This paper inquires into the organizational and spatial dynamics of scientific research by focussing on the evolution of epistemic networks in a specific area of medical practice, glaucoma. As researchers and practitioners struggle to come to grips with this elusive disease, the medical scientific community exhibits a great degree of variety in the ecology of organisations and the associated scientific pathways. Data on scientific publications over a thirty-year period affords a clearer understanding of the changing configurations of a clinical-scientific community, and speaks to the adaptive nature of problem-solving in medicine.