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Vision for 2030: What July 2026 Glaucoma Trends Mean for the Next Four Years · Glaucoma, Vision & Longevity: Supplements & Science

• 0:00
  SPEAKER_00: Glaucoma by 2030, innovations and trends shaping future care.
• 0:04
  SPEAKER_00: Glaucoma, a group of eye diseases that damage the optic nerve and lead to vision loss, already affects tens of millions worldwide and will grow as populations age.
• 0:15
  SPEAKER_00: Today, most patients manage glaucoma with daily eye drops, occasional laser treatments, or surgery.
• 0:21
  SPEAKER_00: But new research, new rules, and new care models are coming that could change how patients are screened, monitored, and treated by 2030.
• 0:30
  SPEAKER_00: This article reviews cutting-edge trends as of mid-2026 in glaucoma research and development, RD, regulation, care delivery, and economics to forecast what glaucoma care might look like by 2030.
• 0:43
  SPEAKER_00: In particular, we explore three emerging approaches: sustained release, depot therapies, artificial intelligence, AI-enabled screening, and home monitoring, examining optimistic and cautious adoption scenarios for each, along with barriers and enablers.
• 1:00
  SPEAKER_00: We also outline likely health policy milestones, e.g., screening guidelines, reimbursements, and workforce needs, glaucoma specialists and allied staff to meet future demand.
• 1:11
  SPEAKER_00: Finally, we suggest key metrics like detection rates, treatment adoption, and disease control, that clinics and researchers should track each year to stay on course.
• 1:20
  SPEAKER_00: Innovation trends in glaucoma RD and care.
• 1:23
  SPEAKER_00: New treatment options.
• 1:25
  SPEAKER_00: Recent years have seen major innovation in how we treat glaucoma.
• 1:29
  SPEAKER_00: One big area is sustained release drug delivery.
• 1:32
  SPEAKER_00: Instead of daily eye drops, which many patients find hard to use exactly every day, doctors are developing implants and devices that slowly release pressure-lowering drugs over months.
• 1:43
  SPEAKER_00: The first FDA-approved example is Dorista, a tiny biodegradable implant placed inside the eye that slowly releases bimatoprost, a prostaglandin analog, and can control eye pressure for about four months.
• 1:55
  SPEAKER_00: Another is IDOSTR, glucose, an anchored titanium implant that releases travoprost.
• 2:02
  SPEAKER_00: In trials it matched twice daily eye drops while freeing 81% of patients from drops at 12 months.
• 2:08
  SPEAKER_00: Eye doctors expect even more of these devices soon.
• 2:12
  SPEAKER_00: For example, a review notes that while Durista is currently the only U.S.
• 2:16
  SPEAKER_00: approved sustained release glaucoma therapy, several other drug-alluding implants, trabecular meshwork inserts, punctal plugs, drug-coded lenses, are in clinical trials.
• 2:27
  SPEAKER_00: One promising approach is the BIM IOL spyglass, an ordinary intraocular lens, like those used in cataract surgery, fitted with a bimatapost drug pad.
• 2:36
  SPEAKER_00: In a 2026 study, a single BIM IOL inserted at cataract surgery allowed 97% of glaucoma patients to stop all other pressure drops for at least a year.
• 2:47
  SPEAKER_00: Other new medications are coming too.
• 2:49
  SPEAKER_00: For example, novel eye drops with new targets, like nitric oxide donors and EP2 receptor agonists are in late-stage trials or recently approved.
• 2:58
  SPEAKER_00: These include roclatan, lenostrosol, omlanti, ominopag isopropyl, and others in testing.
• 3:04
  SPEAKER_00: A 2026 glaucoma pipeline review notes a rich, expanding array of treatments, from new eyedrop drugs and combinations to implants.
• 3:14
  SPEAKER_00: These advances reflect a shift toward earlier and interventional treatment using lasers and devices instead of just waiting until vision worsens.
• 3:23
  SPEAKER_00: Already, trials like the Light study have shown that early laser trabeculoplasty can effectively lower pressure long term, influencing practice patterns.
• 3:32
  SPEAKER_00: Despite all this innovation, some things remain experimental.
• 3:36
  SPEAKER_00: Doctors remain hopeful but cautious about neuroprotective or regenerative therapies aimed at healing nerve cells or restoring the drainage tissue.
