Glaucoma UK are proud to fund medical research into the causes, detection and treatment of glaucoma. We have helped fund new developments in areas like stem cell treatment and technologies that improve the quality of life of people of all ages living with glaucoma.
We were delighted that our research awards panel were able to get back to work in October 2020. They met to assess applications for the Allied Healthcare Professionals award, postponed in March 2020 because of COVID-19.
The panel awarded a Glaucoma UK research grant of £48,380 to Dr Jonathan Denniss, Lecturer in Optometry at the University of Bradford’s School of Optometry & Vision Science. This grant was possible thanks to the generosity of our members and supporters.
The grant will enable Dr Denniss to undertake research into a new vision test for glaucoma.
Dr Denniss told us “Current tests for glaucoma are difficult for some patients to do. This project aims to test the effectiveness of a new vision test that would be extremely easy for patients to perform. If you think about doing normal visual field tests, you have to look at that point in the centre the whole time. You need to sit very still, concentrate, and press the button at the right time. If you look around, you mess it up. There’s none of that in this new system. People simply have to look into a box filled with coloured light for a few minutes while wearing special spectacles.”
A specific type of nerve cell at the back of the eye is known to be damaged by glaucoma. These nerve cells are sensitive to light and respond strongly to certain light combinations when other nerve cells do not. By measuring how the pupil of the eye reacts to these particular light combinations, the researchers hope to be able to measure how well the nerve cells are working. That in turn could tell them whether the patient has glaucoma and if so, how severe it is. Dr Denniss explains “The glasses have a little camera that measures pupil size. When the colour of the light changes, the size of the pupil changes, and that’s the measurement we want. The camera can track your eyes as they move around. Patients don’t have to press any buttons, or even keep their eyes still.”
The team will test the new technique on 30 people with glaucoma and 30 people of the same age without the condition. Participants will each make one or two visits to the lab during the study.
Dr Denniss says “We’ll compare the measurements between the groups and compare the measurement to existing clinical tests results for the glaucoma group. This will tell us whether the measurement can eventually be turned into a clinical test, and if we’re successful it may pave the way for development of a test for use in clinics within six to seven years.”
Under normal circumstances this would be a 12-month project, but we know that the pandemic has had a huge impact on eye research, and it is possible this might add a little time to the study.
Glaucoma UK’s research grants are often vital stepping stones on the research pathway. They frequently provide funding that enables researchers to undertake projects that generate the preliminary data and evidence needed to support applications for major research awards.
Dr Denniss says “What’s great about the type of funding that Glaucoma UK provides is that it allows new ideas to get off the ground. The funding available from big research councils is for research that already has lots of data and they basically know it’s going to work”. He continues “If this research works, and we can show it’s a great new test and needs further development, then hopefully at the end of this grant, we’d be able to go to one of the larger funders and say that we’ve demonstrated that this works and now we need to scale it up into clinical trials.”
In 2018, we funded dispensing optician and optometrist Dr Tamsin Callaghan to complete research looking at home monitoring of visual fields.
The research is currently being written up and analysed, and we hope it will be published soon.
As glaucoma is a life-long condition, people with glaucoma or those at risk have to attend regular appointments in hospital. This is time-consuming, expensive and unpopular with patients. Patients spend only a few hours each year in eye clinics but spend more than 5,000 waking hours each year doing everything else. We wanted to know whether people with glaucoma can monitor their visual field (VF) at home between clinic visits. We are using new technology, called the Eyecatcher visual field test, which uses a tablet to allow people to test their VF at home.
Twenty people with moderate glaucoma in at least one eye were assessed using the standard VF test (the “Humphrey”). They then received training on how to use the Eyecatcher. All 20 were then given an Eyecatcher and asked to monitor the VF on both eyes at home once a month for six months. After the six months had passed, a final Humphrey VF test was conducted. The Eyecatcher results were compared to the Humphrey.
The trial was not just be limited to people confident using tablets and computers, but Dr Callaghan pointed out that, “Most people are increasingly using tablets at home, so they are more confident with this technology than we first realised.” The aim is to develop a model that can be used on a variety of devices people have at home.
We know many of you find VF tests in hospitals and opticians difficult because of distractions in the noisy, busy environments. Luckily, if similar distractions happen in the home environment, the Eyecatcher can handle this. For example, photographs and data from the device can identify if someone is distracted by their phone ringing. Also, because people complete a series of tests the researchers can look at averages in case some results are worse than others. Distractions and other factors like tiredness can always affect the Humphrey test in a hospital too, and those tests are only done once a year.
If the home VF monitoring works, it could have a big effect for people with glaucoma and clinicians. Eye clinic appointments could be shorter, reducing costs and waiting times, and allow people to be seen more quickly. Most importantly, increased monitoring could also detect sooner if the VF is getting worse.
Ophthalmologist Dr Victor Hu received funding from us to look at whether new glaucoma monitoring tests work well and are accurate in both the UK and low-income settings. The project also hopes to create better ways to detecting glaucoma in sub-Saharan Africa, where up to 8% of over 40s have glaucoma and a high proportion have severe sight loss.
The long-term goal is to create a single device which can perform all glaucoma tests, analyse the data and produce a measure of the likelihood of that person developing glaucoma. This should make it easier to diagnose glaucoma and reduce the number of people who already have advanced glaucoma when they are diagnosed. Dr Hu’s team will look at three low-cost tests in the UK and Tanzania, and see how easy it is to conduct the tests and how reliable the results are. The results will be used to create an algorithm (set of rules) for detecting glaucoma. Around 400 people will be tested, including people with healthy eyes right through to advanced glaucoma.
The three tests are:
The visual field test is an important part of diagnosing and monitoring glaucoma. The gold standard uses the Humphrey Field Analyser, but that costs up to £25,000 to buy and more to maintain. In places like Tanzania, getting somebody to service the machine or fix it might take months.
Eventually, all three tests could be done by one single piece of portable equipment. Making the test easy, cheap and portable makes it much more likely people will attend their eye test. And that can only be a good thing for stopping preventable glaucoma sight loss.
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