Moorfields Eye Hospital in London has opened the World’s First Hypotony Clinic, where a study reported that injections of hydroxypropyl methylcellulose significantly improved vision and eye pressure in patients, replacing silicone oil treatment.
New Clinic Targets Rare Cause of Vision Loss
Moorfields Eye Hospital has established the World’s First Hypotony Clinic to treat a rare eye condition marked by abnormally low intraocular pressure, according to a press release. Funded by Moorfields Eye Charity, the clinic began operating this year.
Hypotony occurs when intraocular pressure falls below 6.5 millimeters of mercury, altering the eye’s shape and internal structure. Over time, the condition can lead to progressive and irreversible vision loss and, in some cases, blindness.
The condition may develop after eye disease or damage to the tissue that produces the fluid needed to maintain normal eye pressure, according to the hospital.
Moorfields physicians reported that patients treated at the clinic showed meaningful visual improvement after receiving hydroxypropyl methylcellulose, or HPMC, an inexpensive gel commonly used during eye surgery.
“We are excited that this simple treatment has proved so effective for patients with this rare condition,” said Harry Petrushkin, a consultant ophthalmologist at Moorfields. “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.”
Study Shows Improved Vision and Eye Pressure
The findings were published Jan. 12 in the British Journal of Ophthalmology. The study followed eight patients with chronic hypotony who were treated with ocular injections containing HPMC.
Seven of the eight patients experienced gains in vision and restoration of eye pressure and eye length over a 12-month period, the authors reported.
At the start of treatment, patients’ best-corrected visual acuity ranged from 0.3 to 1.7 logMAR. After one year, visual acuity ranged from 0.1 to 1.6 logMAR, indicating improvement in most cases.
Intraocular pressure initially ranged from 1 to 5 millimeters of mercury, with a median of 3.5. After 12 months, pressures ranged from 3 to 23 millimeters of mercury, with a median of 9.
The axial length of the eye increased in six of the eight eyes studied, with gains ranging from 0.6 to 2.9 millimeters. The median increase was 1 millimeter.
“The data published today indicate that ocular injections containing HPMC can be used safely to increase the volume of eyes with hypotony, increasing both their size and pressure,” the authors wrote.
Treatment May Shift National Care Standards
HPMC replaces the current standard of care, which involves injecting silicone oil into the eye. Silicone oil can cause long-term side effects, including toxicity to ocular structures and obscured vision.
The success of the treatment was supported by structured clinical assessments and collaboration with bioengineers at University College London, who worked with clinicians to better understand the drivers of chronic low eye pressure.
Researchers said the early results are already influencing thinking about how hypotony should be treated more broadly.
Investigators noted that preliminary data from the World’s First Hypotony Clinic are already shaping national thinking on standardized treatment. They added that the findings provide a foundation for future, larger-scale formal clinical trials.
Access to the World’s First Hypotony Clinic is limited to patients referred by their eye specialists. The authors emphasized that individuals with low eye pressure who still retain vision in the affected eye should ask their consultant about referral to Moorfields, as this remains the only way to access the clinic.
