A pioneering clinical project by researchers at University College London (UCL) and Moorfields Eye Hospital has demonstrated that a widely used ocular injection can effectively treat hypotony, a rare and previously untreatable condition characterised by abnormally low eye pressure that can lead to permanent vision loss.
Hypotony occurs when the eye’s internal pressure drops below normal levels, disrupting its shape and structure. Over time, this can cause progressive damage, often resulting in blindness. Traditionally, treatment has involved filling the eye with silicone oil, which, while somewhat effective, carries risks of toxicity to eye tissues and impairs vision clarity.
Published in the British Journal of Ophthalmology, the study shows that injections containing hydroxypropyl methylcellulose (HPMC) – a low-cost gel commonly used in eye surgeries – can safely increase eye volume and pressure in patients with hypotony. This treatment also restored eye anatomy and improved vision. Seven out of eight patients treated over a 12-month period showed significant improvements in eye pressure, size, and sight.
This breakthrough stems from the world’s first dedicated hypotony clinic at Moorfields, funded by Moorfields Eye Charity.
“We are excited that this simple treatment has proved so effective for patients with this rare condition. This is the start of a process of understanding more about the balance of fluid inside the eye, leading to improved care for our patients,” Moorfields consultant ophthalmologist Dr Harry Petrushkin, and lead author of the study, said.
Co-author Professor Gus Gazzard from UCL Institute of Ophthalmology and Moorfields Eye Hospital described the treatment as “a truly transformative new therapy that brings hope to patients otherwise without options, for what was previously an untreatable blinding and disfiguring condition.”
He added that while early results are promising, further research and funding will be necessary to optimise and broaden access to the treatment.
One patient benefiting from this innovative approach is Nicki Guy, who developed sight issues following uveitis after the birth of her son. After experiencing vision loss despite multiple treatments, including steroids and silicone oil, Guy’s consultants trialled the HPMC gel injection.
“As the pressure improved, my vision started to come back. It was incredible! I want to keep my eyesight as long as I can, and this gives me that hope,” she said.
The clinic integrates detailed clinical assessments with collaboration from UCL’s Department of Mechanical Engineering. Engineering students have contributed to developing computational models to better understand and improve the treatment.
This early-stage data is already shaping discussions about establishing national standards for hypotony management and lays the groundwork for larger clinical trials to evaluate this promising therapy’s full potential.
