Subspecialties Glaucoma, Basic & Translational Research

Going for Gold

An “electric” new approach for glaucoma?

Ruth Steer | 07/11/2017

A glaucoma diagnosis typically means eyedrops – if not more invasive treatment. The negative aspects of topical medication are well known, some surgical approaches can result in bleb formation, others fail over time, and newer minimally invasive glaucoma surgery (MIGS) devices can be prohibitively expensive. No wonder that many researchers are seeking alternatives to lower IOP and help patients preserve vision.

Pedro Irazoqui (Purdue University, Indiana, USA), Simon John (The Jackson Laboratory, Maine, USA) and Gabriel Simón (Instituto Gabriel Simón, Madrid, Spain) are offering a new approach: an electromagnetic therapy device that stimulates aqueous drainage. Irazoqui tells us more about the concept and shares their aspirations.

Figure 1. One of Irazoqui’s research students wearing an early prototype

Figure 2. A contact lens containing the gold trace that harnesses and focuses the magnetic field generated by the glasses. Credit: Pedro Irazoqui.

In essence, it looks like a normal pair of glasses, but there is a coil embedded in the frame that generates a magnetic field (Figure 1). The magnetic field creates a current in the eye, which can electrically stimulate the structures in the limbus, such as the muscles around Schlemm’s canal. Using different stimulation parameters we can modulate the flow of liquid into and out of the eye to regulate IOP. We have also incorporated a fine gold trace into a contact lens to capture and focus the magnetic current from the glasses – we use “off the shelf” hydrogel lenses (Figure 2).

We’ve performed studies in rabbits and mice, and last year we tested a “human-sized” device in four patients. We were able to demonstrate up to a 40 percent reduction in IOP in five minutes – it has a very dramatic effect. Right now, we’re obtaining regulatory and ethical approvals to perform a multi-site clinical trial – we want to investigate the longevity of the effect. We’re hoping to have the approvals in place within the next two months, so that we can start enrolling before the end of the summer. Our goal is to have results available by the end of 2017.

Many! Figuring out how to print a tiny gold trace onto a contact lens, making the apparatus small enough to fit in a normal pair of glasses so that patients don’t have to wear a bizarre contraption on their face, and working out the right stimulation parameters are just some of the challenges we’ve faced so far.

I’d love to tell you it was a flash of genius in the middle of the night! But the truth is that, one day, Simon John, Gabriel Simón, and I were discussing the idea of using electroceuticals for glaucoma over lunch. We had the idea, decided to try it out – and it worked much better than we anticipated!

Eyedrops are currently the standard of care for glaucoma, but they take months to have an effect and have associated side effects – and surgical options are invasive. We’re proposing a small modification to what many people do every day – wearing glasses and contact lenses. Ultimately, we hope our non-invasive device could be a first line of defense for glaucoma patients.