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Glaucoma remains among the leading causes of blindness despite many treatmentoptions available today. Effective treatment requires early diagnosis, which isdifficult to achieve with existing imaging technologies that detect the alreadyinflicted irreversible posterior eye damage. One improved approach could be todetect the changes in trabecular meshwork of the anterior eye that precede theintraocular pressure buildup and vision loss. Here we report a device thatenables in vivo exploration of trabecular meshwork at cell resolution. Theinstrument combines two orthogonal views: en face view of time-domainfull-field OCT for high-resolution and cross-sectional view of spectral-domainOCT for aligning to the meshwork. The device resolves micron-levelcorneoscleral and uveal pores, meshwork beams and internal elastic fibers,ciliary body tendons and trabecular cell nuclei. Capable of detecting blockageof trabecular pores, orthogonal view OCT presents a promising solution to thelong-standing problem of early glaucoma diagnosis. Future clinical adoption ofthe device is facilitated by the compact footprint and broad functionality thatincludes corneal imaging in healthy subjects and patients (with keratoconus,Fuchs endothelial dystrophy) using the same design.

Compact orthogonal view OCT: clinical exploration of human trabecular meshwork and cornea at cell resolution