Despite increasingly sophisticated imaging and artificial intelligence (AI), eye health professionals are still regularly faced with glaucoma patients whose findings simply don’t fit neatly into established algorithms.
It is these challenges that will take centre stage at The Grey zones of glaucoma: Uncertainty, judgement, and decision making in everyday practice, a one-day Glaucoma New Zealand symposium taking place on Sunday 2 August in Auckland and online.
Rather than focusing on textbook cases, the conference has been designed around the everyday clinical dilemmas that prompt clinicians to weigh competing management options.
The conference is… built around the concept that uncertainty is not a failure of knowledge but an unavoidable part of glaucoma care.
One of the program’s standout sessions will be Case Battles, in which five complex glaucoma cases will be debated in real time. The session is intended to demonstrate that experienced clinicians can arrive at different, but equally defensible, management decisions when presented with the same patient.
The conference is led by Professor Dame Helen Danesh-Meyer CNZM and built around the concept that uncertainty is not a failure of knowledge but an unavoidable part of glaucoma care.
The emphasis throughout the day is on sharpening clinical judgement – understanding how to interpret imperfect information, when intervention is appropriate, and when continued observation may be the safer option.
The opening keynote from Professor Keith Martin, from the University of Melbourne, will explore how AI, home monitoring and advanced imaging are transforming glaucoma care. While these technologies continue to improve clinicians’ ability to detect and monitor disease, they also introduce new forms of uncertainty that require careful interpretation rather than unquestioning acceptance.
Conference Program
The program is organised around three key areas – diagnosis, testing, and management – with sessions addressing many of the scenarios encountered in routine practice. Discussions will examine how to distinguish physiological cupping from early glaucomatous change, interpret discordant optical coherence tomography (OCT) and visual field findings, and determine whether apparent progression represents true disease or testing artefact. Speakers will also consider how intraocular pressure should be interpreted within the context of an individual patient’s overall risk profile.
Other presentations will explore emerging evidence surrounding nocturnal physiology, sleep, posture, corneal properties beyond central corneal thickness, and systemic and vascular risk factors, alongside ongoing controversies in angle-closure glaucoma. Rather than simply presenting new evidence, presenters will examine whether it should meaningfully influence clinical management.
Management sessions will focus on practical treatment decisions, including when to continue observation, when to initiate topical therapy, where selective laser trabeculoplasty fits into care, how to manage patients who struggle with adherence, and recognising the appropriate timing for surgical referral. A rapid-fire session led by Prof Danesh-Meyer will further reinforce clinical decision making through a series of challenging cases reflecting the pace of everyday practice.
The Grey Zones of Glaucoma: Uncertainty, Judgement, and Decision Making in Everyday Practice will be held on Sunday 2 August at the Hunua Room, Aotea Centre, Auckland, with online attendance also available.