• 3:45
  SPEAKER_00: None are standard yet.
• 3:47
  SPEAKER_00: As one expert panel noted, stem cell or gene approaches are areas of intense scientific interest, but still largely early stage.
• 3:56
  SPEAKER_00: Guidelines are focusing more on proven tools.
• 3:59
  SPEAKER_00: Non-medical strategies like patient education about adherence and lifestyle are also highlighted since consistent medication use is crucial for good outcomes.
• 4:09
  SPEAKER_00: Artificial intelligence and digital tools.
• 4:12
  SPEAKER_00: Artificial intelligence, AI, is another hot area.
• 4:15
  SPEAKER_00: Researchers are developing AI software to analyze eye scans or photos and catch glaucoma earlier.
• 4:21
  SPEAKER_00: For example, deep learning algorithms have shown high sensitivity and specificity for detecting glaucoma from optic nerve images.
• 4:29
  SPEAKER_00: A 2025 review found AI methods that automatically segment the optic disk in photos and match experts' accuracy.
• 4:37
  SPEAKER_00: In other words, AI can look at a retina picture or OCT scan and flag glaucoma risk, sometimes even before obvious symptoms show.
• 4:45
  SPEAKER_00: These algorithms can sift through data at lightning speed.
• 4:49
  SPEAKER_00: One clinician points out that AI could combine imaging, patient records, and visual field tests to predict who is most at risk.
• 4:56
  SPEAKER_00: AI isn't magic though.
• 4:58
  SPEAKER_00: Experts note many challenges.
• 5:00
  SPEAKER_00: Existing studies often use limited non-diverse data sets.
• 5:04
  SPEAKER_00: Models must be trained on more early-stage disease cases, and AI tools must fit into clinic workflows.
• 5:10
  SPEAKER_00: Current AI systems typically automate only parts of the exam, like reading an image.
• 5:16
  SPEAKER_00: Challenges highlighted include data quality and generalizability, ensuring the AI works for different ethnic groups and camera types.
• 5:24
  SPEAKER_00: There are also questions of liability: who's responsible if AI misses a problem, and reimbursement, will insurers pay for the tests?
• 5:32
  SPEAKER_00: So far, no AI device is FDA approved specifically for glaucoma screening, but regulatory bodies like the US FDA and international agencies are actively working on rules for AI-based medical devices.
• 5:46
  SPEAKER_00: For example, FDA updates now tag devices that use modern AI technology, and early principles for AI and health have been published by the FDA, Health Canada, and UK regulators.
• 5:57
  SPEAKER_00: These steps pave the way for AI adoption by clarifying what oversight is needed.
• 6:02
  SPEAKER_00: AI can already improve aspects of care.
• 6:04
  SPEAKER_00: Systems used for diabetic retinopathy screening provide a model.
• 6:08
  SPEAKER_00: Clinics without eye doctors can take a retina photo, have AI analyze it, and identify patients needing referral.
• 6:15
  SPEAKER_00: Early adopters report that such systems save patient time and increase exam capacity.
• 6:21
  SPEAKER_00: We may see similar setups for glaucoma, AI software reading retinal photos in primary care or optometry settings to catch glaucoma red flags early.
• 6:30
  SPEAKER_00: But it will take a few years of evidence and regulatory review to know exactly how to roll this out widely.
• 6:37
  SPEAKER_00: Remote and home monitoring.
• 6:44
  SPEAKER_00: Glaucoma is a chronic disease, so doctors see patients perhaps two to four times a year to check eye pressure and vision.
• 6:50
  SPEAKER_00: However, those snapshots may not capture the full picture of disease progression.
• 6:56
  SPEAKER_00: New home monitoring devices are emerging to fill the gaps.
• 6:59
  SPEAKER_00: The best known is home tonometry.
• 7:02
  SPEAKER_00: These are portable instruments, like the eye care home rebound tonometer that let patients check their own eye pressure at home several times a day if needed.
• 7:11
  SPEAKER_00: Clinical studies have found eye care home readings correlate well with the gold standard Goldman tonometer done in a clinic.
• 7:19
  SPEAKER_00: Importantly, home checks can reveal pressure spikes that are missed when measurements are only taken during office visits.
