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Global Eye Health 2026: Tackling Glaucoma Disparities · Glaucoma, Vision & Longevity: Supplements & Science

• 0:00
  SPEAKER_00: Global Eye Health 2026, Tackling Glaucoma Disparities.
• 0:04
  SPEAKER_00: Evidence reviewed through June 30th, 2026.
• 0:08
  SPEAKER_00: Glaucoma is often called a silent thief of sight because it can damage the optic nerve for years before a person notices a problem.
• 0:15
  SPEAKER_00: Once vision is lost, it usually cannot be restored.
• 0:19
  SPEAKER_00: However, early detection, pressure-lowering treatment, laser therapy, and surgery can often slow or stop further damage.
• 0:26
  SPEAKER_00: The global glaucoma challenge is therefore not simply a lack of effective treatments.
• 0:31
  SPEAKER_00: It is a problem of late detection, unequal access, medicine cost, weak referral systems, limited surgical capacity, and difficulty maintaining lifelong care.
• 0:41
  SPEAKER_00: These problems are most severe in low resource settings, rural communities, and groups facing financial or gender-related barriers.
• 0:49
  SPEAKER_00: The global glaucoma burden in 2026.
• 0:52
  SPEAKER_00: There is no single real-time worldwide glaucoma census.
• 0:56
  SPEAKER_00: Different studies measure different outcomes.
• 0:58
  SPEAKER_00: Total glaucoma disease includes people with early disease who may have no symptoms.
• 1:03
  SPEAKER_00: Glaucoma-related blindness counts people whose glaucoma has caused profound vision loss.
• 1:08
  SPEAKER_00: Disability-adjusted life years measure the combined effect of disability and premature loss of healthy life.
• 1:16
  SPEAKER_00: These measures should not be treated as interchangeable.
• 1:20
  SPEAKER_00: For the full table, please open this article on VisualFieldTest.com.
• 1:24
  SPEAKER_00: The long-standing global projection of 76 million people with glaucoma in 2020 and 111.8 million by 2040 comes from a systematic review of population eye studies.
• 1:37
  SPEAKER_00: The 2024 Global Analysis of Glaucoma-related vision loss estimated 3.61 million people were blind and 4.14 million had moderate to severe vision impairment because of glaucoma in 2020.
• 1:51
  SPEAKER_00: A study published online in June 2026 using Global Burden of Disease 2021 data found that the absolute number of modeled glaucoma cases increased by approximately 86% between 1990 and 2021, even though age-standardized prevalence and disability-adjusted life year rates declined.
• 2:12
  SPEAKER_00: Population growth and aging explain much of this apparent contradiction.
• 2:17
  SPEAKER_00: The risk at a given age may be falling, but more people are reaching the ages when glaucoma becomes common.
• 2:23
  SPEAKER_00: Regional disparities are marked Sub-Saharan Africa, high disease burden, and late presentation.
• 2:29
  SPEAKER_00: Sub-Saharan Africa continues to experience the highest age-standardized burden of glaucoma-related blindness and moderate to severe vision impairment.
• 2:39
  SPEAKER_00: In the 2020 global analysis, the age-standardized prevalence of glaucoma-related blindness among people aged 50 years and older was approximately 0.66% in sub-Saharan Africa, compared with 0.20% globally.
• 2:54
  SPEAKER_00: The region also had the highest age-standardized prevalence of glaucoma-related moderate to severe vision impairment.
• 3:01
  SPEAKER_00: A 2025 systematic review and Bayesian meta-analysis estimated glaucoma prevalence in Africa at 5.59%, with primary open-angle glaucoma accounting for approximately 5.07%.
• 3:15
  SPEAKER_00: The pooled prevalence was highest in Southern Africa and lowest in East Africa, although the authors noted substantial variation between countries and studies.
• 3:24
  SPEAKER_00: Nigeria illustrates the scale of the problem.
• 3:27
  SPEAKER_00: A national population survey estimated glaucoma prevalence at approximately 5.02% among people aged 40 years and older.
