Beware the “silent thief of sight.” Glaucoma sneaks up on people causing irreparable vision loss before diagnosis. Over three million North Americans have glaucoma – about half don’t know it. For society, the economic and social consequences of stolen sight is large. For sufferers, when glaucoma progresses to blindness, it is life changing. But is a cure in sight?

The field of stem cell research is moving at lighting speed. In the search for a cure to glaucoma, adult stem cells, as opposed to the more controversial embryonic stem cells, are the focus. There are two types of adult stems cells. One type comes from tissues such as the brain, skin, or bone marrow. This type only makes more of the same. A stem cell from the liver only makes more liver cells.

Another type is called “induced pluripotent stem cells,” which are programmable. They were discovered in 2006 by Dr. Shinya Yamanaka. He collected a Nobel Prize in 2012, having been the first to achieve success in showing that these stems cells can self-renew indefinitely and change into other cell types. Less than a decade after discovery, the first surgical implant of these cells occurred in the eye of a Japanese patient using her own reprogrammed skin cells, grown in a lab into a sheet of retina cells to fight, in this case, macular degeneration.

Dr. Yvonne Ou is a Harvard Medical School trained ophthalmologist and glaucoma specialist at the University of California, San Francisco, Medical Center. She notes that the use of stem cells in the treatment of glaucoma includes a variety of approaches. Open-angle glaucoma is the most common form of this disease, where eye pressure builds gradually causing vision issues over time, not suddenly as in the other form of glaucoma that causes an urgent medical emergency. “In primary open-angle glaucoma,” Dr. Ou explains, “the drainage system does not properly drain the fluid inside the eye, and eye pressure can increase. One idea is to take pluripotent stem cells and use them to make the cells that drain fluid out of the eye in an effort to restore the eye’s drainage system.”

Currently, eyedrops and laser treatments help glaucoma patients lower eye pressure, but there is no potential for restoration of damage, as promised by stem cells. Stem cells may also offer hope in repairing the cells in the eyes that transmit information. These neurons create the pathway between the retina and the brain, and when they die, vision is lost. Scientists are studying the potential for adult stem cells to be transformed into these neurons, transplanted in the eye, and then encouraged to reach out and connect with the retina and the brain. Accomplishing this goal would certainly be worthy of another Nobel Prize. The race is on, and not just in glaucoma research. Other diseases like Parkinson’s are the subject of similar studies.

Until there is a breakthrough though, prevention is still the best strategy. But here is the alarming truth and the reason glaucoma is still the silent thief. As mentioned, it is estimated that about three million North Americans have glaucoma, and nearly half of them don’t know it. One survey by PreventBlindness America found that 30 percent of those surveyed had never heard of glaucoma. Vision loss from glaucoma is a tragedy, as a series of simple eye exams can detect disease early and existing treatments are effective in reducing further damage. From early in life, and all through it, a healthy diet rich in green leafy vegetables is an excellent antidote to glaucoma too.

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– W. Gifford-Jones, MD