world glaucoma week 2019

World Glaucoma Week 2019

World Glaucoma Week 2019 (10 – 16 March)

During World Glaucoma Week (10 – 16 March) Glaucoma Australia will launch a new risk awareness campaign targeting people who are at greater risk of developing glaucoma to encourage them to get their eyes tested.

Glaucoma is the leading cause of avoidable blindness worldwide, affecting over 300,000 Australians1, yet it is estimated that 50% of those living with glaucoma are undiagnosed1.

While nine out of 10 Australians say that sight is their most valued sense 2, over 8 million Australians are still not having regular eye tests3.

Who is at risk?

Although anyone may develop glaucoma, some people have a higher risk – they are people who:

  • have a family history of glaucoma
  • have high eye pressure
  • are aged over 50
  • are of African or Asian descent
  • have diabetes
  • have myopia (nearsighted)
  • have been on a prolonged course of cortisone (steroid) medication
  • experience migraines
  • have had an eye operation or eye injury
  • who have a history or high or low blood pressure

Abridged: NHMRC Guidelines, 2010

Get tested

Glaucoma Australia recommends all Australians 50 years or older visit an optometrist every 2 years for a comprehensive eye exam, and if you have a family history of glaucoma or are of Asian or African descent we recommend you get your eyes checked every 2 years from the age of 40.

Did you know?

  • Glaucoma is a progressive eye disease and is the leading cause of irreversible blindness in Australia
  • Known as the ‘silent thief of sight’ glaucoma develops slowly and often without any symptoms, leaving people undetected until the disease reaches an advanced stage. Left untreated, it can cause vision loss and may even lead to blindness.
  • While vision loss can’t be restored, early diagnosis and treatment can delay or halt the progression of the disease. That is why it’s so important to detect the problem as early as possible.
  • It is estimated that there are 300,000 Australians living with glaucoma, but over 50% are unaware they have it, thinking they have healthy eyes.
  • Glaucoma is hereditary – you are 10x more likely to have glaucoma if you have a direct family member with glaucoma.
  • First degree relatives of a person with glaucoma have an almost 1 in 4 chance if developing glaucoma in their lifetime, and that risk increases to 56% if their glaucoma is advanced. So knowing your family health is important.

How to get involved

Start a conversation

  • Encourage people at risk of developing glaucoma to get their eyes checked at least every 2 years.
  • Remind anyone with glaucoma to alert first-degree relatives of the benefits of early and regular eye checks.

More information

World Glaucoma Week 2019

Australian tech could end need for daily eye drops

Australian tech could end need for daily eye drops

A clinical-stage Australian biotechnology company, PolyActiva, has recruited patients into its Phase I clinical trial for a new ocular implant that could improve the daily lives of millions of glaucoma patients.

PolyActiva has used its proprietary polymer prodrug technology to develop ocular implants that, when placed in the eye, provide sustained treatment over a six-month period, compared to current glaucoma treatment where patients often need to administer eye drops daily. The revolutionary technology could in the future mean millions of people with open-angle glaucoma no longer need to use daily eye drops.

The potential of removing the reliance on the patient to remember to use eye drops, and the associated difficulty in administering them from the paradigm of glaucoma treatment, is being heralded as major potential health breakthrough by ophthalmologists. Several studies have demonstrated that up to 46 percent of patients have been found not to remember to use their drops or administer them poorly1. Failure to adhere to treatment can lead to faster progression of glaucoma, one of the most common causes of blindness.

“This product is designed to make the lives of glaucoma sufferers easier by removing the need for daily drop administration and thus improving treatment management,” says PolyActiva CEO Dr Russell Tait. “The implant is designed to deliver treatment for six months after which it will disappear without further intervention. We’re excited about starting our first clinical study and look forward to seeing how our lead candidate performs.”

Glaucoma is the second leading cause of irreversible blindness globally, affecting 300,000 Australians and is expected to affect approximately 80 million people worldwide by 2020. Increased intraocular pressure (IOP) in the major risk factor for the optic nerve damage that results in blindness. Treatment is designed to reduce IOP. Eye drop therapy is the mainstay of glaucoma treatment however there are two main deficiencies associated with drop therapy – poor patient adherence resulting from the need to administer drops daily and local side-effects resulting from the topical administration of the drug to the eye. Alternative methods of delivering drugs to the eye are required to increase patient adherence to treatment.

