Glaucoma Awareness Month - January - 01/15/20
Looking back, the last major eye drop innovation for treating glaucoma was approximately 20 years ago. In the field of health and medicine that is changing so rapidly on so many fronts, that seems like ancient times. Cynthia Steel, Phd., in cellular biology, attributes that to a few key factors; lack of animal models to study and lack of funding. Trying to mimic the glaucoma processes found in the human eye with those in an animal’s is difficult. It is a very limiting element for organizing studies to research a disease process that is still being understood. As you can imagine, that information is vital to those providing financial backing for research and development in creating new medicated eye drops.
First, let’s look at the heart of the matter, in the eye, the trabecular meshwork. A porous structure in the anterior section of the eye, you can think of the trabecular meshwork like the strainer in your kitchen sink drain. Research by Dr. Steel in cell biology, finds the meshwork is made up of cells that act as filters and are unlike any cells found elsewhere in the body. Further study has shown the trabecular meshwork as a key component in regulating fluid pressure in the eye. In glaucoma, there is a malfunction in the filtering provided by the trabecular meshwork. The cells of the meshwork have a life span and over time, become less flexible, making them less-effective workers in detecting changes in fluid pressure. The meshwork cells are supported by vital oxygen and nutrients and as they stiffen, like an arthritic joint, less nutrients pass through, which can lead to ineffective cell workers. In turn eye pressure increases and there you have a disease that reduces vision first in the periphery, glaucoma.
Recent research shifts in topical eye drops is providing new information. Now, thoughts are changing from working on reducing eye fluid production to instead attempting to work on restoring balance or equilibrium between production and drainage of fluids in the eye. Topical eye drops with nitric oxide are a newer tool used in our office by Dr. Kriegstein and Dr. Townshend to improve balance or equilibrium within cells of the Trabecular Meshwork. Obtaining balance on a cellular level and, keeping trabecular meshwork cells vital and functioning properly are key.
New thoughts on the subject also include leaning toward an old adage, advocate for a more nitrate rich diet with patients. Yes, that means more leafy greens. Where have you heard that before? Not only does an improved diet improve vascular health and improve blood pressure, we are learning on a cellular level that a nitrate rich diet looks more and more promising as an effective tool in managing glaucoma.
Most effective factor with using tools to manage glaucoma is you. Whatever your regimen, ask questions, and adhere to the plan. Keep your drops out in view next to your coffee cup or next to your toothbrush. Include family members to assist with drops, when difficult. Spread the word, family history is important. Goes without saying, schedule an eye exam on an annual basis. You may not realize your peripheral vision is being compromised until testing is plotted and evaluated.