• 3:36
  SPEAKER_00: In clinical and outreach settings, many people present after substantial damage has already occurred.
• 3:42
  SPEAKER_00: These findings should not be interpreted as evidence that every Nigerian patient is diagnosed late, but they demonstrate the consequences of limited case detection and weak access to continuing care.
• 3:55
  SPEAKER_00: The problem is intensified by workforce distribution.
• 3:58
  SPEAKER_00: A review of glaucoma needs among people of African descent reported that most ophthalmologists in Africa work in urban centers, while much of the population lives in rural areas.
• 4:10
  SPEAKER_00: It also cited estimates that approximately 90% of people with glaucoma in Africa may be unaware that they have the disease, although this figure comes from older and heterogeneous sources and should be interpreted cautiously.
• 4:24
  SPEAKER_00: Asia, large absolute numbers and angle closure risk.
• 4:28
  SPEAKER_00: Asia contains a large share of the global population and therefore carries a substantial absolute glaucoma burden, even where prevalence rates are lower than those reported in parts of Africa.
• 4:38
  SPEAKER_00: The pattern of glaucoma also differs.
• 4:41
  SPEAKER_00: Primary angle closure glaucoma is more common in many East and Southeast Asian populations than in people of European ancestry.
• 4:49
  SPEAKER_00: It can cause rapid and severe visual loss, particularly when an acute pressure crisis occurs.
• 4:56
  SPEAKER_00: Primary open-angle glaucoma remains important throughout Asia, especially as populations age.
• 5:03
  SPEAKER_00: In younger regions of South and Southeast Asia, glaucoma may represent a smaller proportion of all blindness because cataract and other conditions remain more common.
• 5:12
  SPEAKER_00: This does not mean the glaucoma burden is small.
• 5:15
  SPEAKER_00: As life expectancy rises, the number of people needing long-term glaucoma monitoring is expected to increase.
• 5:21
  SPEAKER_00: Europe and North America, better access, but underdiagnosis remains common.
• 5:26
  SPEAKER_00: High-income health systems generally have more ophthalmologists, diagnostic equipment, medicines, and insurance coverage, yet they have not eliminated the detection gap.
• 5:35
  SPEAKER_00: A 2025 analysis of 55,415 participants from seven European countries estimated glaucoma prevalence at 2.99% among adults aged 40 years and older.
• 5:47
  SPEAKER_00: More than half of cases, 56.4%, had not previously been diagnosed.
• 5:52
  SPEAKER_00: In people younger than 50 years, the proportion of undiagnosed disease exceeded 80%.
• 5:58
  SPEAKER_00: Applying these estimates to the European population produced an estimate of 12.26 million people with glaucoma in 2024, including 6.86 million who were undiagnosed.
• 6:11
  SPEAKER_00: High-income countries had the highest proportion of blindness attributed to glaucoma in the 2020 global analysis, approximately 26%.
• 6:20
  SPEAKER_00: This does not mean that high-income countries had the highest glaucoma blindness rate.
• 6:25
  SPEAKER_00: Rather, cataract and other treatable causes of blindness are more often managed, leaving glaucoma as a larger share of the remaining blindness burden.
• 6:34
  SPEAKER_00: The Caribbean and African descended populations.
• 6:38
  SPEAKER_00: People of African descent, including African Caribbean populations, have a higher risk of primary open-angle glaucoma and may develop it at younger ages.
• 6:48
  SPEAKER_00: The disease may also progress more aggressively in some patients.
• 6:52
  SPEAKER_00: Barbados and several other Caribbean countries have reported a particularly high contribution of glaucoma to blindness.
• 7:00
  SPEAKER_00: These risks interact with social conditions.
• 7:03
  SPEAKER_00: High medicine prices, missed appointments, limited surgical capacity, and mistrust after poor surgical experiences can produce severe disease even where specialist services technically exist.
• 7:15
  SPEAKER_00: Why people are missed or untreated.
• 7:18
  SPEAKER_00: Glaucoma is usually asymptomatic early.
