Smart contact lenses are set to revolutionize glaucoma management with a proactive approach to monitoring and treatment.
As we enter 2025, the world of glaucoma management is becoming sleeker, smarter and more efficient. The advent of smart contact lenses is just the tip of the iceberg in what’s likely to overhaul glaucoma care. For patients, the promise of real-time monitoring, personalized treatment plans and improved adherence will make managing glaucoma much easier—and far less stressful.
This year, glaucoma management is bringing a whole new level of tech-savvy swag to the game. Forget about old-school eye drops, cumbersome doctor’s visits and constant worrying about intraocular pressure (IOP)—the future is here and it’s wrapped up in smart contact lenses.
These lenses are reinventing the way glaucoma is diagnosed, monitored and treated—all while delivering realtime data that could save one’s vision.
Let’s dive into the world of these high tech eye savers and see what’s in the works for glaucoma management in 2025.
Tracking IOP 24/7
First things first—glaucoma is a sneaky villain. It often has no obvious symptoms until significant damage has been done. But what if we could track it 24/7, even while you’re sleeping? That’s where diagnostic smart contact lenses come into play.
Sensimed Triggerfish (Sensimed AG; Vaud, Switzerland) is one of the players in the field. This bad boy uses a strain gauge sensor to detect the tiniest changes in the curvature of the eye, which correlates with fluctuations in IOP. And the best part? It works continuously over a full 24- hour period.
“Monitoring IOP fluctuations over 24 hours helps in understanding how IOP changes throughout the day, offering valuable data for early detection and management,” explained Dr. Low Jin Rong, a consultant in the Glaucoma Department at the Singapore National Eye Centre (SNEC).
While IOP measurement by the Goldmann tonometer is considered the gold standard, Prof. Norshamsiah Mohd Din, professor of ophthalmology at the National University Malaysia Medical Center, noted: “24-hour IOP measurement has been shown to fluctuate over time.”
Research indicates that Triggerfish recordings correlate better with visual field progression than multiple in-clinic IOP measurements using the Goldmann tonometer in the clinic.1,2
Patients who recorded steep spikes overnight and a higher number of peaks overall belonged to the fast disease progression group, Prof. Norshamsiah added.
These lenses, therefore, can be used to stratify patients at risk of future functional visual field loss. This level of continuous monitoring isn’t just a game-changer for clinicians; it’s a gift for patients who no longer have
to rely on periodic, office-based IOP measurements. By tracking these fluctuations in real time, doctors can adjust treatment plans faster and more accurately, leading to better outcomes.
Real-time IOP data at your fingertips
But hold your horses. Researchers have also developed smart contact lenses to measure IOP accurately despite variations in the eye’s temperature, which make accurate readings tricky.
One such design is the intelligent wireless measuring contact lens (WMCL) by Dengbao Xiao with the Institute of Advanced Structure Technology, Beijing Institute of Technology, and colleagues. Lab tests showed that it reduced temperature-related errors, providing IOP readings with only a 7% deviation from true values, even across a wide temperature range.3
It doesn’t stop there. The WMCLs can also send the data wirelessly to a doctor’s office or phone. Imagine, no more waiting around for appointments or invasive procedures. With these lenses, doctors have continuous access to a patient’s IOP data, which means they can react immediately if something’s off.
“These lenses feature temperature compensated sensors for precise IOP measurement over time, enabling continuous real-time feedback to both patients and clinicians, reducing the need for multiple visits to the doctor for IOP checks,” noted Dr. Low.
Passive sensors for IP monitoring
Academics from the United Kingdom and Turkey have also developed an electrically passive sensor embedded in disposable contact lenses that can detect changes in IOP over several hours, sending the collected data wirelessly.4
Tested on six volunteers, this system successfully measured IOP fluctuations after inducing pressure changes, such as by drinking water and lying flat. Unlike previous lenses that used bulky silicon chips, this design is more comfortable and flexible for daily wear.
But that’s not all. According to Dr. Low, some biosensor integrated lenses take it a step further by detecting biochemical markers in tears, such as matrix metalloproteinases, which are indicative of early glaucoma.
“These sensors provide a non-invasive and continuous method to monitor disease progression, which is crucial given that glaucoma often develops without obvious symptoms until significant damage has occurred,” he added.
Super lenses that do it all
This next innovation is straight-up futuristic: Theranostic lenses. These super-lenses do it all. Not only do they monitor IOP and other eye biomarkers, but they also deliver medication right to the eye as needed.
