The future for glaucoma detection and management looks bright.
Glaucoma gobally affects more than 60 million people and blinds about 4.5 million of them, making this the most common cause of preventable blindness – with numbers set to rise as the population ages.
Insidious, chronic, and irreversible, most affected persons are unaware of their diagnosis, particularly in the early stages. Major ongoing challenges are to identify those with early disease accurately, as well as those at high risk of progressive damage, to monitor all glaucoma patients more effectively, and to tailor treatments individually.
OVER 60 million affected globally
Our understanding of the major modifiable risk factor in glaucoma – intraocular pressure (IOP) – has evolved with new extraocular (contact lens sensors) and intraocular (implantable IOP transducers) 24 hour IOP monitoring devices currently under investigation. Such technologies should add to the water-drinking provocative test to identify IOP fluctuations and spikes, which are otherwise missed.
4.5 MILLION blind world-wide
Artificial intelligence algorithms already detect optic disc pathology; with large scale database pooling they show promise for screening and in virtual glaucoma clinics. Constant innovations in daily use devices such as smartphones, laptops, and electronic tablets, including the development of tablet-based perimetry, may enable high quality glaucoma care with telemedicine in remote and underprivileged communities. These developments will also enhance home based management.
New classes of topical medications are becoming available with innovative mechanisms of action such as rho kinase inhibitors and nitric oxide donors. Drug delivery technologies promise sustained, slow release that will minimise patient non-adherence and surface side effects from many current topical treatments.
300,000 Australians affected
By identifying new pathological glaucoma pathways, genome-wide association studies may yield novel targets for preventative therapies.
Considerable developments in glaucoma management provide hope for improved visual preservation. We work in exciting times.
Dr Tanya Karaconji and Clinical Professor Ivan Goldberg
