The Eyes Have It
Blood pressure can be monitored at home daily. Diabetics are able to keep tabs on their blood sugar themselves throughout the day.
But people with GLAUCOMA must rely on visits to their eye care professionals to be sure their condition is in check, and these visits are usually only four times a year.
“There’s a tremendous need for those being treated for glaucoma to have access to the same kind of regular monitoring,” says Robert Fechtner, MD, professor of ophthalmology and director of the glaucoma division at NJMS. Thanks to an innovative new technology that he helped develop, that could be changing soon.
This is good news for the one in a hundred Americans who will develop glaucoma, a complicated disease in which damage to the optic nerve leads to progressive loss of vision and, if untreated, blindness. According to the World Health Organization, glaucoma is the second leading cause of blindness in the world. People over 40, especially African Americans, have the highest risk for developing the disease.
“But glaucoma can be treated,” Fechtner emphasizes. “It doesn’t necessarily mean blindness.” He notes that millions are being treated for glaucoma. “For these patients, it’s critical to know what the pressure in the eye is.”
Intraocular pressure is measured by the tonometer, the instrument used by eye care professionals to establish the pressure placed on the optic nerves by the aqueous humor, a clear fluid that is produced within and nourishes portions of the eye. The challenge has been to find a personal tonometer that the patient could use at home.
Using the tonometer in a professional office is not hard to do; the pressure is measured directly by touching the surface of the eyeball with an instrument after the eye has been numbed with anesthetic drops. Anyone who has had an eye examination may remember a test with a bright blue light; they may recall as well the wait for the anesthesia to wear off and normal vision to return.
The eye becomes firmer when the pressure is higher. So to develop a personal tonometer, the central problem is how to take this measurement without discomfort, without anesthetizing the eye, and without directly touching the cornea. “There have been prior efforts to develop a personal instrument,” Fechtner acknowledges, “but no one could overcome these major obstacles.”
That is, until a creative collaboration between UMDNJ and New Jersey Institute of Technology tackled the problem: how to take the measurement with gentle pressure through the eyelid. No anesthesia, no pain, no direct contact with the cornea.
To find the answer, Fechtner turned to NJIT physics professor Gordon A. Thomas, PhD, recently honored by the New Jersey Inventors Hall of Fame for his research and inventions. Fechtner and Thomas, and his colleagues at NJIT, would work together to find the technical solution, to develop the device and computer software. “NJIT brought creative, innovative thought to the table,” says Fechtner. “Newark’s academic community is a truly rich intellectual resource.”
The partnership paid off, and the team created a prototype with great promise.
“We’ve built and tested a lab model of our device,” Thomas reports. “It has a little robot that touches the eyelid gently and measures how hard the eye is.” At UMDNJ’s ophthalmology clinic and at NJIT, more than 30,000 measurements on patients and volunteers demonstrated that the device works. “We’re working hard to help patients get a device they can afford as soon as possible,” he adds. A new version is not yet finished and the goal is to make it as small and comfortable as possible. The team is working on one version that looks like swim goggles.
The device will help patients save their eyesight. “When they get an unexpected high reading, they will contact their doctors,” Thomas explains. “Maybe their medication needs to be modified, or it might be something else. But whatever it is, the patient will now catch it quickly.”
Vince Smeraglia, Esq, UMDNJ director of Technology Transfer and Business Development, adds, “This is a terrific example of a prominent physicist like Dr. Thomas collaborating closely with Dr. Fechtner, an experienced clinician, to address an unmet medical need.” The patent for the device will be held jointly by UMDNJ and NJIT, and the technology has been licensed to the Incubation Factory in St. Louis so that a practical, commercially viable instrument can be developed.
“Monitoring lets the patient work with the health professional,” says Fechtner. “The healthcare system works better that way, whether it’s treating high blood pressure, diabetes, or anything else.” And now, thanks to this new technology, the eyes will have it, too.