• 7:21
  SPEAKER_00: Early glaucoma often causes no pain and does not noticeably reduce central vision.
• 7:26
  SPEAKER_00: People may continue reading, working, and driving while peripheral vision is gradually lost.
• 7:31
  SPEAKER_00: This makes glaucoma different from conditions that encourage people to seek care quickly.
• 7:36
  SPEAKER_00: A person may not feel an immediate benefit from eye drops, while side effects, inconvenience, and cost occur every day.
• 7:43
  SPEAKER_00: This is one reason why diagnosis alone is not enough.
• 7:47
  SPEAKER_00: Patients must be able to start, continue, and monitor treatment.
• 7:51
  SPEAKER_00: For this reason, the most practical approach is usually targeted case finding, followed by confirmatory assessment, rather than referring every person with one abnormal screening measurement directly into lifelong treatment.
• 8:04
  SPEAKER_00: National Institute for Health and Care Excellence guidance describes a two-stage assessment in which an initial abnormal result is confirmed through a more detailed examination.
• 8:15
  SPEAKER_00: Affordability affects every stage of care.
• 8:19
  SPEAKER_00: The cost of glaucoma care includes more than the price of an eye drop patients may need to pay for, transport to a clinic, several diagnostic tests, repeated visits, medicines for the rest of their lives, time away from work or caregiving, surgery and postoperative reviews, travel to a distant referral hospital.
• 8:39
  SPEAKER_00: A worldwide comparison of glaucoma treatment prices found that affordability varied greatly by country and household income.
• 8:46
  SPEAKER_00: Timolol was generally the least expensive medicine, but the overall cost of treatment, laser, and surgery could still be substantial relative to household income in lower-income countries.
• 8:58
  SPEAKER_00: A 2024 Ghanaian cost of illness study found an average patient cost of approximately 60.78 for glaucoma management.
• 9:08
  SPEAKER_00: Direct costs accounted for about 94% of the total, with medicines responsible for 42% and laboratory or diagnostic services for 26%.
• 9:17
  SPEAKER_00: Some patients paid out of pocket for TML, even though they expected it to be covered by the national insurance system.
• 9:24
  SPEAKER_00: These findings support a shift from isolated fee waivers to broader financial protection.
• 9:30
  SPEAKER_00: Essential medicines, diagnostic testing, transport support, and surgery all need to be considered.
• 9:37
  SPEAKER_00: Adherence is a health system issue, not simply a patient issue.
• 9:41
  SPEAKER_00: Common barriers to using glaucoma medicines include forgetting doses, difficulty putting drops into the eye, poor vision or arthritis that makes bottle handling difficult, complex schedules involving several medicines, eye irritation and other side effects, lack of understanding about an asymptomatic disease, medicine shortages, long travel distances to pharmacies or clinics, cost and insurance restrictions.
• 10:08
  SPEAKER_00: A systematic review found that the strongest modifiable barriers were related to treatment characteristics, limited understanding, forgetfulness, and difficulty administering eye drops.
• 10:18
  SPEAKER_00: Simpler regimens, better education, and a stronger patient health professional relationship were important facilitators.
• 10:26
  SPEAKER_00: Medication adherence interventions alone have produced mixed results.
• 10:30
  SPEAKER_00: By contrast, interventions that address transportation, appointment scheduling, social support, and referral completion have shown clearer effects.
• 10:39
  SPEAKER_00: Gender and rural urban inequities overlap.
• 10:42
  SPEAKER_00: Biology and social access do not always point in the same direction.
• 10:47
  SPEAKER_00: In the European Prevalence Study, men had higher age-standardized glaucoma prevalence than women.
• 10:52
  SPEAKER_00: Global burden of disease analyses have also reported higher disability-adjusted life years among men.
• 10:59
  SPEAKER_00: However, the 2020 vision loss analysis found that moderate to severe vision impairment due to glaucoma increased more among women than men between 2000 and 2020.
• 11:10
  SPEAKER_00: Gender affects access through caregiving responsibilities, limited control over household finances, restricted mobility, lower healthcare decision-making power, and the need for a companion to travel.