PolyActiva’s first clinical candidate is designed to provide a constant daily therapeutic dose of latanoprost free acid for at least 26 weeks, which is the active ingredient of a commonly prescribed glaucoma eye-drop (Xalatan®).

The clinical trial will assess the safety and tolerance of the implant when administered to glaucoma patients. The implant is also designed to biodegrade within 90 days after the treatment period and is capable of being administered in an ophthalmologist’s office under a slit-lamp using a custom-designed administration device.

One of the lead investigators, renowned ophthalmologist and cataract surgeon, Dr Nathan Kerr says, “PolyActiva’s treatment approach offers significant potential benefits for patients, addressing adherence and improving treatment of this disease. The bespoke administration device is simple to use and intuitive to operate.”

The Phase I clinical trial is being conducted under the Therapeutic Goods Administration Clinical Trial Notification (CTN) scheme at the Royal Victorian Eye and Ear Hospital in Melbourne, Australia, through the Centre of Eye Research Australia (CERA). The Phase I clinical trial will see seven glaucoma patients enrolled to evaluate the safety and tolerability of its PA5108 ocular implant, with initial results expected in Q1 2019.


1 Laura E. Dreer, Christopher Girkin and Steven L. Mansberger. Determinants of Medication Adherence to Topical Glaucoma Therapy. J Glaucoma. 2012 Apr; 21(4): 234–240.


Article appeared on Glaucoma Australia 


Aussie Tech Could End Glaucoma Eye Drops

Australian tech could end glaucoma eye drops

A clinical-stage Australian biotechnology company has begun recruiting glaucoma patients for a trial of a new implant that could end the need for daily eye drops.

PolyActiva has developed ocular implants that, when placed in the eye, provide sustained treatment over a six-month period, potentially removing the need for patients to manage their own treatment. Such a move could improve glaucoma outcomes, as several studies have demonstrated that up to 46% of patients don’t remember to use their drops or administer them poorly.

PolyActiva CEO Dr Russell Tait told Insight the technology had originally been developed for a different purpose, but its ability to carry a large amount of drugs in a small area and achieve zero order release, while maintaining separate control over the implant’s biodegradation made it ideal for delivering drugs to the eye.

“The implant is designed to deliver treatment for six months after which it will disappear without further intervention.”
Russell Tait, PolyActiva

“This product is designed to make the lives of glaucoma sufferers easier by removing the need for daily drop administration and thus improving treatment management,” Tait said.

“The implant is designed to deliver treatment for six months after which it will disappear without further intervention. We’re excited about starting our first clinical study and look forward to seeing how our lead candidate performs.”

According to Tait, the implant is capable of being administered in an ophthalmologist’s office under a slit-lamp using a custom-designed administration device.

“The implant itself is tiny – it’s about .2 mm in diameter and up to 4 mm in length, depending on the strength of the relevant product,” he explained.

“It sits in the lumen of a 27 gauge needle and it’s administered by clear corneal injection with a custom-built administration. For the glaucoma product it sits in the inferior angle of the interior chamber.”

The clinical trial will assess the safety and tolerance of the implant when administered to glaucoma patients and should be completed by the middle of 2019, with a view to eventually bringing the technology to market in around six years. Trials will initially be restricted to Australia, however as they progress Tait said the company would look to engage centres in the US as well.

“The major investors, MRCF [Medical Research Commercialisation Fund] and Yuuwa Capital, see this technology having a major potential impact on the lives of millions of glaucoma patients globally,” Dr Chris Nave, chairman of PolyActiva and CEO of the MRCF said.

“This innovative drug delivery technology has further potential applications, such as being used to administer other types of medication, including antibiotics and steroids for cataract surgery patients.”

PolyActiva’s first clinical candidate is designed to provide a constant daily therapeutic dose of latanoprost free acid for at least 26 weeks. Latanoprost is the active ingredient of a commonly prescribed glaucoma eye-drop treatment (Xalatan).

