Doctor examining patient's eye

Feeling the pressure to better manage serious eye conditions

Glaucoma and keratoconus are progressive eye diseases. The damage they cause worsens over time, but in both cases early detection improves the prognosis. Researchers at the University of Liverpool are improving the management of these vision-threatening conditions, developing more accurate techniques to avoid misdiagnosis and allow optimal treatment.

The challenge

Glaucoma is caused by increased pressure inside the eye and effects more than 66 million people, mainly over age 60, around the world. Despite being under treatment, 15% of patients lose their eyesight. This poor management outcome is thought to be caused by significant inaccuracies in current methods that measure the eye’s internal pressure, determining which glaucoma treatment or medication is used.

Keratoconus is a thinning of the cornea that degrades visions and disproportionately affects teens and young adults. Early detection and treatment are essential to halt disease progression, but physiological changes in the eye are hard to detect with current techniques, leading to incorrect diagnosis and treatment.

Professor Ahmed Elsheikh leads the University of Liverpool’s Ocular Biomechanics Research Group, where better characterisation of the eye’s soft tissue can develop improved eye healthcare techniques.

Research action

The team has developed a technique to more accurately measure the eye’s internal pressure using a combination of experimental laboratory testing and clinical validation methods, complemented by numerical simulations of the eye (cornea) and its changes during disease and ageing.

The state-of-the-art technique developed for measuring internal eye pressure requires only minimal staff training because it is a non-contact device, ensuring widespread clinical implementation. The technique has been tested in clinical settings, successfully hitting validation targets and improving the reliability of glaucoma management and keratoconus risk profiling.

Working in partnership

The international partnership formed with the main industrial partner, German company Oculus, has streamlined technology testing and enabled swift validation of the risk profiling methods.

The partnership with Oculus has also allowed efficient implementation of new techniques outside of the current partnership to clinicians and researchers across the US, Europe, South America, China and South Korea. These collaborations have catalysed the accumulation of clinical evidence supporting the technique, further accelerating product implementation.

The research was partly funded by the UK’s National Institute for Health Research (NIHR) and the Engineering and Physical Sciences Research Council (EPSRC).

Outputs and outcomes

The new technology that measures the eye’s internal pressure is being implemented in several clinical centres around the world. In addition to better patient outcomes, it can help to relieve the economic burden on healthcare by better and more accurate diagnosis.

While the focus at the beginning was glaucoma management, the technology has been widened to include risk profiling of keratoconus, and now ectasia, another progressive non-reversible eye condition. Early and emerging results indicate the importance of the new technique for selecting suitable patients for refractive surgery, as well as optimising use of the collagen cross-linking treatment used to prevent keratoconus progression.

A more accurate technique for measuring internal eye pressure requires only minimal staff training, ensuring widespread clinical implementation to save people’s sight.

Professor Ahmed Elsheikh

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