Whether it is the patient with suspicious discs but no definitive change, discordant optical coherence tomography (OCT) and field results, or apparent progression despite ‘good’ pressures, uncertainty in glaucoma diagnosis and management is not the exception – it is the rule.
Eye care professionals are invited to attend a conference that will explore these ‘grey zones’ in glaucoma management, and provide a framework for how to weigh competing risks, integrate disparate data, and communicate uncertainty to patients.
“Grey zones of glaucoma: Uncertainty, judgement, and decision-making in everyday practice” will take place on 2 August 2026 in the Hunua Room, Aotea Centre, Auckland.
Hosted by Glaucoma New Zealand, with a keynote address by Professor Keith Martin (University of Melbourne), case battles, and a rapid-fire session led by Professor Dame Helen Danesh-Meyer, this conference is designed to reframe uncertainty not as a failure of knowledge, but as an intrinsic part of clinical practice.
The emphasis will be on sharpening judgement: how to interpret imperfect data, when to intervene, and when restraint is the safer course.
Opening Sessions
In his keynote address, Professor Martin will examine how emerging technologies – artificial intelligence, home monitoring, and advanced imaging – are reshaping glaucoma care while simultaneously introducing new forms of uncertainty.
In the Case Battles session, complex, ambiguous cases will be dissected in real time with five patients and five decisions – each illustrating that even among experts, there is often more than one defensible approach.
A rapid-fire session led by Professor Danesh-Meyer will be designed to mirror the pace and complexity of clinical practice, reinforcing pattern recognition and decision-making under pressure.
Session 1: The Diagnostic Grey Zone
This session will focus on how clinicians distinguish physiological cupping from early glaucomatous change, navigate situations where OCT findings and visual fields do not align, and determine whether apparent progression reflects true disease or simply artefact. It will also examine interpretation of intraocular pressure within the broader context of individual patient risk.
Session 2: Testing in the Grey Zone
This session will explore the potential role of nocturnal physiology, including sleep and posture, in glaucoma progression, as well as the broader significance of corneal properties beyond central corneal thickness. Emerging systemic and vascular risk factors are critically evaluated alongside ongoing controversies in angle closure glaucoma. Importantly, it will challenge clinicians to move past passive interest in new data and instead ask a more pressing question: does this information meaningfully alter clinical management?
Session 3: Management in the Grey Zone
The third session will consider when continued observation is no longer appropriate, how to choose between topical therapy, selective laser trabeculoplasty, or watchful waiting, and how best to approach the persistently non-adherent patient. The session will also address the critical issue of timing, particularly in identifying the optimal window for surgical referral.
Optometry Australia has accredited this programme with 6.5T (6i) CPD.
ODOB – has accredited this programme with 6.16 points (.33 ethical). Certificates for those attending will be issued at the end of the day.
When: Sunday 2 August, 9am – 5pm (NZST), Hunua Room, Aotea Centre, Auckland, New Zealand with FREE parking or online.
