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Glaucoma

Mr Alex MacLeod MA FRCOphth

Consultant Ophthalmologist

Alex has been a consultant at Southampton and Winchester since 1997. Before that, much of his postgraduate training in Ophthalmology was at Southampton, with Fellowships at Moorfields Eye Hospital in glaucoma and external eye disease.

His special interest is in glaucoma, and at Southampton he runs regular clinics and operating lists that are specifically for managing this condition. This clinical experience has highlighted the need for more research into glaucoma, and he is delighted to be part of the Southampton team now carrying out genetic research into this disease at the University of Southampton.
     
Outside work Alex enjoys cycling, gardening and reading.  A highlight of 2007 was the sponsored trek to Macchu Pichu on behalf of the Gift of Sight Appeal.

Glaucoma

Glaucoma is a common eye condition affecting the optic nerve, which transmits vision from the eye to the brain. Each optic nerve contains more than a million nerve fibres, and these appear to be most vulnerable just where they leave the back of the eye. In untreated glaucoma, these fibres gradually die off, resulting in blurred or blank patches in the field of vision.

There are many different types of glaucoma. Sometimes it results from other eye disease or an eye injury. However, the commonest sort, called primary open angle glaucoma, usually starts in a previously healthy eye . 

Primary open angle glaucoma becomes commoner with age, is painless, and doesn't cause other symptoms such as redness, watering etc. Like other types of glaucoma, it is often caused by raised pressure inside the eye, but in some cases can occur even with a normal pressure. Usually a patient can only tell they have it when significant damage has already been done. Unfortunately, there is no treatment which can undo the damage. It is therefore very important to detect glaucoma early, and optometrists are trained to do this as part of an eye check.

Treatment can slow or stop further progression of glaucoma. All current treatments work by lowering the pressure inside the eye, and for most patients, this will mean lifelong eyedrops, administered usually once or twice a day, depending on the type of drop. Where eyedrops are insufficient, surgery can also be carried out to lower the pressure in the eye.

We don't know why people get primary open angle glaucoma, but an important clue comes from genetic studies: it is well known that this type of glaucoma tends to run in families, and is much more likely if a parent or sibling has glaucoma. It seems that particular genes underly this condition, but only some of these genes, affecting a small proportion of glaucoma sufferers, have so far been identified. Further genetic research holds out the promise of leading us to the actual cause of this disease, enabling new and better treatments to be devised, and our department is actively engaged in this work.

Links:
www.iga.org.uk

LATEST UPDATE: The Gift of Sight research team has helped discover a new gene mutation that causes glaucoma.

POSTED 7th October 2010

 

Glaucoma is one of the world’s leading causes of blindness and affects about one person in every 50 over the age of 40. It damages the optic nerve and causes irreversible loss of vision.  It is currently treated by lowering pressure within the eye by taking drops or with surgery – but this is not effective in all patients and those who are diagnosed often do not experience symptoms until their sight has already deteriorated.

Professor Andrew Lotery, together with his colleagues Mr Alex MacLeod and Mr Aby Jacob at Southampton General Hospital’s eye unit, and Drs Jane Gibson and Sarah Ennis from the University of Southampton, collaborated with colleagues in Iceland, Australia, Hong Kong, China, Sweden and the USA and all have contributed to uncovering a new gene that may change this.

It is believed the breakthrough will lead to earlier detection of glaucoma.

The mutation is common among Europeans, with approximately 6% carrying two copies, putting them at 60% greater risk of developing the disease than those who carry none. “In order to make progress in this disease, we need to better understand the basic biological processes which lead to glaucoma,” said Professor Lotery, Professor of Ophthalmology at the University of Southampton. “By doing this, we can then start to develop better treatments. Our work in helping identify a novel gene and biological pathway for glaucoma is an important step forward in this respect.”

He added: “Previously we have seen how finding genes for macular degeneration is now leading to the development of novel clinical treatments and we expect this work in glaucoma will eventually have the same result.”

In 2008, Professor Lotery’s lab team in Southampton identified a major new genetic association with age-related macular degeneration. The gene, named SERPING1, is faulty in up to 25 per cent of sufferers.

Results of the glaucoma study were published earlier this week in the journal Nature Genetics.  Support for this ground breaking work came from the Gift of Sight appeal.