Keith Martin

About Keith Martin

What is the most exciting thing happening in glaucoma right now?

One of the most exciting developments is progress towards treatments that directly protect and even regenerate retinal ganglion cells. We are moving beyond lowering eye pressure as the only treatment for glaucoma and into an era where we can target the disease at a cellular level based on a detailed understanding of individual genetic risk. Gene therapy is revolutionizing the treatment of inherited retinal diseases, several clinical trials are using similar technology for macular degeneration, and I believe glaucoma will not be far behind despite the considerable challenges.

Cell-based therapies are also making remarkable strides. There is growing evidence that transplanted stem cell-derived retinal ganglion cells can integrate into the retina, and several very significant investments internationally are driving the “moonshot” that is meaningful improvement in vision by optic nerve regeneration. While these approaches are still in their early stages, we are now asking questions that would have seemed impossible a decade ago – how do we not just stop glaucoma, but reverse its effects? The speed of progress in this field is remarkable, and I believe we are entering a transformative period where what is possible in glaucoma care will look entirely different from today’s standard treatments. However, like many aspects of healthcare, the gap between what is possible and what is affordable is likely to prove increasingly challenging for individual patients and health systems.

Make a bold prediction for the future of glaucoma treatment.

I believe that within the next 20 years, we will develop treatments that can restore some vision in glaucoma. This will be achieved through a combination of neuroprotection, regenerative medicine, and advances in neural repair. Key breakthroughs will use technologies including gene and cell therapies, which will enable us to protect and replace lost retinal ganglion cells and promote optic nerve regeneration.

Already, we are seeing proof-of-concept studies demonstrating that retinal ganglion cells can survive and regrow their axons under the right conditions. Combining these approaches with cutting-edge biomaterials, and possibly brain-computer interfaces could allow us to re-establish functional vision in patients with significant vision loss. The idea of glaucoma as an inevitably blinding disease could soon become obsolete. Instead, we will think of it as a condition that can be managed proactively, with some degree of vision restoration as a realistic goal. The rapid pace of innovation suggests that the most exciting developments in glaucoma are still ahead of us, and I believe we will see major breakthroughs in our lifetime.

What advice would you give to your younger self?

I would tell myself to be bold, stay curious, and never accept that vision loss in glaucoma is irreversible. When I began my career, the prevailing wisdom was that retinal ganglion cells, once lost, could not be replaced. Today, we are proving that assumption wrong. The biggest advances in science often come from challenging long-held beliefs, and glaucoma is no exception.

I would also advise young researchers and clinicians to embrace collaboration. The future of glaucoma treatment will not come from a single discovery but from the intersection of multiple fields – ophthalmology, neuroscience, genetics, and bioengineering. Some of the most exciting progress is happening at these boundaries, and those willing to work across disciplines will help redefine what is possible.

Finally, I would remind myself – and anyone entering this field – that what we do matters. Glaucoma remains a leading cause of blindness worldwide, but we are in an era where scientific breakthroughs can change lives. There has never been a more exciting time to be in this space, and the next generation of glaucoma specialists will play a pivotal role in shaping a future where blindness from glaucoma becomes a thing of the past.