One of the most challenging aspects of treating glaucoma is that many patients do not realise they have the disease until they’ve suffered irreversible vision loss.

“The problem is that about 50 cent of people with glaucoma are undiagnosed,’’ says Dr George Kong, an ophthalmologist and Honorary Researcher at the Centre for Eye Research Australia.

“In the early stages glaucoma is asymptomatic, so people will not know they have a problem. Even if someone has been diagnosed early, we sometimes see patients in clinic whose vision has deteriorated rapidly between appointments without them noticing it.’’

Glaucoma is often known as ‘the silent thief of sight’ because of the insidious nature of the disease, which damages the optic nerve which sends visual signals between the eye and brain.

In the early stages, because much of the damage occurs in the peripheral vision, patients do not know they are losing their sight until significant damage has occurred. However, early detection and treatment can help prevent vision loss.

Difficult diagnosis

Even when patients do attend an eye examination, it can sometimes be difficult to accurately assess the disease.

The traditional visual field test – which relies on a patient clicking a button to indicate whether they can see small spots of light that are beamed into their peripheral vision – is subjective and difficult for many patients to complete.

“I want to create a simpler, accurate, objective visual field test that a patient can take in less than five minutes to detect any changes in their vision,’’ says Dr Kong, who is also a glaucoma specialist at the Royal Victorian Eye and Ear Hospital.

His plan is to develop a smartphone test using artificial intelligence to check for early changes or monitor vision changes between eye examination.

The ultimate aim is to detect many of the currently undiagnosed cases of glaucoma in the community.

Home monitoring

Dr Kong says the COVID-19 pandemic has highlighted the need for technologies that allow patients to monitor their vision at home.

“During COVID-19 lockdowns many patients cannot visit their optometrist or ophthalmologist and a test like this will enable them to monitor their vision in an objective way.

“When resources are scarce it can also help our health services free up clinical resources for the most urgent patients.’’

Dr Kong says the eye test could also be a game changer in remote regions and developing countries, where there is a shortage of specialist eye care services.

“Even in places where there is a lack of specialist equipment or trained professionals, the smartphone in ubiquitous,’’ he says.

“The smartphone technology could be used by people to monitor their own vision, or by health care workers in the field who are not eye specialists.’’

Innovation Fund

Dr Kong’s research is one of four projects supported in 2020 by the CERA Innovation Fund which provided almost $300,000 to help kick-start research that has clinical or commercial potential.

CERA’s Head of Commercialisation and Legal Tena Cheng says the fund aims to accelerate the translation of research from the lab to the clinic to benefit patients.

“The Innovation Fund help researchers deliver proof of concept data or develop their projects that are in the very early stages to the point where they can attract further commercial investment or funding from traditional sources like the National Health and Medical Research Council,’’ she says.

The projects demonstrate the commitment of researchers to continually strive for new ways of tackling eye disease and coming up with innovative solutions to make a difference for patients.

“We are excited to support George Kong’s research which has great potential to address telehealth needs which have become increasingly important in light of the COVID-19 pandemic,’’ she says.

• CERA is grateful for the generous endowment from the estate of the late Ruth Chitty which supports the Innovation Fund.