OHSU

Glaucoma

Glaucoma Research

305858Researchers at the Casey Eye Institute are working to improve treatment for this devastating eye disease, understand its causes, and ultimately find a cure.

What Is Glaucoma?

Glaucoma is a relatively common disease that causes blindness. It occurs in 2-3 million people in the USA and more than 66 million people worldwide. The frequency of this eye disease increases with age. It most commonly occurs after age 40.

How The Disease Progresses

Damage to the optic nerve, a bundle of nearly one million nerve fibers that carries visual information from the retina to the brain, results in progressive loss of peripheral vision (your side and outer vision). This is called glaucomatous optic neuropathy. Elevated intraocular pressure (the fluid pressure within the eye) and a family history of glaucoma are two primary risk factors.

In a normal eye, the ciliary body produces aqueous humor (a watery fluid) that feeds and bathes the lens and cornea, which have no blood supply. This fluid flows forward, bathing the front of the lens, moving through the pupil and out to the blood through a small filter, called the trabecular meshwork. The trabecular meshwork surrounds the inner surface of the cornea and is porous, looking a little like a sponge or Swiss cheese. Glaucoma obstructs this filter but the pump in the ciliary body keeps pumping causing built up pressure within the eye and damage to the optic nerve. This damage alters the structure of the optic nerve head. We can detect the damage by viewing the optic disk.

Although we know that glaucoma has existed since before the time of Socrates as blindness associated with pressure in the eye, a clear understanding of the causes of this disease remains elusive. Researchers have mapped six different genes causing primary open-angle glaucoma to different chromosome regions in humans and identified one gene, called TIGR or myocilin. Several treatments for glaucoma are available, including several types of eye drops, a laser surgery called laser trabeculoplasty, and several types of conventional surgery. However, none of these treatments is perfect and improved therapies are vitally important.

Basic science research at the Casey Eye Institute focuses on:
  • Understanding the causes of increased intraocular pressure.
  • Understanding the nature and progression of the resultant optic nerve damage.
  • Mapping and identifying the genes that cause hereditary glaucomas.
  • Understanding the efficacy of laser trabeculoplasty, a common treatment for glaucoma.
  • Understanding why TIGR/myocilin mutations cause glaucoma.
  • Psychophysical testing to evaluate neuroretinal damage caused by elevated intraocular pressure and drugs.