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The Future of Glaucoma
A clear vision for a better tomorrow: The Future of Glaucoma can be brighter
A shared vision of the future of glaucoma care
Glaucoma patients and healthcare professionals have different perspectives on glaucoma care, but they share many of the same priorities, finds Michael Marshall
This article was commissioned and funded by Santen.
To map out a possible future for glaucoma care over the next decade, we consulted both glaucoma care specialists and glaucoma patients and sought to obtain a holistic view of the challenges of the current system and how it could be improved – both in terms of direct outcomes, like preserving vision, and the patient experience.
In this article, we outline how glaucoma patients want to see the service improved. We then compare this to a proposed future of glaucoma care, which was developed by healthcare professionals in a workshop. Naturally, these two groups may approach glaucoma care from different perspectives, but most of their preferences are at least consistent, and many of them are aligned.
We recommend reading this article first to get an overview of the proposed future for glaucoma care. Afterwards, you can explore the remaining articles, which explore five enablers of improved glaucoma care that have the power to make that future a reality.
What matters to patients and what could be improved
Kay Fisher, of patient experience company Experience Engineers, carried out our research into the experience of patients today and their recommendations on what could improve glaucoma care in the future. Fisher conducted a series of small, online focus groups, as well as qualitative interviews with glaucoma patients from minority and ethnic groups (see BOX: Patient research methodology).
Patients had very low levels of knowledge about risk factors for glaucoma, such as family history, before their glaucoma diagnosis.3 In particular, they reported that opticians and optometrists did not convey the risk factors – or at least did not do so strongly.3 This was compounded by GPs not emphasising the need to have glaucoma checks, and by the reluctance of some communities to talk about health issues.3
The glaucoma patients also complained of three recurring issues. They felt disconnected from their condition: the diagnosis was usually a shock as they had no prior knowledge of glaucoma, and even post-diagnosis they had little appreciation of their personal risk.3 They had no sense of personalised attention based on their risk factors and the progression of their particular glaucoma.3 And they encountered gaps in the glaucoma care system, finding themselves shunted between different providers with little or no explanation.3
“Unfortunately, patients began their experience with glaucoma in a state of shock – the news of their diagnosis took them by surprise. This disconnect between their own perception of their eye health, and their ‘enrolment’ and ‘journey’ within the care process, never really gets resolved,” states Fisher.
Patients in minority ethnic groups and/or of low socioeconomic status face additional barriers to glaucoma care.4,5 They often perceive visits to the optician as being about vision, not eye health. They may also have low levels of trust in opticians, due to their concern that they will be sold expensive glasses if they attend.3,4 Members of some ethnic minority groups often have a low awareness of risk and may not talk about health issues.6 This is compounded by glaucoma messaging that is not specific to them: for example, not available in their first language.7 See Health Equity and Access.
“Looking to the future, the patients emphasised the need to ‘get the basics right’ so that they could live well with their glaucoma,” says Fisher. More specifically, Fisher identified six recurring themes in the focus groups and interviews.3 Glaucoma patients would like:3
- Accurate, targeted testing. Patients want more emphasis on the need for regular glaucoma testing, as they feel they are being picked up by chance. They also call for targeted messaging for those at greatest risk of sight loss.
- Swift diagnosis. Patients want to wait no more than two weeks to have their diagnosis confirmed. They also want to be told straightaway what their referral is for – some only discovered it was for glaucoma when they found themselves at a glaucoma clinic.
- Options and reassurance. Starting with their first glaucoma appointment, patients want a clear explanation of the major options available to them, both immediately and in the future. Having a clear picture of their long-term management options enabled joint decision-making and reduced anxiety.
- Joined-up care. Patients are eager for more clarity on decision pathways and who is responsible for what, so that they can understand why they are seeing different healthcare providers. Likewise, they want reassurance that all the key stakeholders in their care have the right information to recommend the best treatments.
- Ownership. Patients want clarity on which clinician has clinical ownership of their care, whether it is a consultant, community optometrist or someone else. They tend to place trust in a person, not in the system. They also want more information about the progression of their glaucoma and guidance on what to do outside of clinical touchpoints.
- Patient-friendly communication. Patients need clear and simple explanations of what glaucoma is and what it means for their lives. They reported that the explanations they were given were too technical and numbers-driven, and were not delivered in their terms. More patient-friendly explanations will empower patients to ask questions and ‘own’ their condition.
Healthcare professional perspective on the future of glaucoma
The Future of Glaucoma project also recruited 12 healthcare professionals specialising in glaucoma care. Each was interviewed separately to discover what they predicted to be some of the trends and themes of glaucoma care in the future. We then brought them together for a virtual workshop, during which we explored themes raised by the interviews.
