How NZ research is transforming glaucoma care
Researchers in New Zealand are at the forefront of uncovering new ways to understand, predict, and prevent vision loss from this disease. Three recent studies show how they are changing what we know about glaucoma, from lifetime risks of blindness, to how we define the disease, to what happens in the brain itself.
How Often Does Glaucoma Lead to Blindness?
A team in Auckland led by Dr Jay Meyer reviewed the records of over 400 New Zealand patients with glaucoma who had passed away, asking a simple but powerful question: what was their vision like at the end of life?
The results were sobering. Around 20% were blind in at least one eye, and 10% had severe vision loss in both eyes. The greatest risks were in older people, had very high eye pressure, or already had advanced disease when first diagnosed. This highlights the importance of catching glaucoma early, because once vision is lost, it cannot be restored.
Rethinking How We Define Glaucoma
Another study, led by Dr William Schierding and Professor Helen Danesh-Meyer from the University of Auckland, is working with the massive UK Biobank (over half a million participants). The researchers tackled a more technical but equally important issue: how do we define “glaucoma” in large studies?
Many projects simply rely on a doctor’s diagnosis code. But this research showed that if you only count people who both have a diagnosis and are receiving treatment, you get much stronger signals when looking at genetic risk and eye scan results. In other words, these people likely have more severe disease, and studying them helps uncover the clearest biological clues. This work matters because population biobanks are increasingly shaping how we understand disease and design treatments.
Exploring New Post-Surgical Treatments
Researchers in New Zealand are exploring whether medications traditionally used for other conditions could enhance recovery and improve outcomes after glaucoma surgery. Auckland Ophthalmologist, Dr Mark Donaldson, and his team are investigating the use of colchicine (a drug better known for treating gout) as part of post-operative care following trabeculectomy, a common glaucoma operation.
The idea is that colchicine, which reduces inflammation and scarring, could help keep the surgical drainage channel open for longer, thus improving long-term pressure control in the eye. If successful, this approach could offer patients safer and more durable results from surgery, reducing the need for repeat procedures or additional medications.
Looking Inside the Brain
Work by Schierding and Danesh-Meyer at the University of Auckland and the Mātai Research Institute in Gisborne has explored how glaucoma affects not only the eye but also the brain.
Using advanced MRI scans, they found that people with glaucoma show shrinkage in the brain’s visual centres, and also in areas linked with attention and memory. These changes were closely tied to thinning of the eye’s nerve layers, but not to eye pressure, which is usually the main target of glaucoma treatment. The findings support the idea that glaucoma shares some features with other neurodegenerative conditions, such as Alzheimer’s disease, and may help guide future approaches to diagnosis and therapy.
A new picture of glaucoma
Together, these studies paint a new picture of glaucoma. It is not just about high pressure in the eye, it is about early detection, precise definitions for research, and recognising that glaucoma is a whole-brain disease. The work also positions New Zealand researchers as global leaders in using “big data,” advanced imaging, and careful clinical studies to tackle one of the greatest challenges in eye health.
By diagnosing glaucoma earlier, identifying those most at risk, improving surgical outcomes, and uncovering how the disease affects the brain, we have a powerful opportunity to prevent blindness and change the future for millions around the world.
Special thanks to the Gordon Sanderson Scholars who supported these New Zealand research projects, including Daniel, Sally and Kyla who received the 2022-23 scholarships. This annually awarded scholarship was established in memory of Associate Professor Gordon Sanderson, a founding trustee of Glaucoma New Zealand and a passionate eye health educator in both New Zealand and Australia.