Isn't it interesting that some individuals can have elevated eye pressures and never develop glaucoma? And some patients can have low eye pressures and have devastating vision loss from advanced glaucoma?

This has always been something that causes me to scratch my head and wonder what other processes could be involved in the development and progression of this disease.

This concept is hard to understand and even harder to explain to patients who are on multiple treatments and have low intraocular pressures but continue to lose their vision. Well, recent research has given some insight into the idea that glaucoma could be related to an autoimmune process in which certain cells of the body, if present in elevated levels, attack the optic nerve tissue causing irreversible damage.

Scientists noted that, not only did they find these unusual immune cells in the eyes of mice with glaucoma, but they found that when those cells were removed, the mice did not develop the disease, even if they had elevated intraocular pressures. This could potentially open a new avenue for the treatment and management of our glaucoma patients. 

“Current glaucoma therapies are designed solely to lower eye pressure. However, we've known that, even when patients with glaucoma are treated and their eye pressure returns to normal, they can still go on to have vision loss."  - Read the full article