PROSPECTS FOR GENETIC INTERVENTION IN PRIMARY OPEN-ANGLE GLAUCOMA

Recent advances in glaucoma genetics hold potential for dramatically c hanging the clinical care of glaucoma patients. To date, 5 primary ope n-angle glaucoma genes and 2 congenital glaucoma genes have been mappe d. As more glaucoma genes are identified, earlier diagnosis for glauco ma should become more readily available. Progress in molecular genetic s holds considerable promise for both current and future therapy of gl aucoma. Glaucoma classification will be tailored to each individual ba sed upon that person's family history, i.e. family glaucoma genotype. In the future, the optimum treatment for a specific glaucoma patient m ight rely on the knowledge of the phenotype of that person's causal ge ne, without having to resort to 'trial and error'. At this time, glauc oma treatment is restricted to lowering intraocular pressure. In the n ear future, with the knowledge of the pathophysiology caused by the de fective glaucoma gene, more traditional; drug treatments may be used t o bypass the gene defect. Ultimately, gene therapy would replace the m utant gene with a normal one before visual loss has occurred as has be en done with a model for retinitis pigmentosa, the retinal degeneratio n mouse.