A Brave New World in Glaucoma

American Academy of Ophthalmology 2013

Jonathan S. Myers, MD; George L. Spaeth, MD; Sonya B. Shah, MD; Victor Cvintal, MD


December 06, 2013

Editorial Collaboration

Medscape &

In This Article

Predicting Outcomes With Genetics

Dr. Myers: Dr. Janey Wiggs[4] has done outstanding research in genetics for many years now, and at this meeting is presenting some of her work on genetics. Dr. Spaeth, what was your impression of her findings?

Dr. Spaeth: That is such an interesting subject because we all struggle -- not just the younger clinicians -- but you and me too -- with trying to figure out what is going to happen to this person with glaucoma. Is he going to get worse? Is she going to stay stable? Are they going to respond well to treatment? We have some indicators, but they are pretty shaky. It would be wonderful to say, this person has a genotype of ABCDE, and therefore he is going to go blind.

Dr. Wiggs pointed out that for adults with glaucoma, genetics is not yet what she called "ready." It is getting there, and maybe a whole lot of different genes put together in a panel is going to help, but it's not ready.

However, for congenital glaucomas and the early-onset glaucomas, you can genotype the person and say, this person has a CV1YA, for example, and that person is going to go blind. You can check the members of the family to find out whether they have the same sort of gene. So in infantile glaucomas, it is there now.

Dr. Myers: That has implications. If the other family members don't have the gene, presumably everyone sleeps a lot better.

Dr. Spaeth: That's right.