overcome these issues would be very useful.

After an initial small trial in Singapore showed promise, this longer South African trial uses a punctum plug containing the popular glaucoma medication travoprost (Travatan) which is taken in drop form once a day. The plugs will be trialled over a period of 2 months with pressure being monitored regularly for any signs of change.

Punctum plugs are normally used for helping treat dry eye by blocking the tear ducts

Caffeine raises eye pressure

A big and seemingly well designed study has shown the effect of caffiene on intraocular pressure (IOP).

106 patients split into 4 groups (3 types of glaucoma, 1 no glaucoma) and were seen twice. Before 1 visit they were given caffeine or decaf coffee and then the opposite on the second visit. The study was double blind meaning neither the researchers taking the measurements or the participants knew if they had had the decaf or the fullcaf drink.

The results showed that IOP is increased by about 1 unit after caffeine with maximum effect at about 90minutes but the effect is temporary and not very great so needn’t concern coffee lovers with glaucoma.

Previous studies had put the frighteners on some folks with glaucoma claiming coffee was bad for the condition, but this study will hopefully let them enjoy a cappuccino in peace.

Glaucoma genes identified

The largest study to date on the genetics of glaucoma has identified 2 genetic variations that are associated with the condition.

Over 6000 patients, half of whom had primary open angle glaucoma had their DNA analysed.  Variations were found in 2 genes which may interact with transforming growth factor beta (TGF-beta), a molecule that regulates cell growth and survival throughout the body. Other genetic research into glaucoma have also pointed to a role in glaucoma for TGF-beta.

The researchers  hope that by finding the genes responsible for the condition, new genetic based preventions and treatments can be found. Glaucoma is a leading cause of blindness worldwide and affects around 2% of people over 40. If you have a family history or are concerned about the condition make sure you come and see us.

Glaucoma not just an eye disease

Glaucoma, long held to be a disease primarily of higher than normal pressure inside the eye, in reality may be a degenerative neurological disease which causes the neural cell death in a similar fashion to Parkinson’s or Alzheimer’s.

optic-nerve-regeneration

In a recent article, specialists presented a view of glaucoma focused on the degeneration of the retinal ganglion cells (RGCs) and their axons in the optic nerve rather than the traditional explanation of a lack of blood supply or mechanical pressure on the fragile nerves.

This new thinking could pave the way for a whole new generation of medications for treating glaucoma borrowing research and techniques associated with treating other degenerative neurological conditions.

JS Bach diagnosed with glaucoma

Johann Sebastian Bach (1685–1750) composed over 1000 works, sired 20 children and was famously blind. New research in the journal Acta Ophthalmologica suggests the eventual cause of his blindness was severe glaucoma following cataract surgery.

Early accounts attributed his failing sight in his mid sixties to overstressing his vision in poor illumination. He was convinced to have cataract couching by a British surgeon (where the cataract is simply pushed into the back chamber of the eye). Although his vision improved initially he was confined to bed by excruciating pain in the eyes and body. He died less than 4 months after this procedure.

A common complication of this kind of early surgery is that the eye begins to reject the cataract which has been forced into the back of the eye as foreign material and inflammation takes hold. This in turn can cause a form of glaucoma which can cause severe pain and eventual blindness.

Nowadays cataracts are completely removed during surgery and replaced with a man made implant to correct the vision.

Implant could banish regular eye drops and injections

A new implant could help treat patients suffering from common eye conditions such as glaucoma and age-related macular degeneration.

eye-implantA tiny coil, known as an I-vation is inserted into the back of the eye. Once in place the I-vation slowly releases drugs for a period of up to two years meaning patients no longer need to use regular eye drops or be given eye injections. Early trials of the device have proved effective in the treatment of diabetic macular oedema.

Contact Lens could monitor glaucoma

Material scientists at University of California have created a special contact lens with a bulit-in eye pressure monitoring device.

Glaucoma Monitor Contact LensThe lens could be worn by glaucoma sufferers to allow accurate and continuous measurement of their eye pressure. The prototype has an opaque sensor but the team are looking at ways of producing a transparent version which would allow the lens to be worn without impairing vision.

For more information on glaucoma, click here

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