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Department's physicians work toward a brighter future for people with glaucoma: Department's physicians work toward a brighter future for people with glaucoma

Researchers at the University of Minnesota are working to improve that statistic.

Patient Vera Velasquez listens to Martha Wright, M.D., explain glaucoma surgery using a model of the eye.

The University’s Department of Ophthalmology has a large team of specialists who treat people with glaucoma and conduct research involving the many types of glaucoma. Associate professor Martha Wright, M.D., is director of the department’s glaucoma service.Wright works with professor Alana Grajewski, M.D., and associate professor Mary Lawrence, M.D., M.P.H., to diagnose and manage glaucoma in adults. Many of the people they treat need advanced subspecialty care because their previous treatments have failed.

Although glaucoma is largely considered a disorder that affects older adults, it can occur in people of any age. Grajewski, along with assistant professor and pediatric ophthalmologist Erick Bothun, M.D., specialize in treating infants and children with glaucoma.

“It’s unusual and quite remarkable that there are four of us right here at the University with so much background and interest in glaucoma,” Wright says. “To help people with glaucoma maintain good vision, we know that early diagnosis and early, aggressive treatment are important. We use a preventive approach to help people with glaucoma maintain their vision throughout their lives.”

A new surgical solution

What the University’s specialists learn through their research and clinical work could someday influence the way glaucoma is treated, contributing to a brighter future for people with the condition.

Wright believes the future of glaucoma treatment lies in new surgical techniques, her primary area of research interest.While medication is helpful to many people with glaucoma—and is the most common glaucoma treatment—Wright notes that medications sometimes put a burden on patients, both in terms of costs and adherence. Even the most well-intentioned people don’t always remember to take their medicine, she says.

Surgical treatment options for glaucoma include laser surgery and incisional surgery. The Department of Ophthalmology has an innovative new tool used for laser glaucoma surgery called the selective laser trabeculoplasty (SLT).

Unlike older laser equipment, the SLT precisely targets only the affected cells, preserving the surrounding eye tissue. This allows the surgeon to perform repeat procedures, if necessary, until the desired results are achieved or until incisional surgery is needed.

Lawrence, whose work is based at the Minneapolis Veterans Affairs Medical Center, has similar research interests.Working with colleagues in the University’s Department of Biomedical Engineering, Lawrence is developing a study to examine configuration of the eye’s iris, the colored part of the eye. She is especially interested in learning about how the anatomy of the eye may predispose certain people to glaucoma.

“We want to perform predictive modeling to determine who might get hereditary open-angle or other types of glaucoma to see if there are structural aberrations that lead to the condition,” says Lawrence, who also directs the University’s low vision service.

Ophthalmologist Erick Bothun, M.D., examines pediatric glaucoma patient Benjamin Kempf's eyes.

Tracking treatments

To help younger people who have glaucoma, Grajewski, Bothun, and other members of the department’s pediatric ophthalmology faculty are teaming up with the Bascom Palmer Eye Institute at the University of Miami to create a pediatric glaucoma registry. The registry will allow researchers to track a large number of children over time and then make meaningful observations about which treatment methods are the most effective.

“Every time we get results from these multicenter studies involving large groups of patients, we can direct treatment not based on our biases or preferences, but on evidence,” Grajewski says. “With an uncommon condition such as pediatric glaucoma, combining efforts like this makes it more likely that we will find better ways to diagnose and treat patients.”

The Department of Ophthalmology’s pediatric team—which includes Jill Anderson, M.D.; Bothun; Stephen Christiansen, M.D.; Grajewski; and C. Gail Summers, M.D.—has been able to apply the findings of its groundbreaking research on glaucoma and congenital cataracts directly to patient care. Bothun believes the work they are doing today will have another big impact on the way pediatric glaucoma is treated—and not just locally.

“Through our research and this pediatric glaucoma registry,” Bothun says, “we have the opportunity to help not only the patients we see here at the University, but to influence glaucoma treatment for people around the world.”

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