In 2024, the Lions Eye Institute continued to push the boundaries of what’s possible in the diagnosis, treatment, and understanding of glaucoma – one of the leading causes of irreversible blindness worldwide.
Around 300,000 Australians and more than 70 million people worldwide are affected by glaucoma. Source: Home | Glaucoma Australia
Our world-class researchers and clinicians made significant strides in identifying early biomarkers, trialling new therapies, and improving patient outcomes through cutting-edge technology and personalised care. With a focus on innovation and accessibility, our efforts are helping to preserve sight and transform the lives of people living with glaucoma across Western Australia and beyond.
Individualised Perimetry Progression Observations in Glaucoma Study
The Individualised Perimetry Progression Observations in Glaucoma Study (IPPOGS) is a world-leading three-year longitudinal study involving 140 participants, which commenced in October 2023. This study is evaluating personalised methods for visual field testing and linking them with ultrahigh-resolution retinal imaging to enable earlier detection of changes caused by glaucoma.
Traditional visual field tests use the same pattern for all patients, regardless of individual vision differences; however, IPPOGS is investigating whether tailoring tests to each person’s specific visual profile allows for earlier identification of progressive damage and faster treatment decisions to better preserve sight.
In addition to advanced visual field assessment, IPPOGS incorporates state-of-the-art structural and vascular retinal imaging, combined with sophisticated data analytics through collaboration with the Lions Eye Institute Data Analytics Group. This study is designed to provide evidence for improved clinical methods to monitor glaucoma across the disease lifespan and ultimately enhance patient management and outcomes.
Professor Bill Morgan examining patient Jill.
Improving outcomes in glaucoma filtration surgery
Glaucoma filtration surgeries play a vital role in lowering intraocular pressure and preserving vision, yet high failure rates due to inflammation and scarring within the drainage bleb remain a major challenge. Our research addresses this by investigating the role of the conjunctival lymphatic system in clearing aqueous humour from the bleb, proposing that poor lymphatic drainage contributes to surgical failure.
With support from the McCusker Charitable Foundation, we have developed and patented a world-first, non-invasive Optical Coherence Tomography Lymphangiography system capable of imaging the lymphatic capillary network in the human conjunctiva. Using this innovative technology, we aim to assess lymphatic health before and after surgery, correlate lymphatic function with outcomes, and optimise surgical techniques – such as superficial placement of drainage devices like the XEN® Gel Stent in areas of healthy lymphatic networks – to improve success rates and reduce postoperative interventions.
Our ultimate goal is to transform glaucoma surgery by integrating lymphatic imaging into surgical planning, reducing complications, and improving long-term outcomes for patients worldwide.
Midland Glaucoma Project
In 2024, the Lions Eye Institute, in collaboration with the University of Western Australia (UWA) and Royal Perth Hospital, launched the Midland Glaucoma Project to pilot a new model of glaucoma care. Supported by the WA Government’s Future Health Research and Innovation Fund, the trial integrates UWA Doctor of Optometry students into the Midland clinic to support patient care under expert supervision. This innovative pilot of a new model of care aims to manage stable glaucoma locally and ease pressure on hospital services, ensuring timely, high-quality care for those who need it most.
This collaborative, multidisciplinary model ensures patients with stable glaucoma are managed by the right service provider, with those requiring advanced care referred to Royal Perth Hospital. “It’s about filtering patients who genuinely need ophthalmologist input, rather than funnelling everyone through an already overstretched hospital system,” Professor Bill Morgan, ophthalmologist and researcher at the Lions Eye Institute, explained.
Lions Eye Institute patient, Niki, uses a tonometer at home to measure her eye pressure. She uploads her regular tonometry results to a cloud server, which is directly linked to her medical records and the Lions Eye Institute.
Glaucoma at home
In 2024, the Lions Eye Institute advanced its work in home-based glaucoma monitoring, aiming to make care more accessible and responsive. Our researchers have developed a software system
that collects intraocular pressure data remotely, displaying real-time trends and daily fluctuations for both clinicians and patients.
Supported by a major industry grant, we are trialling 40 portable monitoring devices with selected patients to refine these systems. By empowering patients to track their eye health from home, we are enabling earlier detection of progression, reducing avoidable vision loss, and reshaping glaucoma care around patient needs.
Listening to lived experience
At the Lions Eye Institute, we are committed to ensuring the voices of people living with glaucoma shape the future of research and care. In 2024, we strengthened this commitment through three
consumer engagement committees – two focused on glaucoma and one supporting intracranial pressure research. Insights from these groups have directly influenced projects like the Midland Glaucoma Project and guided improvements in telehealth, outreach models, and patient education.
By listening to real-world experiences, we are addressing challenges in access, communication, and treatment adherence, ensuring that patient perspectives drive meaningful change across our glaucoma services.
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