Ocular Hypertension and Glaucoma in United States Army Personnel: Barriers to Detection and Impact on Operational Readiness

Glaucoma and ocular hypertension rank high among the etiologies of irreversible visual impairment. Their presentation to active-duty United States (US) Army personnel carries unique implications for unit force readiness. Both peripheral and central vision are utilized by soldiers for operational tasks of marksmanship, navigation, and surveillance. Risk factors, including ocular trauma, blast exposure, and systemic corticosteroid use specific to military services, may result in earlier onset or progression of glaucomatous disease. Despite the necessity for soldier visual acuity, routine screenings for ophthalmic disease, including glaucoma and ocular hypertension, remain inconsistent across Army healthcare settings. Limited access to ophthalmologic care in field environments, logistical constraints, and the asymptomatic nature of early disease pose barriers to timely diagnosis. Such untreated cases may directly put individual health and unit readiness at risk, as well as quality of life due to the possibility of vision degradation over time. This narrative review synthesizes literature from PubMed, Google Scholar, and the Cochrane Library between 1999 and 2025 to examine glaucoma and ocular hypertension epidemiology in the US Army. Relevant Department of Defense (DoD) publications, clinical guidelines, and Military Health System (MHS) reports were included in this search. Risk factors, barriers for effective screening, and the evaluation for ocular dysfunction on soldier operational readiness are presented to strengthen screening measures, enhance continued care, and preserve visual performance across the military life cycle for the future.