• 11:24
  SPEAKER_00: A 2025 scoping review of eye care interventions identified women-led services, community care, gender-sensitive clinic arrangements, and sex disaggregated data as promising approaches.
• 11:36
  SPEAKER_00: Rural residents face additional barriers, fewer eye care professionals, unreliable transport, weaker medicine supply chains, limited electricity and internet access, and greater distance from surgical centers.
• 11:49
  SPEAKER_00: A study comparing rural and urban glaucoma patients in Ghana found a higher male to female ratio among rural patients and interpreted this mainly as a difference in who reaches care, rather than a clear biological difference in disease risk.
• 12:03
  SPEAKER_00: Scalable models of glaucoma care.
• 12:06
  SPEAKER_00: A supervised task sharing model.
• 12:09
  SPEAKER_00: Task sharing can extend glaucoma services beyond the specialist hospital, but it must be carefully designed.
• 12:15
  SPEAKER_00: A practical model could divide responsibilities as follows.
• 12:19
  SPEAKER_00: Community health workers.
• 12:21
  SPEAKER_00: Explain that glaucoma can be present without symptoms.
• 12:24
  SPEAKER_00: Identify people with a family history or previous diagnosis.
• 12:28
  SPEAKER_00: Check whether patients have run out of medicine, provide appointment reminders, help arrange transport and referrals, train nurses, optometrists, or ophthalmic technicians, measure visual acuity, measure intraocular pressure, take optic nerve or retinal photographs, perform visual field testing where equipment and training permit.
• 12:48
  SPEAKER_00: Identify urgent cases, explain correct eyedrop technique, ophthalmologists or glaucoma specialists, confirm the diagnosis, classify the type and severity of glaucoma, set a treatment target, decide on medicines, laser, or surgery, supervise the lower levels of care through teleconsultation and periodic outreach.
• 13:08
  SPEAKER_00: Task sharing should not rely on symptoms alone.
• 13:11
  SPEAKER_00: A study in three African countries found that common symptoms and signs had poor sensitivity for detecting sight-threatening eye disease when used individually.
• 13:21
  SPEAKER_00: Combining signs improved sensitivity to 80.8%, but specificity was only 53.2%, meaning many people would still need further assessment.
• 13:31
  SPEAKER_00: The lesson is clear.
• 13:32
  SPEAKER_00: Task sharing works best when workers use standardized measurements and referral algorithms, not informal visual inspection alone.
• 13:40
  SPEAKER_00: Community screening linked to guaranteed referral.
• 13:44
  SPEAKER_00: Community screening is useful only when it is connected to diagnosis and treatment.
• 13:48
  SPEAKER_00: In Nigeria, 24 outreach screening events examined 1,881 people and identified 120 people with glaucoma or suspected glaucoma, equivalent to 6.38% of those screened.
• 14:02
  SPEAKER_00: The study compared people identified through outreach with patients who presented directly to a tertiary clinic, highlighting the value of taking services into communities that may not otherwise reach specialist care.
• 14:15
  SPEAKER_00: The Michigan Screening and Intervention for Glaucoma and Eye Health through telemedicine program recruited 1,171 adults from a free clinic and a federally qualified health center.
• 14:27
  SPEAKER_00: Participants were examined by trained technicians, and images and measurements were reviewed remotely by ophthalmologists.
• 14:34
  SPEAKER_00: Glaucoma or suspected glaucoma was identified in 24% of participants, 41% were referred for ophthalmology follow-up, 71% received low-cost glasses, and 99% reported being satisfied or very satisfied.
• 14:49
  SPEAKER_00: The program reported startup costs of approximately US$103,185 and recurring costs of approximately US$248,103 per clinic.
• 15:03
  SPEAKER_00: These United States costs cannot simply be transferred to Africa, Asia, or Latin America.
• 15:08
  SPEAKER_00: They do, however, demonstrate the value of placing screening in trusted community settings and using remote specialist review.
• 15:15
  SPEAKER_00: Patient navigation to close the referral gap.
