Glaucoma – more than meets the eye?

New insights into the damage in the brains of glaucoma patients suggest more than just raised intraocular pressure (IOP) may be occurring in the disease.

The finding has impacts for the treatment of glaucoma, which primarily focuses on reducing IOP.

Brain scans of 30 patients with normal-pressure glaucoma and 21 age-matched controls showed there was significant degradation in several areas of the brain, in the study published in the journal Ophthalmic & Physiological Optics.

This included areas – such as the corpus callosum fibres that connect the brain’s two hemispheres – that are unconnected to the brain’s visual systems.

Previous research has found degeneration in the brains of glaucoma patients, but it had been thought that this damage spreads to the visual systems from the optic nerve, which was itself degenerated from long-term eye pressure.

However, the international team of scientists behind the study says that observing damage beyond the visual system – which they described as a “remarkable finding” – challenges this notion.

The team explains that there may be a “brain component to glaucoma … independent from the eye damage” – something that may be going undetected and untreated as current approaches focus on IOP.

The authors concluded that: “[The] study contributes to the idea that neuroprotective medication could be prescribed to prevent degeneration of the primary visual pathways and other brain structures, in addition to the standard treatment that is aimed at normalising IOP.”