Glaucoma: now and beyond

The glaucomas are a group of conditions leading to irreversible sight loss and characterised by progressive loss of retinal ganglion cells. Although not always elevated, intraocular pressure is the only modifiable risk factor demonstrated by large clinical trials. It remains the leading cause of irreversible blindness, but timely treatment to lower intraocular pressure is effective at slowing the rate of vision loss from glaucoma. Methods for lowering intraocular pressure include laser treatments, topical medications, and surgery. Although modern surgical innovations aim to be less invasive, many have been introduced with little supporting evidence from randomised controlled trials. Many cases remain undiagnosed until the advanced stages of disease due to the limitations of screening and poor access to opportunistic case finding. Future research aims to generate evidence for intraocular pressure-independent neuroprotective treatments, personalised treatment through genetic risk profiling, and exploration of potential advanced cellular and gene therapies.

Automated summary

Glaucomas are a group of conditions that cause irreversible sight loss due to progressive loss of retinal ganglion cells. Intraocular pressure, although not always elevated, has been identified as the only modifiable risk factor. Timely treatment to lower intraocular pressure is effective in slowing down the vision loss caused by glaucoma. Methods for lowering intraocular pressure include laser treatments, topical medications, and surgeries. However, the introduction of many surgical innovations has lacked supporting evidence from randomized controlled trials. Screening limitations and poor access to opportunistic case finding often result in undiagnosed cases until the disease reaches advanced stages.