There’s nothing new about glaucoma. It’s not a modern disease brought about by pollution or 24/7 lifestyle choices, although lifestyle can play a part in its development. Nor is glaucoma confined to humans. For example, certain breeds of dogs are prone to developing glaucoma, and in 2011 an elephant at Paignton Zoo was diagnosed with the condition.
It may well be that our earliest ancestors were already familiar with the degenerating eyesight, which comes from damage to the optic nerve. Certainly, by the time Hippocrates was writing in around 400 BCE, glaucoma was being described as a disease of the elderly bringing about dimness of sight. [1] However, it appears that Hippocrates may have also been including cataracts alongside glaucoma in his description rather than seeing them as two separate conditions.
Over the succeeding centuries, our understanding of glaucoma slowly developed. In the tenth century Abul Hasan Al-Tabari, writing in “The Book of Hippocratic Treatment”, mentioned the theory that high intraocular pressure might be linked to glaucoma. In the early 1600s, Richard Banister described the link between the hardness of the eye (raised pressure) and blindness. [2]
However, it was another two hundred years before physicians started to truly understand the causes of glaucoma. The breakthrough came about with the invention of the ophthalmoscope by Hermann Helmholtz in the mid-1800s. This, for the first time, enabled physicians to see deep into the living eye and examine the damage caused to the optic nerve.
Shortly afterwards, German ophthalmologist, Albrecht von Graefe showed that treatment of glaucoma through surgery could be possible. His iridotomy technique which involves removing part of the iris in order to restore fluid flow and reduce pressure, is still one of the prime treatments for closed-angle glaucoma today.
A further breakthrough came in 1905 when Professor Hjalmar Schiotz demonstrated his tonometer to the Norwegian Medical Society. This was the first instrument to reliably measure intraocular pressure, enabling ophthalmologists to identify those at risk of vision loss and to start appropriate treatments.
Fast forward to today, and we now understand that glaucoma is not a single condition. One of the most common forms, primary open-angle glaucoma, occurs when the channels that drain fluid from the eyes become clogged. This condition tends to worsen over time, so regular eye check-ups can help with early identification and treatment.
On the other hand, acute angle-closure glaucoma may develop suddenly, perhaps as a result of an injury or as a side effect of certain types of medicine. This requires urgent treatment to prevent permanent damage from occurring. The more we understand about our eyes, the more we can treat and prevent conditions such as glaucoma. And it is thanks to those pioneers over the centuries that our understanding of glaucoma has developed and grown.
Occuity is working on the PM1, the world's first handheld, non-contact pachymeter, to allow both clinicians and technicians to take a corneal centre thickness measurement quickly and easily. The PM1 will assist in the earlier, faster, and more accurate diagnosis of glaucoma, allowing patients to prevent vision loss through timely diagnosis and appropriate treatment.