A Moorfields paper published today in the British Journal of Ophthalmology demonstrates the effectiveness of a widely-used eye injection to manage the previously untreatable rare condition, hypotony.
This condition is characterised by abnormally low eye pressure, which alters the eye’s normal shape and internal structure. Over time, this can lead to progressive and permanent vision loss, often taking several years to result in blindness. Hypotony may develop as a result of underlying eye conditions that damage the part of the eye responsible for producing the fluid that maintains normal eye pressure.
Until now, the standard treatment for eyes losing vision from low pressure has been to fill them with silicone oil. This has many benefits but is not ideal as it can be toxic to the eye over long periods of time and is difficult to see through clearly.
The data published today indicates that ocular injections containing HPMC (hydroxypropyl methylcellulose) – a low-cost gel used in most eye surgery - can be safely used to increase the volume of eyes that have lost sight but still detect light with hypotony, increasing both their size and pressure.
Remarkably, in addition to restoring the eye’s anatomy, patients also regained sight. Seven of the eight patients who received the treatment experienced improvements in vision, eye pressure and length restoration after a twelve-month course of treatment. These all came from the world’s first dedicated hypotony clinic, enabled by funding from Moorfields Eye Charity.
Nicki’s story
Nicki’s sight issues began shortly after the birth of her son, when she was diagnosed with uveitis. For several years, she lived symptom-free, until a cataract developed in her right eye. Following routine surgery, she lost vision in it. At this stage, she was referred to Moorfields by a clinician treating her in Grand Cayman, who had trained with us.
Multiple treatments were attempted, including the use of steroids and silicone oil.
The next two years were spent try to manage the left eye to stop sight loss occurring. While some offered temporary relief, others led to sudden drops in pressure or even complete loss of vision. Unfortunately, despite all current treatment, the left eye lost vision following cataract surgery due to low pressure.
Through every challenge, Nicki remained determined to preserve what sight she still had. Losing her sight had been frightening, but it also pushed her to find out about treatment options and cutting-edge research, saying:
“After I lost vision in my left eye, I thought, ‘there has to be something else we can try’. It felt good that I’d been able to advocate for myself, like they understood my concerns.”
Her turning point came when her consultants at Moorfields began exploring an alternative to silicone oil. Encouraged by her persistence, they trialled a new approach – an injection of clear gel designed to support pressure and restore function.
Reflecting on that moment, Nicki said: “We went ahead and, as the pressure improved, my vision started to come back. It was incredible!
“I want to keep my eyesight as long as I can, and this gives me that hope, as my sight has slowly returned.
The progress I’ve made feels extraordinary, especially knowing that patients before me have faced irreversible sight loss.
“The progress I’ve made feels extraordinary, especially knowing that patients before me have faced irreversible sight loss.
“I remember seeing Mr Petrushkin and him saying, ‘Before this treatment, people were going blind.’ It’s incredible to know that people are regaining vision.
“I highly recommend this treatment. Giving people their sight back is something special.”
Moorfields consultant ophthalmologist Harry Petrushkin said: “We are excited that this simple treatment has proved so effective for patients with this rare condition. This is the start of a process of understanding more about the balance of fluid inside the eye, leading to improved care for our patients.”
The Moorfields clinic integrates structured clinical assessment and collaboration with bioengineers at UCL to understand the drivers of chronic low intraocular pressure.
This preliminary data is already informing thinking on standardised hypotony treatment nationally. It provides a foundation for future, larger-scale formal clinical trials to evaluate the potential of this highly promising approach.
This project could not have taken place without the funding from Moorfields Eye Charity.
If you have low eye pressure which you think may be caused by a pre-existing eye condition, and still have vision in the affected eye, please ask your consultant for a referral to Moorfields; this is the only way to access the NHS hypotony clinic.
This service is also available through Moorfields Private. You can self-fund or use private medical insurance for your treatment.
Moorfields Private’s financial surplus is invested back into Moorfields Eye Hospital NHS Trust for the benefit of all patients.
Click here to register for all appropriate current and future Moorfields clinic trials
12 January 2026