The “Eye Movement Test” in the Clinical Management of Chronic Open-Angle Glaucoma

Glaucoma is a neurodegenerative disease characterized by increased Intraocular Pressure (IOP), progressive apoptosis of retinal ganglion cells, increased optic nerve head excavation, reduced visual field and visual acuity. The most common form of glaucoma is Chronic Open-Angle Glaucoma (COAG) and the main cause of ocular hypertension is increased resistance to aqueous humor outflow at the level of the iuxtacanalicular tissue of the trabecular meshwork. The aim of this study is to investigate the usefulness of a new diagnostic technique called “EYE MOVEMENT TEST” in the clinical management of COAG. Two hundred subjects (400 eyes) were enrolled and divided into two groups. Group A consisted of 100 patients with COAG and group B consisted of 100 patients without a diagnosis of ocular hypertension. Group B was divided into two subgroups: B1 consisting of 80 patients (160 eyes) with IOP ≤ 18 mmhg and B2 consisting of 20 patients (40 eyes) with IOP ≥ 19 mmhg classified as “subjects at risk of glaucoma.” After performing Goldmann applanation tonometry, subjects were asked to move their eyes in all gaze positions by fixing an aim for 1 minute and immediately afterwards, their IOP was measured again. In 172 eyes of group A (subjects with COAG) and in 16 eyes of group B2 (subjects at risk of glaucoma) there was a non-significant decrease in mean IOP (< 1 mmHg), while in group B1 the decrease in mean IOP was ≥ 1 mmHg (range 1 – 3 mmHg). This technique, through the changes in IOP induced by eyeball movement, aims to investigate the degree of elasticity and efficiency of the trabecular meshwork, verify the effectiveness of therapies that act on trabecular outflow and most importantly help identify subjects with borderline IOP, at risk of developing the disease.