Nearly 60,000 people in Scotland living with glaucoma could benefit from carrying out tests at home, a study funded by Sight Scotland and the Royal College of Surgeons of Edinburgh has shown. Sight Scotland is highlighting the research in Glaucoma Awareness Week 2021 during which a range of initiatives are organised to raise awareness of the disease.
The research team from the University of Edinburgh set out to establish if self-testing of pressure levels inside the eye by patients at home could be a beneficial alternative to requiring these tests to be carried out at hospital or optometrist appointments.
The study has indicated tonometry – the method used by eye specialists to measure intraocular pressure (IOP) – carried out at home by patients themselves, using a self testing device, could help to better identify if and when eye pressure levels are high. This improves the ability for eye doctors to determine the risk of worsening sight loss from glaucoma and the types of treatment the patient should receive.
Glaucoma is caused by a problem with the eye's plumbing system, causing a build up of fluid inside the eye leading to high eye pressure. The high pressure causes damage to the optic nerve, the nerve connecting the eye and brain. Damage to the optic nerve causes gradual and irreversible loss of vision.
Currently, eye pressure measurements can only be taken using specialist equipment in optometry or hospital clinics. The study found an alternative approach of home monitoring could increase the number of pressure measurements, due to there being no restriction on day or time for testing to take place, and so provide a better indication of when IOP levels are high and whether treatments are working.
The research team from the University of Edinburgh was led by Consultant Ophthalmologist Dr Andrew Tatham. Dr Tatham said: "Glaucoma is a major cause of blindness, but as it usually develops gradually, many of those affected are unaware that they are slowly losing sight. The treatment of glaucoma depends on using eye drops, laser, or surgery to lower pressure inside the eye. Traditionally it was only possible to measure eye pressure in the clinic, for example using an air-puff machine. This meant we would normally need to make important treatment decisions based on one or two measurements per year. Like blood pressure, eye pressure fluctuates, so having only a few measurements can make it difficult to know what level of pressure has caused damage to the eye, and whether treatment has successfully lowered eye pressure. Thanks to the funding from Sight Scotland, our research has shown that it is now possible for patients to measure their own eye pressure accurately at home. This can provide many more measurements and allow more close monitoring of responses to treatment. Home monitoring has been incredibly useful in other diseases such as high blood pressure. It has the potential to reduce sight loss from glaucoma, reduce the number of hospital visits needed, and give patients more control over their disease."
Mark O’Donnell, Chief Executive of Sight Scotland and Sight Scotland Veterans said: “Glaucoma is a life-changing condition for thousands of Scots, and our services support many people living with glaucoma to help them live well with sight loss. This research shows that if patients can be supported to carry out home tests they may require fewer hospital appointments and have better data on their condition. These are important findings, and we are delighted to have supported this research which we hope will benefit many people living with glaucoma in the future.”
Professor Stephen Wigmore, Chairman of the Research Committee of the Royal College of Surgeons of Edinburgh said: "The Royal College of Surgeons of Edinburgh are delighted to work in partnership with Sight Scotland to promote and support research in eye disease in Scotland and the wider United Kingdom. These projects are making a real differences to people's lives as can be seen from the outstanding results from the research on glaucoma by Dr Tatham and colleagues at the University of Edinburgh. Sight Scotland and the Royal College of Surgeons of Edinburgh have funded many other projects in different types of eye disease and we hope to continue supporting this important area of research which affects so many people’s lives."
Eddie McKay of Inverclyde was diagnosed with glaucoma in 2007 and is a member of Sight Scotland Veterans. Eddie said: “Living with glaucoma has had a significant impact on my life, but since I was diagnosed fourteen years ago I have benefitted from advances in treatment. I’m pleased this research into treating glaucoma patients has been funded by Sight Scotland and the Royal College of Surgeons of Edinburgh because I know personally the difference supporting research like this can make, and I hope it will benefit many people with glaucoma in the future.”