Hypotony: Diagnosis and management

From theory to practice

Chronic structural ocular hypotony is a rare but sight-threatening condition with limited treatment options and no established standard of care.

This brand new one-day course provides a comprehensive overview of chronic structural ocular hypotony and introduces a novel treatment protocol developed at Moorfields Eye Hospital. Based on the STRETCH protocol, the first prospective case series demonstrating improved visual acuity, intraocular pressure, and axial length following intravitreal viscoelastics injections in selected patients with chronic structural hypotony.

The morning sessions will consist of live lectures delivered face-to-face at Moorfields Eye Hospital and simultaneously streamed online. Topics will include:

• Pathophysiology and classification of ocular hypotony.
• Clinical phenotyping and multimodal imaging.
• Assessment of visual potential using flash VEP and full-field ERG.
• Inclusion and exclusion criteria for treatment.
• Premorbid axial length and treatment endpoints.
• Results and lessons from the STRETCH protocol.

The afternoon sessions will be delivered face-to-face only and will focus on:

• Practical aspects of intravitreal viscoelastics injections.
• Management of adverse events.
• Interactive case discussions.
• Review of imaging and treatment planning.

Faculty will include members of the Moorfields multidisciplinary Hypotony Service, with expertise in uveitis, glaucoma, ocular ultrasound, electrophysiology, and retina. The course will be highly interactive, with opportunities for participants to discuss real cases and ask questions throughout the day.

You can choose to attend online for the morning session only (cost £200) or in-person for the full day (cost £400).

Course aims

• Provide a structured approach to the assessment and management of chronic structural ocular hypotony.
• Disseminate the findings of the STRETCH protocol and the Moorfields Hypotony Service treatment protocol.
• Teach participants how to identify patients with visual potential who may benefit from treatment.
• Review the practical aspects of intravitreal viscoelastics injections, including treatment endpoints and complication management.
• Encourage multidisciplinary collaboration and stimulate future research in this challenging area.

Key learning outcomes

By the end of this course, participants will be able to:

• Distinguish between numerical and structural hypotony and recognise their clinical implications.
• Identify reversible causes of hypotony and understand when intervention is appropriate.
• Assess visual potential using electrophysiology.
• Apply the STRETCH protocol for patient selection, treatment planning, and monitoring.
• Recognise and manage complications associated with intravitreal HPMC injections.