The guest speaker this month was Optometrist Dr Jonathan Denniss. Jonathan is an Associate Professor in the School of Optometry & Vision Science, Bradford University, and he spoke about developments in Optometry. He has carried out research to improve understanding of changes to the eye and visual function caused by common age-related eye diseases, particularly glaucoma and macular degeneration. This research aims to improve clinical tools for detection and/or monitoring of these diseases, thus helping patients to preserve their vision in older age.

An important part of effective treatment for glaucoma is an accurate early diagnosis. Glaucoma is the world’s leading cause of irreversible blindness, affecting 3% of those aged over 40 in the UK. It is also becoming more common as the population ages, with 112 million people worldwide predicted to be affected by 2040.

Eye pressure is controlled by watery fluid called aqueous humour, or just ‘aqueous’. Aqueous is made in a ring of tissue that sits behind the iris called the ciliary body. It then flows through the pupil and drains away through tiny channels called the trabecular meshwork.

The trabecular meshwork is found in the angle between the cornea and the iris (often called the drainage angle). In a normal eye, there is a balance between inflow and outflow of fluid, but in some eyes this balance is disturbed, and that causes the eye pressure to rise.

Existing diagnostic imaging for glaucoma uses optical coherence tomography (OCT) which is fast, non-invasive, and straightforward to use. However, glaucoma diagnosis is difficult. Misidentification of healthy eyes as glaucoma is common, costing the NHS over £36 million per year. In addition, current techniques also miss 20-30% of true cases, contributing to preventable sight loss.

Jonathan explained that the current approach to OCT was focused on measuring the thinning of retinal tissue in cross-sectional (front-to-back) slices. The proposed new method works with existing equipment to create new 3Dimages that provide improved diagnostic information. A reduction in the number of false positives of just 5% would equate to a saving of around £1 million a year for the NHS. When tested on a small group of patients, the technique detected more early defects than existing approaches. It also showed potential to reduce false positives, which means fewer people being referred for treatment unnecessarily.

These findings are part of a Retinal Imaging Study (2025–2029), a £1.18 million project funded by the Medical Research Council and led by Jonathan with a colleague, Dr Riccardo Cheloni. It converts standard optical coherence tomography (OCT) cross-sectional retinal measurements into new 3D images to detect early glaucoma defects and reduce NHS misdiagnoses.

Riccardo also explored how the position of the main blood vessels in the eye relates to patterns seen in the retinal nerve fibre layer, which is commonly measured in glaucoma assessment. Using detailed eye scans from healthy volunteers, there is a clear relationship between blood vessel location and nerve fibre layer patterns. Understanding these natural differences between individuals may help improve the accuracy of glaucoma detection in the future.

The third member of Jonathan’s team – Thomas - worked on early detection of glaucoma by measuring the retinal nerve fibre layer. The current method resorts to slow, error-prone manual tracing or data heavy Artificial Intelligence systems. But a newly developed, fully automated computer programme solves this by using standard image processing techniques to measure scans rapidly and with expert level accuracy.

Our members were invited to ask questions at the end of Jonathan’s presentation, and many members had some ready. Our speaker responded to each one and took the time to provide an explanation or advice to the person asking and to the audience in general.

He has also left some reading matter, quickly taken up by people attending, a text entitled ‘Glaucoma research team: an update This included the paragraph:

Glaucoma Research Project: an update We're pleased to share that data collection for Phase l was completed in March. We would really like to thank everyone who took part - your support is greatly appreciated. ln total, we screened 86 participants (43 with glaucoma and 43 with healthy eyes). 74% of each were fully eligible for the study, which is fantastic as we exceeded our target of 3O glaucoma and 30 healthy eyes. The team is now working hard on analysing the data gathered and refining our methods of analysing the images that we've collected. We will soon start to prepare for the next phase of the project - fibre layer within the retina.

Before this, one of our members stepped up to provide a heartfelt and amusing few minutes for Jonathan’s visit and proposed a vote of thanks. This was taken up to great applause from the audience, especially those who had volunteered to take part in the research.

Finally Jonathan once again reminded the audience they should have regular eyesight tests, including checks for possible glaucoma symptoms.