• 7:26
  SPEAKER_00: A recent review noted that peak out-of-office pressures are often higher than those measured in clinic, and devices like eye care home can catch these hidden peaks.
• 7:37
  SPEAKER_00: Regular home IOP monitoring could help doctors adjust treatment more precisely.
• 7:42
  SPEAKER_00: Other home tests include virtual reality, VR perimetry, and smartphone vision tests.
• 7:47
  SPEAKER_00: For example, head-mounted VR devices like Visual allow patients to do a visual field test at home, mapping their vision without needing a bulky in-clinic machine.
• 7:58
  SPEAKER_00: Trials of these tools have shown they can closely match standard visual field results.
• 8:03
  SPEAKER_00: Similarly, smartphone tablet apps, like the Melbourne Rapid Fields app let patients do basic vision checks at home with data sent to the clinic.
• 8:12
  SPEAKER_00: A 2025 systematic review of telemonitoring found these home VF and home pressure tools are not only feasible but cost-effective.
• 8:20
  SPEAKER_00: They reduce patient travel and wait times and improve satisfaction.
• 8:25
  SPEAKER_00: In summary, technical feasibility is there.
• 8:28
  SPEAKER_00: Many studies report that home tests give results very similar to clinic tests.
• 8:33
  SPEAKER_00: Barriers remain, however.
• 8:35
  SPEAKER_00: Many patients, older adults, may struggle to perform tests correctly without help.
• 8:40
  SPEAKER_00: Devices like iCare Home can be expensive, thousands of dollars, and insurance coverage for home monitoring is still limited.
• 8:48
  SPEAKER_00: Some virtual field tests require a smartphone or computer and good understanding of the app.
• 8:53
  SPEAKER_00: Finally, doctors must handle large amounts of patient-generated data.
• 8:58
  SPEAKER_00: As one specialist notes, we now have the tools, but key questions are how to integrate them in the right way for routine care.
• 9:06
  SPEAKER_00: Implementing these tools will require training staff, setting up data platforms, and getting payers to reimburse remote testing.
• 9:14
  SPEAKER_00: Enablers include patients' desire to avoid frequent clinic trips and the healthcare system's push for telehealth.
• 9:21
  SPEAKER_00: Many clinics have already started teleglaucoma programs where techs gather test data remotely for later review by doctors.
• 9:29
  SPEAKER_00: The pending shortage of specialists, see below, may also drive wider use of optometrists and telemedicine teams, with home monitoring devices helping support non-ophthalmologists manage stable patients.
• 9:42
  SPEAKER_00: In summary, moderately fast adoption of home testing by 2030 is plausible if cost and training issues are addressed.
• 9:50
  SPEAKER_00: Policy milestones and care models.
• 9:53
  SPEAKER_00: Screening guidelines and reimbursement.
• 9:55
  SPEAKER_00: National and international policies will shape how these innovations are used.
• 9:59
  SPEAKER_00: Currently, for example, the U.S.
• 10:00
  SPEAKER_00: Preventive Services Task Force, USPSTF, has an eye insufficient evidence stance on routine glaucoma screening in primary care.
• 10:09
  SPEAKER_00: That means no formal recommendation yet to screen everyone at a certain age with eye tests.
• 10:15
  SPEAKER_00: If, however, robust AI screening tools become available, public health agencies may revisit this.
• 10:21
  SPEAKER_00: By 2030, we might see new guidelines recommending targeted glaucoma screening, e.g., for high-risk groups, using advanced imaging or AI.
• 10:30
  SPEAKER_00: Reimbursement is another policy area.
• 10:33
  SPEAKER_00: Telemedicine laws loosened during COVID may continue to allow billing for virtual eye exams and home monitoring.
• 10:39
  SPEAKER_00: Payers, Medicare insurers will need codes to cover remote glaucoma tests and fund new treatments.
• 10:46
  SPEAKER_00: For example, creative value-based contracts could pay more for durable implants if they reduce long-term disability.
• 10:53
  SPEAKER_00: Regulatory bodies will also decide on approvals for new devices and algorithms.
• 10:58
  SPEAKER_00: We expect the FDA to clear more AI-based systems, which already review screening tools for other eye diseases, and to set guidelines for new drug-device combos.
• 11:08
  SPEAKER_00: Internationally, the World Health Organization's eye care initiatives, Vision 2030 goals, may push countries to include glaucoma care in health plans.
