Posted by: Nathan Binder Post Date: January 24, 2020

Do You See the Problem?

Over 3 million people in the United States and 60 million globally would be on the path to blindness if it were not for recent medical advances. Glaucoma is an ocular disease that causes a loss of vision through damage to the optic nerve.

Once the vision is lost, it cannot be regained, although steps may be taken to preserve the vision of a patient once they have been diagnosed. Diagnosing glaucoma is not difficult – an optometrist can administer a pressure test and dilate a patient’s pupils to view the optic nerve – but recognizing the symptoms can be tricky. Often, 40% of vision is lost before a person notices they are losing vision, and experts estimate that half of the people diagnosed with glaucoma are not aware that they have it[1].

 Types of Glaucoma

There are multiple forms of glaucoma, but two are the most common – primary open-angle glaucoma (POAG) and angle-closure glaucoma. These two types of glaucoma are caused by an increase of intraocular pressure (IOP). POAG is more common and has therefore garnered the most focus on treatment and support. It also has the potential to advance to a late-stage before being noticed by the patient, while angle-closure glaucoma can manifest in an “attack” – often characterized by severe pain in the optical area, redness, decreased/blurry vision, halos, headache, nausea, and/or vomiting. Angle-closure glaucoma is caused by the draining angle being, well, closed[2].

Treatment

There are several methods for treating glaucoma. A doctor may prescribe eye drops or oral medication designed to lower pressure by decreasing fluid production or helping with fluid drainage. Surgery can also be performed to help with fluid drainage. Laser surgery for POAG involves the surgeon using a laser to improve the flow through the already-open drainage angle, while surgery for closed-angle glaucoma will create a hole in the iris for fluid to flow to the drainage angle.

An ophthalmologist may also opt for a surgery where a new drainage channel will be created in the eye. Another surgery is a trabeculectomy, during which a pocket will be created, and fluid will drain into the pocket before being absorbed by the tissue surrounding the patient’s eye. The other option is a drainage device, which is where medical advances are focused. These drainage devices are often called minimally invasive glaucoma surgery (MIGS) devices and are among the smallest medical implants in the world[2].

 

MIGS Devices

For a patient with POAG, a little help may be all that their eye needs to reduce IOP and prevent the advancement of glaucoma. Some patients are still prescribed eye drops or oral medication, but their IOP is normally greatly reduced through a MIGS device. These devices normally work by creating a pathway through the trabecular meshwork into Schlemm’s Canal to allow for fluid drainage (see above). For patient comfort, these devices are as small as possible – some are about the size of an eyelash, and others are almost too small to see!

How GLE Fits

Recently, the team at GLE Precision has been focusing on displaying our core capabilities. We hired a cinematography company to create some videos that showcase our talents, have written blogs on the subject, and displayed some of the parts on our blog/social media. One of these capabilities is small parts, which lends itself well to these MIGS devices. Below is a picture of our machinist Scott holding part of the tooling we recently made for a MIGS device supplier – the tooling is only the step at the end of the shaft, and more details were added later!

Tight tolerances are also a large part of the medical implant industry. The tolerance of a distance dimension on the above part was requested to be at +/-.000020”. We thought we could come close to hitting that target, but we could not accurately measure that tolerance, or find anybody that could! The customer for these parts has recently been using us as a source for a lot of their R&D work and it is always exciting to see what technology we will help them pioneer next.

 

Don’t hesitate to reach out to us at GLE Precision if you are in the glaucoma or larger medical industry, or part of any other company that could use our gaging expertise for R&D, tooling, gaging, or production parts.

[1] https://www.glaucoma.org/news/glaucoma-awareness-month.php

[2] https://www.mayoclinic.org/diseases-conditions/glaucoma/symptoms-causes/syc-20372839