The Phase I clinical trial is being conducted under the Therapeutic Goods Administration Clinical Trial Notification (CTN) scheme at the Royal Victorian Eye and Ear Hospital in Melbourne, through the Centre of Eye Research Australia (CERA).

Article appeared on Insight

05/09/2018 • By Matthew Woodley


iStent Significantly Reduces Unmedicated IOP in Glaucoma

iStent Significantly Reduces Unmedicated IOP in Glaucoma

Glaukos’ iStent inject trabecular micro-bypass system achieved a statistically significant reduction in unmedicated diurnal intraocular pressure (IOP) in patients undergoing cataract surgery, according to results from a two-year U.S. Investigational Device Exemption (IDE) pivotal trial data.

Results of the iStent inject prospective, randomised, multicenter clinical trial, which included 41 investigational sites and 505 open-angle glaucoma (OAG) subjects, were presented at the American Society of Cataract and Refractive Surgery (ASCRS) Annual Meeting by Dr. Thomas W. Samuelson, an ophthalmic surgeon at Minnesota Eye Consultants. In the study, 387 subjects were randomised to iStent inject in combination with cataract surgery and 118 subjects were randomised to cataract surgery only. Subjects were followed through 24 months with annual medication washouts.

The iStent inject met the study’s primary and secondary effectiveness endpoints as follows:

  • At 24 months, 75.3 per cent of the iStent inject cohort achieved a 20 per cent or greater reduction in unmedicated IOP, compared to 61.9 per cent for the cataract-only cohort.
  • At 24 months, the mean unmedicated IOP reduction was 6.9 mmHg for the iStent inject cohort, compared to 5.4 mmHg for the cataract-only cohort.
  • Through 24 months, the overall rate of adverse events for the iStent inject, in combination with cataract surgery, was similar to cataract surgery only.

Additional Findings

While not part of the effectiveness claims being pursued by the company, additional key findings include:

At 24 months, observed data show that the iStent inject cohort achieved a 31 per cent mean reduction in unmedicated (post-washout) IOP to 17.1 mmHg from an unmedicated (post-washout) mean baseline IOP of 24.8 mmHg.

At 24 months, observed data show that 62.6 per cent of the iStent inject cohort achieved unmedicated mean IOP at or below 18 mmHg, compared to 49.2 per cent for the cataract-only cohort.

At 23 months, observed data show that the iStent inject cohort achieved a 75 per cent reduction in the mean number of medications, compared to 47 per cent for the cataract-only cohort.

The iStent inject is designed to improve aqueous humor outflow into Schlemm’s canal and reduce IOP in mild-to-moderate Open Angle Glaucoma (OAG) patients undergoing cataract surgery. It includes two heparin-coated titanium stents preloaded into an auto-injection system that allows the surgeon to inject stents into multiple trabecular meshwork locations through a single corneal entry point.

The iStent inject relies on the same fluidic method of action as Glaukos’ first-generation iStent trabecular micro-bypass stent, which was approved by the U.S. Food and Drug Administration (FDA) in 2012 and has been shown to lower IOP in adult cataract patients with mild-to-moderate OAG. Each iStent inject stent is approximately 0.23 mm x 0.36 mm, or about one-third the size of iStent, which the company believes is the smallest medical device ever approved by the FDA.

The iStent inject is commercially available in the European Union, Armenia, Australia, Brazil, Canada, Hong Kong, Singapore and South Africa. The iStent inject is not approved for use in the U.S. Glaukos submitted a pre-market approval application for the iStent inject to the FDA in December 2017

Glaukos is also currently pursuing FDA approval for four additional MIGS surgical and sustained pharmaceutical therapy pipeline products, all of which are investigational in the U.S.:

  • iStent SA trabecular micro-bypass system, which is a standalone, two-stent procedure that is similar to the iStent inject and designed to reduce IOP in pseudophakic, mild-to-moderate OAG eyes.
  • iStent infinite trabecular micro-bypass system, which is a standalone, three-stent procedure, designed to reduce IOP in refractory OAG patients.
  • iStent supra suprachoroidal micro-bypass stent, which is designed to reduce IOP in mild-to-moderate OAG subjects undergoing cataract surgery by accessing the eye’s suprachoroidal space. This device is approved in the European Union.
  • iDose travoprost, which is an implant containing a special formulation of travoprost, a prostaglandin analog used to reduce IOP. Implanted during a micro-invasive procedure, the iDose travoprost is designed to continuously elute therapeutic levels of the medication from within the eye for extended periods of time.

