Challenges and Unmet Needs in the Diagnosis and Management of Glaucoma: Recommendations for Future Research and Practice

Prompt diagnosis of glaucoma is vital for treating and lowering intraocular pressure. However, delayed disease presentation or diagnosis, and poor treatment adherence leads to challenges in glaucoma management. This paper aims to provide expert insights on current challenges and unmet needs in glaucoma diagnosis and management. A forum of an international panel of experts on glaucoma took place in June 2023. Insights from this forum and extensive literature search on glaucoma diagnosis and management were reviewed. Key challenges to diagnosis and management of glaucoma include delay in disease presentation, lack of awareness of the disease in patients and non-specialist healthcare professionals, lack of screening tests, paucity of qualified specialists, poor access to facilities and limited treatment options. For early diagnosis, targeted engagement, education and implementation of guideline-based screening and diagnosis recommendations are required. Poor adherence to treatment can be due to existing modes of drug administration and side effects. Support to ophthalmologists, training, patient education/ awareness to treatment adherence, modes of drug administration, screening practices and access to glaucoma services need to be improved for better outcomes. Challenges to glaucoma care are seen across nations, but strategies should be targeted at local and regional levels.