We asked the professionals to identify and agree ambitions for the future of glaucoma care. They agreed on four key aims:
- Equitable access: All glaucoma patients will receive prompt equitable access to advanced diagnostics, treatments, and ongoing care, regardless of their ethnicity, geographical location, socio-economic status, or other potential barriers.
- Empowerment and education: Glaucoma patients will be empowered, educated, and actively involved in key decisions throughout their treatment journey, ensuring they have a comprehensive understanding of their condition and the available treatment options.
- Personalised care: Glaucoma management will be highly personalised, utilising patient-specific data and advanced technologies to tailor treatment plans.
- Holistic and Expert Care: Glaucoma patients will receive holistic treatment from health professionals whose expertise is matched to the complexity and risk level of their condition.
To explore how this ambitious vision could be achieved, we asked the healthcare professionals to consider the future of glaucoma care on a more fine-grained level. They identified five enablers of improved care:
- Artificial intelligence (AI): These emerging technologies could be used to enable diagnosis and monitoring of glaucoma.
- Sustainable service delivery: By improving the logistics of diagnosis and treatment, the healthcare system could more effectively care for the increasing number of glaucoma patients.
- Innovative treatment of glaucoma: New drugs and surgeries could help prevent vision loss.
- Health equity and access to care: The healthcare system needs to lower the barriers to care faced by people from ethnic minorities and people living in poverty.
- Patient engagement and education: Helping patients to understand and engage with their glaucoma will empower them to better manage their condition.
We explore each of these five enablers of change in detail in the following Future of Glaucoma articles.
Ambitions for the future
While the two groups saw the problems of glaucoma care from different vantage points, their concerns and aspirations can largely be mapped onto each other. This suggests it is crucial for healthcare professionals and patients to cooperate in reimagining glaucoma care for the future.
The patients broadly supported the four aims proposed by healthcare professionals and agreed that the existing system does not yet achieve them. They were in favour of equitable access, and of empowerment and education – both of which they felt the current system did not fully deliver. Likewise, they liked the idea of holistic and personalised care, but their actual experience of glaucoma care was often disjointed and inconsistent.
There are also clear commonalities between the healthcare professionals and the patients. For instance, both groups identified communication as an area of glaucoma care that needs significant improvement. The core need is for clearer, more patient-friendly communication – and for reassurance that blindness is not inevitable in glaucoma. By communicating better with patients about their personal risk and their treatment options, particularly at the start of their treatment journey, clinicians can improve the experience and level of engagement of people with glaucoma.8
However, the healthcare professionals also prioritised managing the sheer volume of glaucoma patients. This creates time pressures and makes it harder to spend time explaining the condition. The glaucoma specialists perceive themselves as caught between a rock and a hard place: they are eager to process more patients so no one is excluded, but also keen to spend more time with individual patients, especially those at high risk. While health professionals talk about seeing the right type of health professional, with expertise matched to the complexity of the disease (i.e. not everyone needs to see an ophthalmologist every time), patients demand more joined-up care.
Patients’ desire for clearer information and more ownership of their care could become a reality if the more routine elements of glaucoma care were automated or given to other allied health professionals, leaving specialists free to spend more time with the patients who most need them. In particular, clinicians and patients agreed that many patients were more anxious about their glaucoma than they needed to be, given their personal risk, and that a combination of clearer information and reassurance from health professionals at all stages of their journey could improve that.
While our health professional group discussed equitable access to diagnosis, treatment and care, our patients, understandably, did not refer to the situation in the same terms. The things that mattered to them, which relate to equitable access, were accurate and targeted testing, swift diagnosis and appropriate patient communication.
“No individual patients talked about equitable access per se, but for those whose clinical risk is elevated (certain ethnic groups) and for whom communication and access is an issue (lower socio-demographic groups), there were clear and specific points throughout their experience which put them at a disadvantage,” Fisher highlights.
Patients emphasised that they want to know about their treatment options, at least in outline, straightaway. This will become even more crucial as the range of treatment options expands, with new forms of surgery and technologies like intra-ocular implants becoming more widely available. This meshes with the healthcare professionals’ ambitions of empowerment and personalised care. Aligned to this, patients are keen to have a better understanding of their own glaucoma risk, especially how likely their condition is to progress rapidly.
Patient research methodology
Fisher recruited 18 participants for online focus groups: six each of ages 35-50, 50-65 and 65+. Patients had a mix of genders and of time since diagnosis. Each focus group lasted 90 minutes.