Published by mivision | 9 May 2018


Could vitamin B3 be the answer to treating glaucoma?

A humble vitamin B3 supplement could be the key to treating one of the biggest causes of irreversible vision loss in the world.

Researchers from the Centre for Eye Research Australia (CERA) in Melbourne are conducting a world-first human trial of an over-the-counter vitamin supplement to treat glaucoma, a disease of the optic nerve which affects 60 million people worldwide.

Professor Jonathan Crowston is the lead investigator of the study and Dr Flora Hui is the Research Fellow conducting the six-month clinical trial. They hope to prove that therapeutic use of high dosage vitamin B3 (nicotinamide) could be used to support existing therapies for glaucoma, such as daily eye drops or in severe cases, surgery.

“Imagine your car’s engine is running a bit rough and as a result, the car doesn’t drive smoothly. If you top up the engine with oil, the car runs better, even though you haven’t fixed the underlying problem,” explains Dr Hui.

“Our study hopes to confirm that vitamin B3 can protect nerve cells from dying, in a similar way that adding oil to a faulty car engine can still allow it to run more smoothly,” she concludes.

Professor Jonathan Crowston leads the Glaucoma Research and is Managing Director of the Centre for Eye Research Australia. “Glaucoma currently has no cure and vision loss is generally thought to be irreversible,” he said.

“We have recently discovered that in the early stages after an injury, visual function can in fact recover, but that the ability to recover diminishes with increasing age. We have developed clinical tests that now allow us to look for visual recovery in the clinic and are beginning to look at treatment that could boost recovery. Our premise is that if you can improve optic nerve recovery after an injury that we can reduce the risk of glaucoma progressing,” said Prof Crowston.

In 2017, a US research team led by Prof Simon W.M. John and Dr Pete Williams from the JAX laboratories in the USA, found that vitamin B3 given to glaucoma-prone mice prevented optic nerve degeneration and glaucoma. In fact, this treatment also reversed the negative effects of ageing in the mouse eye. “We were very excited by these findings and are now looking at the effect of vitamin B3 in glaucoma patients,” said Prof Crowston.

World Glaucoma Week is 11-17 March 2018

Recruitment for the vitamin B3 trial has reached capacity. To register your interest in future clinical trials with CERA, please register your details at Clinical Trial Registry Web Sight

This research was made possible by the generosity of the Jean Miller Foundation, the Jack Brockhoff Foundation, The Marian & E.H. Trust and the Ophthalmic Research Institute of Australia.

Glaucoma Research: A Year of Progress

Glaucoma Research: A Year of Progress
Dr. Simon Skalicky & Clin Assoc Prof Andrew White | 28 February 2018

Greater knowledge of disease risk factors, new approaches to detection and monitoring, and innovative treatments are positively impacting glaucoma outcomes.
Over the past year we’ve seen a continued shift towards surgical/laser management of glaucoma, coupled with depot preparation medication trials rather than drop therapy. A major prospective trial looking at the efficacy of depot bimatoprost intracamerally has just finished recruiting (ARTEMIS 1) and two more are still underway (ARTEMIS 2 and ATHENA). Other similar trials are underway as well as assessment of an ocular ring releasing bimatoprost.1,2

Should We Add Vitamin B3 to the Water?
The paper with the biggest potential therapeutic impact this year described the potentially protective role of Vitamin B3 in glaucoma. A team from the Jackson Labs in the US fed vitamin B3 to mice prone to ocular hypertension, resulting in a significant reduction in the risk of ganglion cell death. This effect was even greater than targeted gene therapy treating the proposed metabolic/inflammatory pathway implicated in the disease process.3 Small scale clinical trials have already started. Much like the findings from the Nurses Health Study and nitrates, there seems to be an increasing role for dietary and nutritional supplementation in preventing glaucoma and/or halting progression.4

Minimally Invasive Glaucoma Surgery
Undoubtedly in 2017, glaucoma clinical practice focused on minimally invasive glaucoma surgery (MIGS).