• 11:18
  SPEAKER_00: If National Health Services adopt cataract surgeries that include glaucoma-lowering IOLs, like BIM IOL, that would be a major step.
• 11:26
  SPEAKER_00: In short, key policy milestones by 2030 could include official recommendations on glaucoma screening, e.g., new USPSTF or WHO guidance, telehealth reimbursement for remote glaucoma monitoring, FDA and equivalent approvals of AI diagnostic devices or new therapies, e.g., implants, gene therapies, funding programs for vision care, workforce training, patient education, economics and health system impacts.
• 11:53
  SPEAKER_00: Glaucoma's economic burden to society is substantial.
• 11:56
  SPEAKER_00: A Finnish study found that beyond the costs of eye doctors and treatments, glaucoma patients had much higher overall health care use due to vision loss and other health issues.
• 12:06
  SPEAKER_00: For example, Finnish glaucoma patients incurred about 2,660 euros more in annual direct medical costs and 4,080 and more in indirect costs, mainly lost productivity per patient than those without glaucoma.
• 12:21
  SPEAKER_00: Nationwide, glaucoma added an extra€202 million euros in health spending and 71 million euros in lost work in Finland alone.
• 12:30
  SPEAKER_00: These numbers highlight that losing vision has ripple effects, falls, injuries, other medical visits.
• 12:37
  SPEAKER_00: By 2030, health systems may push more for prevention because every case of avoidable vision loss means big costs later.
• 12:44
  SPEAKER_00: On the other hand, new technologies often come at a price.
• 12:48
  SPEAKER_00: Durable implants and high-tech monitoring devices can be expensive.
• 12:52
  SPEAKER_00: Health economists will watch whether their long-term benefits, better adherence, fewer vision losses justify costs.
• 12:59
  SPEAKER_00: Payers may demand evidence that a new implant or AI tool not only works clinically, but also reduces downstream costs, like fewer surgeries or nursing home placements.
• 13:10
  SPEAKER_00: Value-based frameworks, common for drugs in some countries, could affect which therapies spread widely.
• 13:16
  SPEAKER_00: For instance, if an intraocular implant costs several thousand dollars, insurers may require data showing it prevents expensive vision decline.
• 13:25
  SPEAKER_00: Given these factors, by 2030 we might see more integrated care models, especially for high-risk patients.
• 13:33
  SPEAKER_00: For example, multidisciplinary teams might monitor glaucoma patients, an ophthalmologist technician in clinic supported by data from the patient's optometrist or home device.
• 13:43
  SPEAKER_00: Community screening programs, perhaps led by optometrists or digital kiosks, could triage those needing a specialist.
• 13:51
  SPEAKER_00: Bundled payment models, paying one rate for a glaucoma episode of care, could incentivize keeping patients stable with cheaper remote tools rather than costly procedures late.
• 14:02
  SPEAKER_00: Economic pressures will likely favor preventing vision loss over waiting until advanced disease.
• 14:07
  SPEAKER_00: Adoption scenarios, depot therapies, AI screening, and home monitoring.
• 14:12
  SPEAKER_00: Looking at the next three to four years, we can sketch best case rapid adoption and worst case slow scenarios for the three big innovations.
• 14:21
  SPEAKER_00: Depot, sustained release therapies.
• 14:24
  SPEAKER_00: Best case, by 2030, widely adopted.
• 14:27
  SPEAKER_00: Drug-alluding implants become common as alternatives to eye drops.
• 14:31
  SPEAKER_00: Most glaucoma specialists offer an implant like Derista or IDOS for patients who struggle with drops.
• 14:37
  SPEAKER_00: Health plans cover them for patients who qualify, for example, those with poor adherence or moderate disease.
• 14:44
  SPEAKER_00: Cataract surgeons routinely consider adding drug-delivering IOLs, like BIM IOL, when a glaucoma patient needs cataract surgery.
• 14:53
  SPEAKER_00: Manufacturing scales up and prices come down due to competition and volume.
• 14:58
  SPEAKER_00: Clinics develop efficient workflows for injection implant procedures.
• 15:01
  SPEAKER_00: As a result, patient use of daily drops falls, adherence improves, and many patients maintain target pressure with fewer office visits.