• 15:18
  SPEAKER_00: Many people who screen positive never reach the next appointment.
• 15:21
  SPEAKER_00: Patient navigation addresses the practical reasons, scheduling, transportation, reminders, insurance, language, and confusion about where to go.
• 15:31
  SPEAKER_00: In a randomized trial involving people identified through community telemedicine screening, a navigation and social work intervention increased attendance at the first local ophthalmology appointment from 39.4%.
• 15:47
  SPEAKER_00: Annual follow-up adherence during the first year increased from 8.1% to 18.6%.
• 15:53
  SPEAKER_00: The more recent New York screening and intervention for glaucoma through telemedicine trial also found higher attendance after community screening when navigators help patients schedule and attend an in-office examination, 51.8% with navigation compared with 38.1% with usual care.
• 16:12
  SPEAKER_00: The navigation calls cost about US$13 per referred participant, and the intervention was estimated to be cost-saving by US$8.78 per randomized participant.
• 16:24
  SPEAKER_00: For low resource settings, navigation does not have to mean a new professional cadre.
• 16:29
  SPEAKER_00: It may be provided by trained community health workers, existing clinic staff, peer supporters, or local volunteers using mobile phones.
• 16:38
  SPEAKER_00: Teleophthalmology with local examination.
• 16:41
  SPEAKER_00: Teleophthalmology can allow a specialist to review photographs and test results without requiring every patient to travel to a city.
• 16:49
  SPEAKER_00: It is most useful when local staff can collect high-quality measurements and when a clear referral pathway exists.
• 16:55
  SPEAKER_00: However, teleophthalmology is not automatically low cost.
• 17:00
  SPEAKER_00: Common barriers include internet connectivity, electricity, equipment maintenance, data protection, staff training, and poor communication after a patient receives a positive result.
• 17:11
  SPEAKER_00: A systematic review of teleophthalmology in low-resource settings found that these practical issues often determine whether a program is sustained.
• 17:20
  SPEAKER_00: The most reliable model is therefore a hub-and-spoke system.
• 17:24
  SPEAKER_00: Local clinics and outreach teams collect standardized information.
• 17:28
  SPEAKER_00: A specialist hub reviews images and measurements.
• 17:31
  SPEAKER_00: Patients with confirmed or urgent disease are referred.
• 17:35
  SPEAKER_00: Local staff continue routine monitoring and medicine support.
• 17:38
  SPEAKER_00: The central service audits outcomes and quality.
• 17:42
  SPEAKER_00: Laser treatment to reduce dependence on eye drops.
• 17:45
  SPEAKER_00: Selective laser trabeculoplasty can reduce reliance on daily eye drops for many people with suitable open-angle glaucoma or ocular hypertension.
• 17:54
  SPEAKER_00: In the light randomized trial, treatment naive patients receiving selective laser trabeculoplasty were within their target pressure range at 93.0% of visits, compared with 91.3% of visits among those starting with eye drops.
• 18:09
  SPEAKER_00: No patients in the laser first group required glaucoma surgery during the trial compared with 11 patients in the eye drop first group.
• 18:17
  SPEAKER_00: The study estimated a 97% probability that laser first treatment was more cost-effective over three years in the United Kingdom.
• 18:26
  SPEAKER_00: The results are encouraging, but the trial was conducted in a well-resourced health system.
• 18:32
  SPEAKER_00: Scaling selective laser trabeculoplasty elsewhere requires reliable equipment, trained personnel, follow-up capacity, and careful patient selection.
• 18:42
  SPEAKER_00: It is not suitable for every type or stage of glaucoma.
• 18:46
  SPEAKER_00: Low-cost surgical pathways.
• 18:48
  SPEAKER_00: For advanced or uncontrolled glaucoma, surgery may be more practical than indefinite medicine use, especially where medicines are expensive or unreliable.
• 18:57
  SPEAKER_00: The Rigay 12 program in Trinidad and Tobago transferred surgical skills for trabeculectomy with mitomycin C using the Moorefield's Safer Surgery System.
