Brain May Be The Key To Early Glaucoma Detection

David Calkins, Ph.D., Director of Research at the Vanderbilt Eye Institute published a study indicating that the brain may hold the key to the early signs of glaucoma.  Published in the Proceedings of the National Academy of Sciences, the study indicates that glaucoma may be like other central nervous system disorders with its origins being in the brain.

Traditional thinking regarding glaucoma is that the either the high pressure slowly crushes the nerve fibers or the pressure decreases blood flow to the optic nerve.  Should Dr. Calkins’ findings be confirmed in human studies it would cause a paradigm shift in the treatment and diagnosis of glaucoma.  Dr. Calkin’s study demonstrates that glaucoma starts in the brain and then as the disease progresses the optic nerve starts to show evidence of the disease.  Currently Dr. Calkins’ research is directed toward looking for medical therapies that can restore the connection of the nerve fibers between the brain and the retina.

I have to applaud Dr. Calkins and his team for thinking outside the box in their pursuit of answers to the second leading cause of blindness.  The study was funded by the National Eye Institute, the Glaucoma Research foundation and Research to Prevent Blindness.  More details on the study results are available on The Reporter, Vanderbilt Medical Center’s Weekly Newspaper.

4 responses to “Brain May Be The Key To Early Glaucoma Detection

  1. I doubt glaucoma starts in the midbrain. What probably is occurring in glaucoma is that axons are being axotomized against the scleral edge as a result of sinking of the optic disc. Due to severing of the axons there is retrograde degeneration of the ganglion cells of the retina proximally and of the neurons in the LGN and also in the occipital cortex distally.

  2. That is an interesting thought, Dr. Hasnain. I’m curious as to why you think the optic disc is sinking in glaucoma.
    Researchers are on the cusp of putting together the similarities in such neurodegenerative diseases as Alzheimer’s, Parkinson’s, M.S., and I would add glaucoma and normal pressure hydrocephalus. Their research includes the evaluation of sluggish CSF and venous flow, placing pressure on such structures as the optic nerve.
    I eagerly await hearing more about this research, as it may also answer the perplexing condition of normal pressure glaucoma.

  3. Dr. Diana,

    Thank you for your comments. When we talk about chronic glaucoma, we should always keep in mind one most important established fact: that the arcuate and peripheral fibers are selectively destroyed first in the early stages whereas the central vision fibers last until the end stage of glaucoma. I think perhaps this is the only lead we have in discovering the pathogenesis of glaucoma. Based on selective destruction of arcuate and peripheral fibers in early stages, glaucoma just could not be a neurodegenerative disease. In my opinion a neurodegenerative disease will occur generalized or randomly but to specifically start first with those ganglion cells of the retina or of the neurons of the lateral geniculate nucleus which serve the arcuate or peripheral fibers will be most unlikely.

    My hypothesis that the optic disc may be sinking or in other words herniating in the scleral canal is based on selective destruction of the arcuate and peripheral fibers in the early stages of glaucoma. There are two main points in my hypothesis. One is that optic disc is sinking and secondly due to sinking the axons are being severed (not atrophy). Glaucoma may not be neuropathy but axotomy of the optic disc. My sinking disc hypothesis will attempt to answer all the unanswered questions of glaucoma. You may like to visit my website: where I have put forward my arguments in favor of sinking disc hypothesis. But you are the judge

  4. Hello,
    I am 43 and have been diagnosed with idiopathic normal pressure hydrocephalus since the age of 37 and have just been diagnosed with beginning stages of glaucoma. I don’t have a shunt and don’t take any medication yet, eye dr just started me on eye drops for the glaucoma i think there is a link between the hydrocephalus and the glaucoma do you know of any research being done in the Detroit area