Real-time intraocular pressure monitoring and responsive drug release in preclinical models by an all-polymer smart contact lens

Glaucoma remains a leading cause of irreversible blindness worldwide, yet conventional topical therapies are often hampered by poor patient adherence, and standard in-office applanation tonometry captures only static measurements, failing to capture the dynamic nature of intraocular pressure (IOP). Smart contact lenses have emerged as promising tools for home-based, real-time IOP monitoring and feedback-guided therapy; however, most rely on bulky or rigid electronics that impair comfort, safety, and visual performance. Here, we report a battery-free, all-polymer microfluidic theranostic smart contact lens (AP-TSCL) that enables autonomous IOP-responsive glaucoma therapy without bulky electronic components. The AP-TSCL integrates a noninvasive microfluidic IOP sensor with a multistage, pressure-gated drug delivery architecture. Embedded microchannels define distinct activation thresholds, enabling lens deformation under elevated IOP to drive staged release from multiple drug reservoirs. Across in vitro (artificial eye model), ex vivo (enucleated bovine eyes), and in vivo (rabbit ocular hypertension) studies, the device achieved tonometry-aligned IOP tracking, pressure-triggered delivery of timolol or brimonidine above preset thresholds, and IOP lowering comparable to conventional topical therapy. This preclinical evidence suggests that the fully integrated platform may overcome key limitations of existing technologies and offers a clinically translatable solution for personalized ocular care.