These all-in-one solutions are perfect for people who need continuous monitoring and quick intervention when their IOP spikes. “This integrated system ensures continuous monitoring and precise medication administration, helping to keep IOP at optimal levels for better glaucoma control,” said Dr. Low.
What does this mean for the patient? It’s all about ease and precision. You get constant tracking of your eye health, and whenever your IOP rises to a dangerous level, the lens kicks into action, releasing medication to keep things in check. It’s almost like having a built-in eye doctor right inside your lens.
Prof. Norshamsiah highlighted the work of Pohang University of Science and Technology, South Korea, where researchers have developed a smart lens with both IOP sensors and drug delivery systems, providing on-demand medication release to keep IOP under control.5
Prof. Norshamsiah highlighted the work of Pohang University of Science and Technology, South Korea, where researchers have developed a smart lens with both IOP sensors and drug delivery systems, providing on demand medication release to keep IOP under control.5
“When the pressure reaches a high risk threshold, a drug delivery module in the contact lens can apply an anti glaucoma drug to the eye as needed,” said Prof. Norshamsiah.
Some questions she raised include whether there is enough space to contain these intricate wireless systems within a thin lens and still be comfortable enough to be worn by patients.
“Attention should also be given to ensure that the circuit chip within the lens will not cause inadvertent electrical flow into the tear film and subsequent burn to ocular tissue. Furthermore, incorporating a drug depot to be released in response to increased IOP requires careful design,” she said.
The future is bright and contact-lens-shaped
With all the innovations in diagnostic, therapeutic and theranostic lenses, we can look forward to a future where glaucoma is no longer an invisible enemy, but one that can be caught and controlled with the click of a
button—or more accurately, the blink of an eye.
As Dr. Low put it, “Smart contact lenses with diagnostic and therapeutic capabilities represent a significant leap forward in the way glaucoma is managed. While still in the development and clinical trial stages, the potential for these innovations to revolutionize glaucoma care is immense,” he added.
However, there may yet be hurdles. “While all these innovations show promising developments in glaucoma management, the challenges of applying a contact lens on the cornea for a long period still exist, akin to the
challenges of contact lens wear for all other situations,” cautioned Prof. Norshamsiah. There remains the risk of corneal infection, corneal abrasion and chronic corneal hypoxia.
Furthermore, the inclusion of circuit chips in wearable tonometers often makes lenses thicker and less comfortable. To address this unmet need, Purdue University researchers have developed smart contact lenses using “sticktronics,” which are sticker like items containing electronics or smart tech.7 This wearable biomedical device can continuously unobtrusively monitor IOP, even during sleep. These lenses aim to improve patient comfort and enable 24-hour IOP tracking.
As more advancements are made, it’s clear that smart contact lenses could play a pivotal role in reshaping glaucoma management, offering a more seamless, comfortable, and efficient approach to eye care.
Editor’s Note: A version of this article was first published in COOKIE magazine Issue 18.
References
- De Moraes CG, Mansouri K, Liebmann JM, Ritch R; Triggerfish Consortium. Association Between 24-Hour Intraocular Pressure Monitored With Contact Lens Sensor and Visual Field Progression in Older Adults With Glaucoma. JAMA Ophthalmol. 2018;136(7):779-785.
- Tojo N, Hayashi A, Otsuka M. Correlation between 24-h continuous intraocular pressure measurement with a contact lens sensor and visual field progression. Graefes Arch Clin Exp Ophthalmol. 2020;258(1):175-182. Li X, Chen W, Li H, et al. Temperature Self-Compensating Intelligent Wireless Measuring Contact Lens for Quantitative Intraocular Pressure Monitoring. ACS Applied Materials & Interfaces. 2024;16(17):22522-22531.
- Ozgur K, Aydin MA, Teymoori M, et al. A first-in-human pilot study of a novel electrically-passive metamaterial-inspired resonator-based ocular sensor embedded contact lens monitoring intraocular pressure fluctuations, Cont Lens Anterior Eye. 2024(2):102102.
- Kim TY, Mok JW, Hong SH, et al. Wireless theranostic smart contact lens for monitoring and control of intraocular pressure in glaucoma. Nat Commun. 2022;13(1):6801. Yang C, Wu Q, Liu J, et al. Intelligent wireless theranostic contact lens for electrical sensing and regulation of intraocular pressure. Nat Commun. 2022;13(1):2556.
- Neuroscience. New High-Tech Startup Developing Smart Contact Lenses for Glaucoma Diagnosis and Management. January 9, 2023. Available at: https:// neurosciencenews.com/glaucoma-smart-contacts-22204/. Accessed on December 25, 2024