• 15:09
  SPEAKER_00: Slow adoption scenario.
• 15:11
  SPEAKER_00: Depot therapies remain niche.
• 15:13
  SPEAKER_00: High costs, both product price and the revenue lost to clinics from fewer visits, slow reimbursement.
• 15:20
  SPEAKER_00: Patients hesitate to have an injection or implant surgery.
• 15:23
  SPEAKER_00: Ophthalmologists worry about the new logistics, office procedure time, training.
• 15:28
  SPEAKER_00: Insurers only approve implants for trial use or when all other treatments fail.
• 15:33
  SPEAKER_00: By 2030, only a modest fraction of suitable patients get implants, while most continue on traditional drops.
• 15:40
  SPEAKER_00: Barriers.
• 15:41
  SPEAKER_00: Cost is a big one.
• 15:43
  SPEAKER_00: These implants and surgical lenses can run several thousand dollars, including surgery.
• 15:48
  SPEAKER_00: Clinicians are also cautious about potential side effects.
• 15:51
  SPEAKER_00: For example, Darista has restrictions due to corneal cell loss risk after multiple implants.
• 15:57
  SPEAKER_00: There's also the question of who does it.
• 15:59
  SPEAKER_00: Injectors or surgeons may need new skills or workflow changes.
• 16:03
  SPEAKER_00: And repeat injections, e.g., every 6 to 12 months, raise questions about long-term safety and attendance.
• 16:11
  SPEAKER_00: Enablers.
• 16:12
  SPEAKER_00: Strong trial data can help.
• 16:14
  SPEAKER_00: For example, IDOSE TR showed excellent pressure control with 93% of patients still well managed on one implant at 12 months.
• 16:23
  SPEAKER_00: Patient convenience is an enabler.
• 16:25
  SPEAKER_00: Many patients who struggle with eye drops might eagerly switch to an every few months implant.
• 16:30
  SPEAKER_00: If implant procedures can be bundled into routine visits or into cataract surgery cases as with BIM IOL, adoption will go faster.
• 16:39
  SPEAKER_00: Competition in this field, multiple companies developing implants and sustained release devices, also keeps prices competitive and fosters innovation.
• 16:47
  SPEAKER_00: Regulatory clarity, FDA approvals, or clear guidelines will be key.
• 16:52
  SPEAKER_00: AI-enabled BEST case.
• 16:54
  SPEAKER_00: Effective AI tools for glaucoma screening hit the market by the late 2020s.
• 16:59
  SPEAKER_00: Primary care doctors and optometrists use automated retinal imaging systems with AI that flag suspicious cases.
• 17:06
  SPEAKER_00: For example, portable fundus cameras attached to smartphones, combined with a cloud AI service, can identify glaucoma, glaucoma suspicion on the spot.
• 17:16
  SPEAKER_00: National health services or insurers begin covering AI screening exams for high-risk groups, older adults, African Americans, diabetics.
• 17:24
  SPEAKER_00: Mass screenings might even happen at pharmacies or community centers via AI kiosks.
• 17:29
  SPEAKER_00: As a result, many people with early glaucoma who would otherwise not notice any symptoms get detected and referred sooner.
• 17:36
  SPEAKER_00: Electronic health records seamlessly integrate AI reports.
• 17:40
  SPEAKER_00: Slow adoption scenario.
• 17:42
  SPEAKER_00: Regulators and doctors remain cautious.
• 17:44
  SPEAKER_00: No AI glaucoma detector is approved as a standalone diagnostic device by 2026.
• 17:50
  SPEAKER_00: Pilot projects of AI screening sputter due to technical and legal challenges.
• 17:55
  SPEAKER_00: Payers are reluctant to reimburse AI for glaucoma unless a human confirms it.
• 17:59
  SPEAKER_00: By 2030, AI is mostly used as a research tool or for second opinions in large eye centers, not routine screening.
• 18:07
  SPEAKER_00: Barriers.
• 18:08
  SPEAKER_00: Ensuring accuracy across all patient groups is hard.
• 18:11
  SPEAKER_00: An AI trained mostly on one population may miss glaucoma in others.
• 18:15
  SPEAKER_00: Integration into busy clinics is non-trivial.
• 18:18
  SPEAKER_00: Staff must image eyes properly and send it to the AI system.