MIGS represents a broad group of small surgical devices characterised by minimal conjunctival dissection, short operating times, rapid recovery and a good safety profile. This is a rapidly expanding field with trans-trabecular devices (eg iStent, Glaukos), increasingly performed in conjunction with cataract surgery.

Other devices are available, with a growing body of supportive data, such as the Cypass (Alcon), which creates a cyclodialysis cleft and drains to the suprachoroidal space and the Hydrus microstent (Ivantis), a fenestrated curved tube that enters, passes through and dilates Schlemm’s canal.

Currently, Medicare restricts the use of these devices to only at the time of cataract surgery, although work is underway to expand the availability for the procedure to a wider body of glaucoma patients, and potentially allow stand-alone MIGS procedures.

There is still a scarcity of robust MIGS scientific data. A meta-analysis of all MIGS papers released up until 2016 found that while overall safety data from MIGS is reassuring, good head-to-head random clinical trials comparing MIGS devices to one another or to traditional glaucoma surgery is lacking.5 As clinicians in this field, it is imperative we collect quality local data that evaluates MIGS in real-world clinical practice, and audit through communal software platforms such as the Save Sight Registry.*

Hydrus was compared head-to-head with selective laser trabeculoplasty (SLT) in a small (n=56) case series. Hydrus resulted in a greater reduction in medication dependence than SLT at 12 months.6

Filtration Surgery
Glaucoma filtration surgery (eg. trabeculectomy, tube surgery) involves creating an aqueous drainage pathway from inside the eye to the subconjunctival space. Some preliminary results have been released for the Primary Trab vs. Tube Study (PTVT) that attempts to settle the question as to whether a primary drainage tube may be better than trabeculectomy as a first surgical procedure for glaucoma. In a word, no.7,8 IOP control was better in the trabeculectomy group, especially in those with lower starting IOP. The complication rate was similar despite more early complications/interventions in the trabeculectomy group.

The Xen Gel Implant (Allergan) is a soft collagen implant that is inserted, ab interno, from the anterior chamber into the subconjunctival space creating a bleb. In many ways it is more similar to traditional filtration surgery than to other MIGS devices. It is increasingly used as an alternative to trabeculectomy, although quality head-to-head studies comparing Xen to trabeculectomy are few.

The Xen was shown to be effective in uveitic glaucoma, despite the potential for sight-threatening complications of hypotony, bleb infection9 or suprachoroidal haemorrhage10 (ie similar complications to a trabeculectomy).

Lasers in Glaucoma
The efficacy and safety of SLT in the treatment of open angle glaucoma (OAG) continues to be supported by the literature. SLT was evaluated in Afro-Carribeans with primary OAG (POAG) and found to have a 12 month success rate of 78 per cent.11 In Belgium, SLT was evaluated as replacement therapy for medically controlled OAG; it was able to completely replace medical therapy in 77 per cent of eyes after 18 months12 and improved treatment related quality-of-life (QoL)13 with similar efficacy between phakic and pseudophakic eyes.14 However, when 24-hour IOP rhythm was evaluated by the contact lens sensor Triggerfish, SLT was not shown to alter the amplitude or pattern of the IOP rhythm.15

Angle Closure and Glaucoma
Angle closure is frequently missed, both among patients referred for cataract surgery who are often dilated without prior gonioscopy, and among patients with POAG who can develop phacomorphic angle closure with age. Two studies from Canada elegantly demonstrated this; of patients referred for cataract surgery, 1.5 per cent were found to have undetected narrow angles,16 and one in 11 patients, with a diagnosis of OAG referred to a tertiary glaucoma centre, were found to in fact have angle closure.17

Dysphotopsia is a rare but debilitating complication of laser peripheral iridotomy (LPI). Previous data suggested the frequency of this can be reduced by temporal placement of the LPI.18 However, a larger (n=595) Indian/US RCT found that location, LPI size, and amount of laser energy used did not affect the frequency of dysphotopsia reported.19

Another large Indian study confirmed that LPI hastens the development of cataract.20 These findings support the landmark EAGLE study that compared early clear lens extraction (CLE) to laser iridotomy in the management of primary angle closure glaucoma (PACG). CLE showed greater efficacy and was more cost-effective than laser iridotomy.21

Externally applied micropulse cyclophotocoagulation (M-CPC) is an alternative mode of laser delivery to continuous wave cyclophotocoagulation (CW-CPC). Micropulse has a high post-treatment inflammation rate (46 per cent after three months) and a similar but potentially lower complication profile than CW-CPC.22 More head-to-head studies are required comparing micropulse to continuous wavelength and to endoscopic CPC to better elucidate this rapidly developing technology.

