The Role of Technology in Managing Glaucoma

The key to managing glaucoma lies in early detection and regular, ongoing eye care monitoring – an area where technology now plays an increasingly valuable and significant role. As one of the leading causes of irreversible blindness worldwide, glaucoma often progresses silently, with few noticeable symptoms until significant vision loss has occurred. 

This makes timely diagnosis and consistent follow-up essential to preserving sight. In recent years, advancements in imaging, artificial intelligence, and remote monitoring have transformed how eye care professionals detect, track, and treat the disease. From high-resolution optical coherence tomography (OCT) scans to AI-powered diagnostic tools, these innovations are enhancing the accuracy of assessments and improving patient outcomes. 

Technology that helps optometrists detect and monitor glaucoma

Optical Coherence Tomography (OCT) - This scan is now a standard part of most eye examinations at most practices and is bulk billed with every eye test at Specsavers. It provides a detailed view of the layers in your retina and helps to measure the thickness of the retinal nerve fiber layer—thinning of this layer indicates an early sign of glaucoma. If you already have glaucoma, an OCT scan helps monitor any progression of the disease and guides us in determining whether your treatment needs to be adjusted.

Using OCT to test the anterior segment – In addition to the above, the optometrist may use an OCT to scan the anterior chamber (front section) of the eye, where the eye's natural drainage system is located. When the anterior chamber is too narrow, eye pressure can rise and lead to angle-closure glaucoma, so it is important that your optometrist keeps a close watch on it.  
 
Tonometer – A tonometer is a device that measures your eye pressure. It has been around for many years and manufacturers continue to refine and enhance these devices. A good example of recent innovation is the hand-held tonometer (such as the iCare Home2), which allows individuals to measure their own eye pressure at home over time.  This can help identify pressure spikes that may be harmful to the optic nerve.

Genetic Testing – Some optometrists may also suggest genetic tests to analyse multiple genetic variants that carry the risk for developing primary open angle glaucoma.  These genetic tests can also help to predict the progression of the glaucomatous disease. 

Laser and surgical advancements in managing glaucoma 

There are several procedures that can assist people with glaucoma. The most common are:

1. Selective Laser Trabeculoplasty (SLT) - A laser procedure that targets the melanin or pigment in the eye’s natural drainage system (trabecular meshwork) to better regulate fluid outflow and reduce eye pressure.

2. Minimally Invasive Glaucoma Surgery (MIGS) - A group of surgical techniques that are less invasive in lowering eye pressures e.g. Xen Gel Stent, Hydrus Microstent, iStent. 

If you have any questions about these, your optometrist or ophthalmologist can explain them to you in more detail.

Future directions in technology for managing glaucoma 

We’re living in a world where technology is consistently being developed to assist people with glaucoma. Here are a couple of emerging trends that may benefit people with glaucoma:

Artificial Intelligence (AI) - AI and its role in eyecare is currently being researched. The goal is to assist early detection of glaucoma by analysing visual field tests and OCT scans.  

Implantable Drug Eluting Devices - An implant that is surgically placed in the eye that releases eye pressure lowering therapeutic drug directly into the eye.  
 
Technology is giving us powerful tools to detect glaucoma early, monitor it closely, and treat it more effectively. Optometrists and ophthalmologists use these tools to protect your vision and help you live well with glaucoma.

As we continue to embrace these technologies, the future of glaucoma care promises to be more proactive, personalised, and precise than ever before.

If you have questions about any of these technologies or treatments, feel free to discuss them at your next eye health appointment. Together your optometrist and ophthalmologist can build a care plan that is best suited for you.

References 
1. Wagner IV, Stewart MW, Dorairaj SK. Updates on the diagnosis and management of glaucoma. 
Mayo Clinic Proceedings: Innovations, Quality & Outcomes. 2022 Dec;6(6):618–35. 
doi:10.1016/j.mayocpiqo.2022.09.007  
2. Lee JWY, Chan PP, Zhang X, Chen LJ, Jonas JB. Latest developments in normal-pressure glaucoma: 
Diagnosis, epidemiology, genetics, etiology, causes and mechanisms to management. Asia-Pacific 
Journal of Ophthalmology. 2019 Nov;8(6):457–68. doi:10.1097/01.apo.0000605096.48529.9c  
3. Alon S. Selective Laser Trabeculoplasty: A Clinical Review. JOURNAL OF CURRENT GLAUCOMA PRACTICE [Internet]. 2013 May 9;7(2):58–65. Available from: 
https://doi.org/10.5005/jp-journals-10008-1139