• 18:22
  SPEAKER_00: Liability is a concern.
• 18:24
  SPEAKER_00: If an AI misses a case, who's at fault?
• 18:26
  SPEAKER_00: Also, unlike retinal scans for diabetic retinopathy, which focus on one disease, eye exams are holistic.
• 18:33
  SPEAKER_00: The AI would need to decide on multiple conditions: glaucoma, macular degeneration, cataract signs.
• 18:39
  SPEAKER_00: Finally, reimbursement rules lag behind technology.
• 18:43
  SPEAKER_00: Currently, routine glaucoma screenings aren't covered well.
• 18:46
  SPEAKER_00: Experts note that for adopted diagnostic AI, challenges include who bears the liability and how doctors get paid for watching AI reports.
• 18:55
  SPEAKER_00: Enablers.
• 18:56
  SPEAKER_00: AI tools are already proving themselves in related areas.
• 18:59
  SPEAKER_00: Diabetic retinopathy AI, like iArt, IDXDR, are FDA cleared and used in some clinics.
• 19:04
  SPEAKER_00: These pave regulatory pathways for other IAI.
• 19:07
  SPEAKER_00: Large dataset projects like UK Biobank becoming accessible help develop robust glaucoma AI.
• 19:13
  SPEAKER_00: Tech companies and consortia, possibly guided by FDA MHRA principles, can standardize AI development.
• 19:20
  SPEAKER_00: If early wins appear, say a pilot program showing AI screener performs as well as an ophthalmologist for early glaucoma detection, momentum will build.
• 19:29
  SPEAKER_00: As one Fortune KFF article observed, the convenience and immediate results of AI retina exams have been a godsend for patients.
• 19:37
  SPEAKER_00: A similar success could catalyze glaucoma AI adoption.
• 19:40
  SPEAKER_00: Home monitoring best case?
• 19:42
  SPEAKER_00: By 2030, many glaucoma patients have home monitoring devices.
• 19:46
  SPEAKER_00: For example, patients own an eye care home tenometer and measure their IOP weekly or as advised.
• 19:52
  SPEAKER_00: They upload readings automatically to the cloud.
• 19:55
  SPEAKER_00: Visual field tests via VR headsets or smartphone apps are part of home care.
• 20:00
  SPEAKER_00: Program managers or telehealth nurses review patients' home data and adjust treatments between visits.
• 20:06
  SPEAKER_00: Clinics bill insurers for remote check-ins.
• 20:09
  SPEAKER_00: Patients enjoy fewer clinic trips, and doctors get a richer picture of disease.
• 20:14
  SPEAKER_00: Slow adoption scenario.
• 20:16
  SPEAKER_00: Use of home devices is rare.
• 20:19
  SPEAKER_00: The technology is mostly limited to specialty research centers.
• 20:23
  SPEAKER_00: High cost and training requirements limit devices to a small number of adherent patients.
• 20:28
  SPEAKER_00: Data overload and skeptical doctors mean the home readings have little impact on management.
• 20:33
  SPEAKER_00: By 2030, standard care is still office pressure checks two to four times per year.
• 20:39
  SPEAKER_00: Barriers.
• 20:39
  SPEAKER_00: Cost again is key.
• 20:41
  SPEAKER_00: An eye care home tenometer can cost a patient or clinic several thousand dollars.
• 20:46
  SPEAKER_00: Many insurance plans do not cover home devices yet.
• 20:49
  SPEAKER_00: Patients, especially older ones, need training and dexterity to use these gadgets correctly.
• 20:54
  SPEAKER_00: Doctors and staff must also figure out billing.
• 20:57
  SPEAKER_00: Currently, home IOP monitoring does not have a simple code like a lab test does.
• 21:02
  SPEAKER_00: Data security and integration with medical records is another hurdle.
• 21:06
  SPEAKER_00: Enablers, COVID taught both doctors and patients to be more comfortable with remote care.
• 21:12
  SPEAKER_00: Manufacturers are improving ease of use.
• 21:15
  SPEAKER_00: Some clinics already loan instruments to patients between visits.
• 21:19
  SPEAKER_00: Telemedicine reimbursement has become more accepted, and by 2030, clear billing codes for teleye exams may exist.