Monitoring and Detection
We have yet to improve the 50 per cent undiagnosed glaucoma rate in Australia. However, new advances in diagnostic technology, a greater drive for optometry-led detection, and an emphasis on first-degree relative screening such as through the TARRGET study may improve the detection rate.

Australian-developed tablet-based perimetry has the potential to revolutionise glaucomatous monitoring, allowing home or waiting-room self-screening for glaucoma. It is easy to use and sensitive to glaucomatous progression.23,24

Three separate studies have confirmed the importance of central (eg 10-2) visual fields in glaucoma diagnosis to complement 24-2 fields; the latter might miss early glaucomatous defects. This trend persisted irrespective of the type of field machine used.25-27 Furthermore 10-2 changes had a greater impact on vision-related quality of life (QoL) than 24-2 changes.28

The frequency of monitoring for glaucoma patients continues to vex strained clinics. One study found twice yearly visual field testing had similar sensitivity to thrice yearly for detecting glaucoma progression, provided two quality baseline tests were available for reference.29 These findings support the UK Glaucoma Treatment Study, in which a few early visual fields established a firm baseline; this allowed sensitive detection despite greater intervals between later field tests.30

OCT-angiography (OCT-A) continues to be explored in glaucoma. Adding to vascular loss previously described at the optic nerve head, new studies have found macular vascular density declines in glaucoma.31,32 However this finding was not consistent; one study found the macular vessels were spared in glaucoma.33 In addition, the diagnostic sensitivity of OCT-A is lower than traditional OCT metrics (RNFL and MGC complex thickness).33

One drawback of OCT analysis glaucoma is a floor effect of the peripapillary RNFL (sensitivity is lost in advanced disease). In agreement with prior studies, the ganglion cell inner plexiform layer metric was again shown to be more sensitive for advanced glaucoma than the peripapillary RNFL and continued to demonstrate progression once the RNFL had reached its floor effect.34,35

More data has supported the water drinking test, finding IOP spikes induced by the water-imbibed challenge were predictive of future glaucomatous progression.36

The Genetics of Glaucoma
The last few years have seen an explosion of genes identified in glaucoma pathogenesis. Novel loci include: for POAG (ABCA1, AFAP1, GMDS, PMM2, TGFBR3, FNDC3B, ARHGEF12, GAS7, FOXC1, ATXN2, TXNRD2); PACG (EPDR1, CHAT, GLIS3, FERMT2, DPM2-FAM102); and pseudoexfoliation syndrome glaucoma (CACNA1A).37 There are so many genes implicated that work is beginning to move towards better phenotyping of glaucoma for targeted gene studies, and studies looking at the functionality of these genes and interactions with each other (ie. is it combinations of gene anomalies rather than a single gene that is causative?). Stay tuned.

Health, Socioeconomic and Lifestyle Factors
Smoking was the smoking gun for glaucoma in 2017. A Spanish cohort population study of 16,797 participants over 8.5 years demonstrated a direct association between current smokers and glaucoma incidence, and the risk increased with number of pack-years.38

Additionally, a retrospective study looking at risk factors for rapid glaucoma progression showed rapid progressors were older, had significantly lower baseline IOP and central corneal thickness, and significantly higher rates of cardiovascular disease and hypotension.39 Further prospective study needs to be done to better understand the pathophysiology behind this finding.

A Taiwanese study evaluated the influence of different socioeconomic factors on vision-related quality of life in glaucoma. A lower education – but not income – affected QoL detrimentally, suggesting the importance of additional counselling for patients with a lower educational level to help them cope with the disease.40

Other Medical Therapies
Drug development for new glaucoma therapies has been slow but continues.