• 19:06
  SPEAKER_00: In a retrospective case series of 33 eyes, intraocular pressure was 21 mm of mercury or lower in 92.6% of eyes at one year and 87.5% at five years, with or without medicine.
• 19:20
  SPEAKER_00: 73% of patients had equal or better best corrected visual acuity at final follow-up.
• 19:26
  SPEAKER_00: However, loss to follow-up after five years was 79%, showing that a technically successful operation can still be undermined by weak long-term care.
• 19:36
  SPEAKER_00: A low-cost surgical pathway should therefore include local surgeons trained through supervised skills transfer, standardized surgical protocols, affordable anti-scarring medicines and consumables, a reliable operating theater and sterilization system, early postoperative reviews, access to laser suture adjustment, injections, or needling when needed, transport support for postoperative visits, a registry to track pressure control, complications, vision, and loss to follow-up.
• 20:06
  SPEAKER_00: The OROLAB glaucoma drainage device has been studied as a lower cost alternative to more expensive implants.
• 20:13
  SPEAKER_00: The Ghana primary tube versus trabeculectomy study was designed to compare the device with trabeculectomy using mitomycin C because medicine costs, advanced disease, and poor adherence make medical treatment difficult in West Africa.
• 20:27
  SPEAKER_00: However, the trial registry does not provide posted results, illustrating the need for more publicly available, locally conducted surgical evidence.
• 20:36
  SPEAKER_00: Policy levers with measurable impact.
• 20:40
  SPEAKER_00: Include glaucoma in universal health coverage.
• 20:43
  SPEAKER_00: The World Health Organization's package of eye care interventions is designed to help countries integrate eye care into health service packages, particularly in low and middle income settings.
• 20:53
  SPEAKER_00: It covers interventions across community, primary, secondary, and specialist levels.
• 21:00
  SPEAKER_00: For glaucoma, financial protection should cover more than the first consultation.
• 21:04
  SPEAKER_00: National benefits packages should consider generic pressure lowering medicines, diagnostic testing, selective laser trabeculoplasty where available, trabeculectomy and appropriate drainage devices, postoperative medicines and reviews, transport or referral support for people in remote areas, strengthened procurement and medicine supply.
• 21:26
  SPEAKER_00: A medicine that is listed in a national formulary but is unavailable at the local pharmacy does not provide effective coverage.
• 21:33
  SPEAKER_00: Governments and insurers should use pooled procurement, generic competition, minimum stock levels, and transparent reimbursement.
• 21:41
  SPEAKER_00: The Ghana cost study shows why this matters.
• 21:44
  SPEAKER_00: Medicines were the largest direct cost, and patients paid out of pocket even when insurance coverage was expected.
• 21:52
  SPEAKER_00: Fund referral completion, not just screening numbers.
• 21:56
  SPEAKER_00: Programs should not be judged by the number of people screened alone.
• 22:00
  SPEAKER_00: They should report percentage of people with a positive screen who receive confirmatory examination, time from screening to diagnosis, percentage starting treatment, percentage returning at 12 months, visual field or optic nerve progression, medicine availability, surgery completion and postoperative attendance, patient-reported financial hardship.
• 22:22
  SPEAKER_00: The navigation trials demonstrate that referral completion can improve substantially when it is actively supported.
• 22:29
  SPEAKER_00: Build rural services around regular outreach.
• 22:32
  SPEAKER_00: One-off eye camps may detect disease but are poorly suited to a chronic condition requiring lifelong monitoring.
• 22:38
  SPEAKER_00: Rural programs should combine scheduled mobile clinics, permanent links to district hospitals, local medicine refills, teleconsultation, transport assistance, community health worker follow-up, periodic specialist surgical visits.
• 22:54
  SPEAKER_00: The aim should be continuity rather than a single event.
• 22:57
  SPEAKER_00: Make equity measurable.
• 22:59
  SPEAKER_00: Health ministries and hospitals should report glaucoma data by sex, age, rural or urban residence, income or insurance status, ethnicity or ancestry, where appropriate, and ethically collected.