• 21:27
  SPEAKER_00: Enthusiastic patients who hate frequent office fills may volunteer for home monitoring.
• 21:33
  SPEAKER_00: Studies have shown no high-risk issues with home telometry.
• 21:36
  SPEAKER_00: Indeed, eye care home readings correlate very well with clinic measurements.
• 21:41
  SPEAKER_00: And in some studies, home pressure readings revealed worrisome spikes that the doctor would otherwise have missed.
• 21:46
  SPEAKER_00: These advantages, together with studies like the one noting home based visual field testing, closely matching in clinic tests, suggest growing patient and doctor buy in.
• 21:58
  SPEAKER_00: As one review concludes.
• 22:00
  SPEAKER_00: Telemonitoring in glaucoma is feasible and cost-effective, and helps reduce patient travel and waiting times.
• 22:08
  SPEAKER_00: Ultimately, if payers recognize that intensive monitoring prevents vision loss and its costs, they may help fund home devices speeding adoption.
• 22:17
  SPEAKER_00: Workforce and system needs.
• 22:19
  SPEAKER_00: Glaucoma specialists and allied personnel?
• 22:22
  SPEAKER_00: Trends point to rising demand but relatively flat supply.
• 22:25
  SPEAKER_00: In the U.S., a 2023 projection found that by 2035, the number of ophthalmologists will drop by 12%, while the population's needs grow by 24%.
• 22:36
  SPEAKER_00: That leaves about a 30% shortfall in the ophthalmologist workforce.
• 22:41
  SPEAKER_00: Ophthalmology is expected to have one of the largest shortages of any medical specialty by 2035.
• 22:48
  SPEAKER_00: Similar concerns apply in many countries.
• 22:50
  SPEAKER_00: A 2026 global survey found only 275,000 ophthalmologists worldwide, about 34 per million people, and estimated serious workforce gaps in eye care.
• 23:02
  SPEAKER_00: Optometrists and eye care technicians similarly remain sparse in many regions.
• 23:07
  SPEAKER_00: Glaucoma is especially manpower intensive since it requires frequent monitoring and specialized procedures.
• 23:14
  SPEAKER_00: To keep up, health systems will need to train more eye care professionals and use task sharing.
• 23:20
  SPEAKER_00: For example, increasing ophthalmology residency slots, creating more glaucoma subspecialists, and training optometrists or ophthalmic technicians to do community screening and monitoring.
• 23:31
  SPEAKER_00: Policies might expand optometrist scope, where allowed, to evaluate glaucoma suspects using AI tools.
• 23:37
  SPEAKER_00: New care team models, e.g., ophthalmologist teams led by a glaucoma specialist with support from optometrists, will be important.
• 23:46
  SPEAKER_00: Additionally, educating health providers and primary care doctors on new technologies helps adoption.
• 23:52
  SPEAKER_00: Professionals must stay updated on emerging treatments and workflows.
• 23:56
  SPEAKER_00: Experts emphasize that ongoing learning is needed beyond residency for glaucoma care.
• 24:02
  SPEAKER_00: Support infrastructure.
• 24:04
  SPEAKER_00: Clinics may need more technicians for imaging and monitoring devices, more IT systems for handling remote data, and more time allocated per patient if complexity grows.
• 24:14
  SPEAKER_00: Clinic schedules might adapt to longer visits for new interventions, e.g., preparing for an implant procedure or training home device use.
• 24:23
  SPEAKER_00: Shipping and logistics for devices, like delivering home tenometers to patients, will require planning.
• 24:29
  SPEAKER_00: Health policies should plan funding for training these staff.
• 24:33
  SPEAKER_00: Quality and surveillance.
• 24:35
  SPEAKER_00: Health authorities will likely define glaucoma care quality metrics.
• 24:39
  SPEAKER_00: For example, Portugal recently developed consensus quality indicators for glaucoma clinics, including process measures, did the patient receive all recommended tests on schedule, and outcomes, surgical success rates.
• 24:54
  SPEAKER_00: Similar metrics could be adopted more widely.
• 24:57
  SPEAKER_00: By 2030, we expect quality programs to measure things like percentage of patients having visual field and eye exam per guideline interval, percentage achieving target pressure, and surgery success rates to ensure the system is improving.
• 25:12
  SPEAKER_00: Key metrics to track.