Rhopressa (Netarsudil 0.02 per cent) is a once daily topical agent with two mechanisms of action and two targets. Rhopressa targets rho-kinase (ROCK) and a norepinephrine transporter (NET). Trial results (ROCKET1-4) yet to be published seem promising. The most common side effect was mild redness of the eyes.

A combination product, Roclatan, is a once daily, combination of netarsudil 0.02 per cent + latanoprost 0.005 per cent made by the same company (Aerie Pharmaceuticals). Initial results from two trials (Mercury 1 and 2) also seem promising.

A new pathway for treatment was discovered this year that may also show promise. The angiopoietin-Tie2 system is crucial in the development and maintenance of Schlemm’s canal and hence IOP control. Antibody mediated activation of Tie2 resulted in an increase in drainage apparatus in Schlemm’s canal when injected in mice. Further development of this pathway may lead to a new IOP lowering agent in the future.37

As clinical and laboratory science marches forward, we must stay nimble in our approach to clinical practice, and translate the new knowledge into better, more efficient and more inclusive glaucoma care delivery to all patients.

Clinical Associate Professor Andrew White is a clinician scientist ophthalmologist at Westmead Hospital with a subspecialty interest in glaucoma. He is a Clinical Senior Lecturer and has research affiliations with the University of Sydney at both the Save Sight Institute and Westmead Millennium Institute where he has an active laboratory. Clin.Assoc. Prof. White has multiple peer-reviewed scientific publications and published conference abstracts. He is a regular invited speaker at overseas conferences and is actively involved in training medical students, registrars and fellows in cataract and glaucoma. He also lectures optometrists and optometry students in Glaucoma.

Dr. Simon Skalicky, FRANZCO, PhD, BSc (Med), MPhil, MMed, MBBS (Hons 1) is a glaucoma subspecialist in Melbourne. He is a Clinical Senior Lecturer at the University of Sydney and University of Melbourne. Dr Skalicky is widely published and actively involved in teaching. He is a federal Councillor for Glaucoma Australia and Associate Advisory Board member for the World Glaucoma Association. Dr. Skalicky specialises in glaucoma and cataract surgery.

*To find out more about participating in the Save Sight Registrar Glaucoma module visit:


LPI Glaucoma treatment – Laser Peripheral Iridotomy

What types of conditions will benefit from Laser Peripheral Iridotomy?

Glaucoma is an eye disease which can damage the optic nerve. It typically occurs in people over the age of 60 and those with a family history. LPI Glaucoma treatment is performed in cases of “angle closure”. The eye “angle” is the are where fluid drainage channels are located, and if closed, and attack of acute angle closure glaucoma (extreme rise in eye pressure) can occur. LPI creates a hole in the iris in order to re-open or prevent angle closure and therefore minimise any damage to the eye as a result of the acute pressure rise in the eye.

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SLT Glaucoma treatment – Selective Laser Trabeculoplasty

What types of conditions will benefit from Selective Laser Trabeculoplasty?

Glaucoma is an eye disease which can damage the optic nerve. It typically occurs in people over the age of 60 and those with a family history. SLT Glaucoma treatment is an option for lowering the pressure in the eye to treat open angle glaucoma. SLT Glaucoma treatment uses short pulses of light to target melanin-containing cells in the trabecular meshwork (the tiny channelsin your eye which fluid flows through). The aim of the laser is to help fluid drain through these channels, lowering intraocular pressure.

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eye conditions, glaucoma simulation

Glaucoma – Causes, Symptoms, Diagnosis and Treatments

What is Glaucoma ?

Glaucoma is an eye disease which can damage the optic nerve. It typically occurs in people over the age of 60 and those with a family history. They have a build up of pressure inside the eye which results from either too much fluid formation, or a problem with drainage. This pressure in turn damages the delicate optic nerve fibres resulting in vision loss or even blindness. There are many types of glaucoma, but the most common is Chronic Open Angle Glaucoma  ( COAG ).

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What types of conditions will benefit from Trabeculectomy?

Trabeculectomy is a surgical procedure used in the treatment of Glaucoma.

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