Balance Goggles – A New Approach to Glaucoma Treatment

Written by Dr. David Evans   Last modified on September 13, 2018

Glaucoma is a leading cause of irreversible vision loss for people over the age of 60. Typically viewed as an age-related vision problem, glaucoma is associated with abnormal pressure levels inside the eye (intraocular – IOP) resulting from a buildup of fluid. (Although in Asian countries, many glaucoma patients do not have high IOP.) There is no curative treatment available for glaucoma, however there are a number of options available to help slow its progression and limit additional vision loss. These treatment methods have typically included the use of medicated eye drops, drugs and eye surgery aimed at reducing IOP.

Given the serious impact of glaucoma and its relative common nature, there is ongoing research aimed at developing new and innovative treatments (I’ve previously written about exfoliation glaucoma research). One such new and innovative treatment that recently caught my attention is Balance Goggles.


What are Balance Goggles?

The Balance Goggles are a first-of-their-kind device aimed at regulating the pressure within the eye. Developed by a South Dakota-based company called Equinox through a research grant from the National Space Biomedical Research Institute Industry Forum, Balance Goggles are engineered to offer a nonsurgical, nonpharmacological treatment for glaucoma.

The goggles themselves are similar in appearance to regular swim goggles. For patients, rather than helping to protect the eyes and help you see underwater, Balance Goggles create a vacuum over the eye that works to lower IOP. An attached tube connects the goggles with a vacuum pump which controls the pressure inside the goggles within 1 mm Hg. The goal is to balance IOP with another type of pressure that has gained a bit more attention in recent years: cerebrospinal fluid pressure (CSFp), the pressure inside the head pushing against the back of the eye.

Cerebrospinal Fluid and Glaucoma

Dr. John Berdahl — Founder and CEO of Equinox — is a specialist in advanced cataract surgery, corneal surgery and glaucoma surgery at Vance Thompson Vision. He is a leading advocate behind the idea that glaucoma could actually be a “two-pressure disease,” those pressures being IOP and CSFp.

The idea of the Balance Google came about in two ways that merged through research. When scuba diving with his wife, Dr. Berdahl wondered why scuba divers don’t get glaucoma as a result of spending so much time in increased pressure. His theory was that the same pressure is being applied all over the body, and that perhaps there was an imbalance at play with regard to glaucoma. This imbalance was confirmed through research by Dr. Berdahl and his team. It was found to cause “cupping” of the optic disc, which could lead to eventual optic nerve damage.

Another idea for the Balance Goggles came about through the NASA program, in which scientists were looking for a non-invasive way to help astronauts struggling with vision loss as a result of long-term space travel. (Believe it or not it’s related.) The issue for astronauts is essentially the opposite of that faced by glaucoma patients. Their CSFp is higher than IOP, again creating a vision-damaging imbalance. Dr. Berdahl thought about how to increase eye pressure to restore balance, and the idea of wearing pressurized goggles was born. And if you can pressurize a pair of goggles to help astronauts, why couldn’t you depressurize them with a vacuum to help glaucoma patients?

What This Means for the Treatment of Glaucoma

The Balance Goggles are certainly a new and innovative approach to glaucoma and its treatment. Although proof-of-concept and in-human trials have been conducted, the device has yet to see clinical trial testing; though it is expected to begin sometime in 2019. Dr. Berdahl certainly has my attention and Better Vision Guide will be following the Balance Goggles as they see more testing and yield additional treatment data.

Noninvasive, Nonpharmacologic, Nonsurgical Glaucoma Therapy – EyeWorld  – Sep 2018
Glaucoma Faces Pressure – American Academy of Ophthalmology – Feb 2016