• 25:13
  SPEAKER_00: To adjust strategies year by year, clinics and researchers should monitor a few key indicators.
• 25:19
  SPEAKER_00: Detection rate, what fraction of the population at risk, age groups, receives glaucoma screening.
• 25:25
  SPEAKER_00: How many new glaucoma cases are diagnosed annually?
• 25:28
  SPEAKER_00: Useful for seeing if outreach and screening, AI or otherwise, is effective.
• 25:33
  SPEAKER_00: Disease stage at diagnosis.
• 25:35
  SPEAKER_00: Are more patients being caught early, mild glaucoma versus late?
• 25:39
  SPEAKER_00: Shifts over time indicate screening success.
• 25:42
  SPEAKER_00: Treatment adoption, percent of patients on new therapies, e.g., percentage using sustained release implants or receiving a laser procedure versus traditional drops.
• 25:52
  SPEAKER_00: This shows uptake of innovations.
• 25:54
  SPEAKER_00: Disease control, proportion of patients who maintain target IOP and stable vision fields over a year.
• 26:01
  SPEAKER_00: For example, the percent with no progression on visual field testing, adherence metrics, data on medication adherence or persistence, and conversely, number of drop-free patients with implants or procedures.
• 26:13
  SPEAKER_00: Also, measure how many patients complete scheduled visits tests.
• 26:17
  SPEAKER_00: Vision outcomes, rates of significant vision loss or blindness among all glaucoma patients, tracked annually.
• 26:24
  SPEAKER_00: Declines here would be a win.
• 26:26
  SPEAKER_00: Patient access, wait times for first glaucoma clinic appointment and for surgery.
• 26:31
  SPEAKER_00: This reflects capacity versus demand.
• 26:33
  SPEAKER_00: Healthcare costs, average cost per patient year, including inpatient or other medical costs as glaucoma is linked to other conditions.
• 26:41
  SPEAKER_00: Monitor whether early interventions lower down or downstream costs.
• 26:46
  SPEAKER_00: Workforce indicators, number of glaucoma specialists per million population, and allied personnel over time.
• 26:52
  SPEAKER_00: Also track training seats filled, patient experience, patient-reported outcomes, quality of life, ease of use of new devices.
• 27:00
  SPEAKER_00: For example, tracking vision-related quality of life questionnaires can show if new care models help patients feel safer.
• 27:08
  SPEAKER_00: Collectively, these metrics guide whether the system is moving toward earlier to detection, better outcomes, and efficient use of new tools.
• 27:16
  SPEAKER_00: If screening rates stall or progressions still high, strategies can be revised, e.g., invest more in AI screening.
• 27:24
  SPEAKER_00: If implant use lags despite evidence, policy changes could encourage it.
• 27:28
  SPEAKER_00: These numbers will help doctors and planners course correct on the road to 2030.
• 27:34
  SPEAKER_00: Conclusion.
• 27:36
  SPEAKER_00: The glaucoma care landscape in 2030 will be shaped by how rapidly new technologies and models are adopted.
• 27:42
  SPEAKER_00: Patients may see a world where regular eye drops are often supplemented or replaced by long-lasting implants, where an algorithm highlights glaucoma on a retinal photo taken at the pharmacy or primary care office, and where patients confidently measure their eye pressure at home.
• 28:00
  SPEAKER_00: Reaching that vision requires navigating cost, training, regulation, and clinical workflows.
• 28:06
  SPEAKER_00: Policymakers will need to update guidelines and funding to keep pace.
• 28:10
  SPEAKER_00: Health systems must grow the eye care workforce and invest in data infrastructure.
• 28:15
  SPEAKER_00: Progress should be measured by tracking detection rates, treatment uptake, control of disease, and patient outcomes.
• 28:22
  SPEAKER_00: If clinics and researchers watch these metrics yearly, they can adjust strategies to ensure that by 2030, glaucoma patients enjoy safer vision and easier care than ever before.
• 28:34
  SPEAKER_00: All links to sources are available in the text version of this article.
• 28:38
  SPEAKER_00: You can find the full article at Visual FieldTest.com.
• 28:42
  SPEAKER_00: Thanks for listening.
• 28:43
  SPEAKER_00: To check your visual field, click the link at the bottom of this article or visit visualfieldtest.com.