A commonly used, low-cost gel, has restored sight to people suffering from a rare and untreatable condition that causes blindness, British scientists have said.
Sky News reports that HPMC – hydroxypropyl methylcellulose – used in most eye surgeries, restored vision for seven out of eight patients with hypotony, the researchers at Moorfields Eye Hospital in London found.
Hypotony, which affects about 100 people in the UK each year, is abnormally low pressure in the eyeball, which usually results in a change to its shape.
After 12 months of fortnightly HPMC injections in people with the condition, researchers found the shape of the eye was restored.
The clear and colourless gel is usually used in surgery to maintain the eye’s shape during operations, or to coat its surface for protection and to prevent it from drying out.
Harry Petrushkin, consultant ophthalmologist at Moorfields, said patients undergoing eye surgery “will have had this gel in or on their eye at some point, but normally it is washed off or washed out afterwards”.
He said the “really safe” substance is not dissimilar to cosmetic fillers.
“It fills the space, but in this context, it fills the space with something that’s transparent and see-through, and allows you to give a certain amount per patient to fill the eye up to the size it’s supposed to be,” he added.
“A bit like when you’re pumping up a ball – you can pump it up to exactly the right size, and then the eye can see much better.”
Hypotony can be caused by a number of different diseases, as well as trauma, inflammation or complications after surgery, and all management plans “have had quite a lot of problems”.
It is currently treated by filling the affected eye with silicone oil, which can be toxic to the eye and is not great in the long-term, he added.
“The advantage of using a gel rather than silicone oil is that you can actually see through it much better.”
The research, published in the British Journal of Ophthalmology, included eight patients with hypotony whose eyes were injected with HPMC every couple of weeks.
The jabs not only restored their eyes’ shape, but also returned sight to seven patients after 12 months of treatment, with no serious side effects to date, Petrushkin said.
In some cases, injections were stopped after the eye was restored to its normal size.
Moorfields has treated 35 hypotony patients so far and Petrushkin said the results “are holding up”. He is now applying for funding for a large clinical trial to test different gels to find which needs the fewest injections.
Study details
Novel therapeutic strategies to restore vision in ocular hypotony (STRETCH): results from a prospective pilot series
Karla Orsine Murta Dias, Elizabeth Yang, Harry Petrushkin et al.
Published in The BMJ Ophthalmology on 11 January 2026
Abstract
Background/Aims
To report visual and anatomical outcomes following intravitreal hydroxypropylmethylcellulose (HPMC) for the treatment of chronic structural hypotony.
Methods
This study is a prospective interventional case series. Eight patients with chronic structural hypotony for more than 3 months, defined by an intraocular pressure (IOP) of <6.5 mm Hg. All patients had evidence of visual potential, clear cornea and a clear visual axis.
Patients received multiple intravitreal HPMC injections (70 µL–1400 µL), administered every 2–4 weeks until either pre-morbid axial length was achieved, an IOP of 10–15 mm Hg was sustained for 4 weeks without signs of hypotony, or axial length of the contralateral eye was reached. They were followed up for 12 months after the first intravitreal injection.
Results
Best corrected visual acuity (BCVA) logarithm of the minimum angle of resolution (LogMAR) improved in 87.5% of eyes, with one eye remaining stable. The initial BCVA range was 0.3–1.7 LogMAR, and the final range was 0.1–1.6 LogMAR. IOP increased in 87.5% of eyes, from an initial range of 1–5 mm Hg to 3–23 mm Hg. Axial length increased in 75% of eyes, with a median increase of 1 mm (range 0.6–2.9 mm).
Two adverse events occurred: uveitis flare-ups leading to loss of HPMC clarity in two eyes, managed with topical and intravitreal steroids, and two cases of temporary vision loss post-injection, resolved after paracentesis.
Conclusion
This is the first case series to use a structured protocol for intravitreal HPMC in chronic hypotony management. The treatment improved vision and restored ocular anatomy, showing promise for managing structural hypotony in eyes with visual potential.
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