• 23:11
  SPEAKER_00: Disease stage at diagnosis, distance from the treatment center.
• 23:15
  SPEAKER_00: Without these data, a program may appear successful while missing women, rural residents, poorer patients, or communities at highest biological risk.
• 23:24
  SPEAKER_00: Use the World Health Organization's integrated care framework.
• 23:28
  SPEAKER_00: The World Health Organization recommends integrated people-centered eye care rather than isolated disease programs.
• 23:35
  SPEAKER_00: Its 2030 Global Eye Care targets focus on effective coverage for refractive error and cataract surgery, but glaucoma requires additional chronic care measures because successful treatment depends on repeated monitoring and sustained access to medicines, laser, or surgery.
• 23:52
  SPEAKER_00: A practical implementation roadmap for 2026 to 2030.
• 23:57
  SPEAKER_00: A pragmatic program could proceed in three phases.
• 24:00
  SPEAKER_00: First 12 months, prepare map glaucoma burden, workforce, referral hospitals, pharmacies, and travel distances.
• 24:07
  SPEAKER_00: Select high-risk districts using age, ancestry, family history, and local disease data.
• 24:14
  SPEAKER_00: Define a standard screening and referral algorithm.
• 24:17
  SPEAKER_00: Add essential glaucoma medicines and surgical supplies to procurement plans.
• 24:21
  SPEAKER_00: Establish baseline measures for diagnosis, treatment, follow-up, and financial hardship.
• 24:27
  SPEAKER_00: Years two and three.
• 24:28
  SPEAKER_00: Implement trained community and primary care workers in standardized measurements.
• 24:33
  SPEAKER_00: Establish teleophthalmology links with specialist hubs.
• 24:37
  SPEAKER_00: Add patient navigation to every community screening program.
• 24:40
  SPEAKER_00: Provide regular rural outreach rather than isolated screening campaigns.
• 24:44
  SPEAKER_00: Introduce selective laser trabeculoplasty or low-cost surgery where trained staff and follow-up are available.
• 24:51
  SPEAKER_00: Audit outcomes by sex, rural residence, and socioeconomic status.
• 24:56
  SPEAKER_00: Years four and five.
• 24:57
  SPEAKER_00: Scale and improve.
• 24:58
  SPEAKER_00: Expand only the models that demonstrate completed referrals and sustained follow-up.
• 25:03
  SPEAKER_00: Use local cost and outcome data to revise insurance benefits.
• 25:07
  SPEAKER_00: Create regional surgical training and mentorship centers.
• 25:10
  SPEAKER_00: Publish complications, visual outcomes, and loss-to-follow-up rates.
• 25:15
  SPEAKER_00: Link glaucoma care with diabetes, hypertension, aging, and primary care programs.
• 25:21
  SPEAKER_00: Conclusion.
• 25:22
  SPEAKER_00: The central lesson for global eye health in 2026 is that glaucoma disparities are not caused by a complete absence of effective treatments.
• 25:30
  SPEAKER_00: They are caused by missed disease and interrupted care.
• 25:34
  SPEAKER_00: The most promising response combines targeted community case finding, supervised task sharing, teleophthalmology with local examination, patient navigation, affordable and reliable medicines, selective laser treatment where appropriate, low-cost surgery with strong postoperative follow-up, equity-focused data and financing, a screening program that cannot provide diagnosis is incomplete, a prescription that patients cannot afford is ineffective.
• 26:02
  SPEAKER_00: A successful operation without postoperative care is fragile.
• 26:06
  SPEAKER_00: The Sustainable Solution is a connected system that brings glaucoma detection, treatment, affordability, and long term support into the communities where the burden is greatest.
• 26:17
  SPEAKER_00: All links to sources are available in the text version of this article.
• 26:21
  SPEAKER_00: You can find the full article at VisualFieldTest.com.
• 26:25
  SPEAKER_00: Thanks for listening.
• 26:27
  SPEAKER_00: To check your visual field, click the link at the bottom of this article or visit visualfieldtest.com.