To capture a wider range of perspectives, Fisher also conducted eight individual interviews seven of which were with patients who belonged to ethnic minorities that often have limited access to glaucoma care (three African Caribbean, four Asian), or were otherwise at high risk. Each interview lasted 60 minutes.
The focus groups and interviews were planned to explore the entire glaucoma care journey. Volunteers were encouraged to reflect on their key touch points and express their priorities for each stage. Finally, patients were asked to consider what they thought would work well and what they would like to see in the future.
Conclusion
“Whilst it is encouraging that both health professionals and patients are broadly aligned around a blueprint for improved glaucoma care, it will be important for the improvements to be framed with patients’ needs in mind. Acknowledging and improving the patient experience will augment the efforts to drive up clinical outcomes in this area,” says Fisher.
Over the following articles, we explore in more detail how the five enablers of change in glaucoma management might make this future a reality, drawing out the many synergies between them. None of these approaches is a silver bullet, but by deploying them in tandem it should be possible to significantly improve the care of glaucoma patients and meet the ambitions of the health professionals who care for the sight of their patients and the patients themselves.
References
- Tonti E, Tonti S, Mancini F, et al. Artificial intelligence and advanced technology in glaucoma: a review. J Pers Med. 2024;14(10):1062. doi:10.3390/jpm14101062
- Dhawale KK, Tidake P. A comprehensive review of recent advances in minimally invasive glaucoma surgery: current trends and future directions. Cureus. 2024;16(7):e65236. doi:10.7759/cureus.65236
- Fisher, K. Experience Engineers. The Future of Glaucoma: Essential Themes from Patient Perspective. November 2024
- NHS Race and Health Observatory. Rapid evidence review: Improving trust and understanding of NHS ethnic health inequalities. Published February 2022. Last Accessed September 2025. Available at: https://www.nhsrho.org/wp-content/uploads/2023/05/RHO-Rapid-Review-Final-Report_Summary_v.4.pdf
- Musa I, Bansal S, Kaleem MA. Barriers to care in the treatment of glaucoma: socioeconomic elements that impact the diagnosis, treatment, and outcomes in glaucoma patients. Curr Ophthalmol Rep. 2022;10(3):85 – 90. doi:10.1007/s40135-022-00292-6
- Cross V, Shah P, Bativala R, Spurgeon P. Glaucoma awareness and perceptions of risk among African–Caribbeans in Birmingham, UK. Divers Health Soc Care. 2005;2(2):81 – 90.
- Pulse Today. Patients having to ask GPs to translate English-only hospital letters. Published 27 April 2023. Last Accessed September 2025. Available at: https://www. pulsetoday.co.uk/news/referrals/patients-having-to-ask-gps-to-translate-english-only-hospital-letters
- Zaharia AC, Dumitrescu OM, Radu M, Rogoz RE. Adherence to therapy in glaucoma treatment – a review. J Pers Med. 2022;12(4):514. doi:10.3390/jpm12040514
Read The Articles Here
Article 1: Introduction
A clear look at a better future for glaucoma care. Glaucoma is one of the most common causes of vision loss and blindness. More than 3% of people over 40 have glaucoma, and perhaps 10% of over-75s.
Article 2: Setting the Scene
A shared vision of the future of glaucoma care. Glaucoma patients and healthcare professionals have different perspectives on glaucoma care, but they share many of the same priorities.
Article 3: Artificial Intellegence
AI could help the highest-risk patients get glaucoma care . While artificial intelligence has many possible uses in glaucoma, its greatest potential is in identifying those at greatest risk.
Article 4: Sustainable Service Delivery
Ensuring the right patient is seen by the right person at the right time. How can the healthcare system ensure that every glaucoma patient is seen, while also maintaining empathic health professional - patient relationships.
Article 5: Innovative Treatments
The new cornucopia of treatments for glaucoma. From new types of pharmaceuticals to novel surgical approaches, there are now many more treatments available for glaucoma.
Article 6: Health Equality
Ensuring access to glaucoma care is truly equitable. Poor people and members of ethnic minorities often receive worse glaucoma care. Fixing these inequities requires a tailored approach.
Article 7: Patient Education and Engagement
People with glaucoma need clarity about their condition. Patients with glaucoma who are educated about their diagnosis are more likely to actively engage in their care and often have better outcomes.
Article 8: Conclusions and Recommendations
What if we got it right? The Future of Glaucoma Care in the UK. Shaping the future of glaucoma care at every level will not only improve patients’ lives but deliver lasting benefits for society.
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