Ultimately, Sensimed believes it may be possible to use Triggerfish to detect glaucoma at earlier stages in people with a family history of the disease or other risk factors. If a high-risk patient has a relatively normal daytime pressure, says company president and CEO Jean-MarcWismer, he might benefit from a preventative 24-hour monitoring session every once in a while. “We would like to be able to diagnose glaucoma earlier, before it actually causes damage that affects vision.”
This may be a bit premature, says Andrew Iwach, the executive director of the Glaucoma Center of San Francisco. “Some patients have high intraocular pressure, but their optic nerve tends to do fine. Others have lower pressure, but still have a major impact on their optic nerve,” says Iwach, who’s also spokesperson for the American Academy of Ophthalmology. The problem, experts say, is that increased intraocular pressure is the only symptom of glaucoma that is treatable and can slow or stop disease progression.
However, both Iwach and Stanford ophthalmology professor Kuldev Singh believe that continuous monitoring of intraocular pressure is something the field desperately needs, and note that there are multiple groups working toward such a goal. But while the new device will likely have a major benefit in understanding individual patients’ treatments, Singh says, it also provides an important opportunity to better understand the disease. “The idea of a continuous measurement device for eye pressure is a very, very good one,” he says. “I think the most important use for it is to better study the relationship between eye pressure and glaucoma progression.”
“From a scientific standpoint, this type of technology will be groundbreaking in letting us understand the relationship between eye pressure and glaucoma, and how treatments work over a 24-hour period,” says Singh, who is also chair of the Glaucoma Research Foundation’s board of directors.
To date, the device has only been used clinically in about 80 patients–the holdup, says Mansouri, is price: It’s not yet reimbursed by the Swiss health care system. Prices should drop, however, as reimbursement increases and production scales up.