Recipient organisationCardiff UniversitySource-published name: Cardiff University
Funding£1.5M
PeriodDec 2021 — May 2026
In plain English
AI plain-English summary
A redesigned eye test could detect glaucoma years earlier than current methods, catching vision loss before it becomes irreversible. Glaucoma slowly destroys peripheral vision, often unnoticed until advanced stages. The standard test for detecting it—perimetry, which measures how dim a light a person can see at different points in their visual field—was designed over 40 years ago, before scientists understood how the disease actually damages the eye. Its high measurement variability means it can take years of repeated testing to confirm even moderate deterioration. This delay matters: 500,000 people in England and Wales have glaucoma, and with an ageing population, that number is rising. The research team will optimise a new form of perimetry based on two recently discovered functional biomarkers for glaucoma—physiological signals that indicate damage earlier than current tests can. If successful, the new test should detect visual loss sooner, allowing earlier treatment and better preservation of sight. The test is also designed to be more accessible and affordable, which could expand screening beyond specialist clinics into community settings. This is a translational project, moving laboratory findings toward clinical use, not fundamental science.
View original technical description
Glaucoma, a chronic, progressive, age-related degeneration of retinal ganglion cells, is characterised by a slow, irreversible loss of visual field. It is the world's leading cause of irreversible blindness, affecting approximately 500,000 people in England and Wales, and 80 million people worldwide. With an ageing population, prevalence of glaucoma is rising. The peripheral visual field is slowly lost first, often going unnoticed by patients until advanced. Perimetry, the clinical method for identifying visual field loss involves presenting stimuli (spots of light) to the retina and determining the dimmest that can be detected at multiple locations in the field. However, the current standard perimetry test was designed >40 years ago, before the disease mechanisms in glaucoma were understood. A test design that was largely imported from the predecessor of the current standard (Goldmann kinetic perimetry) when tests became more automated, and high associated measurement variability, make it difficult to identify glaucomatous loss in the first instance and detect signs of progression. In fact, it can take many years of repeated measures to identify even moderate rates of deterioration. There is a timely need to redesign perimetry with 40 years of knowledge and understanding from basic science (physiological, psychophysical) and clinical studies, as well as with more accessible and affordable technology, in order to increase accessibility to testing, detect visual loss sooner, treat sooner, and improve prognosis for vision. In this multi-disciplinary, multi-site project, we will initiate the path to translation of a novel, more evidence-based form of perimetry from the laboratory to the clinical setting on the basis of two recently discovered functional biomarkers for glaucoma. We propose a stage 1 programme of research in which we will optimise various test parameters to maximise the accuracy, precision, and efficiency of the novel test for identification of glaucomatous visual field loss.
David Garway-Heath (Co-Investigator)James Morgan (Co-Investigator)Padraig Mulholland (Co-Investigator)Roger Anderson (Co-Investigator)Tony Redmond (Principal Investigator)
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