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Glaucoma
Journal article   Peer reviewed

Glaucoma

Henry Bair, Mak Djulbegovic and Joel S Schuman
Handbook of clinical neurology, v 218, pp 219-239
2026
DOI: https://doi.org/10.1016/B978-0-443-22212-2.00010-0
PMID: 42217975

Abstract

Animals Glaucoma - diagnosis Glaucoma - therapy Humans Intraocular Pressure - physiology
Glaucoma, a prevalent cause of blindness, refers to a group of optic neuropathies that result in the degeneration of retinal ganglion cells. Glaucoma can be broadly classified based on the anatomy of the anterior chamber angle (open vs closed), though each group can be further subdivided by underlying etiology and chronicity. Given that chronic glaucoma is the most common type and usually progresses insidiously, periodic eye exams are critical to assess both anatomic integrity and visual function. The most important modalities for screening and monitoring at-risk patients or those with a diagnosis are ophthalmoscopy for appraising the appearance of the optic nerve head, gonioscopy for examining the anterior chamber angle, tonometry for measuring intraocular pressure, optical coherence tomography for evaluating structural damage to the optic nerve head, macula, and retinal nerve fiber layer, and perimetry for assessing visual function. Since most cases of glaucoma involve elevated intraocular pressure due to an abnormality in the drainage of aqueous humor out of the eye, current treatments, including medications, laser therapies, and surgeries, focus on lowering intraocular pressure. This chapter additionally includes a summary of significant clinical trials that have helped establish current standard practices, and concludes with an overview of promising emerging research, including stem cell therapies, gene therapies, visual prosthesis, and artificial intelligence/computer vision. Neurologists should be familiar with the diagnosis and management of glaucoma, given its similarities in pathophysiology with other neurodegenerative conditions as well as the fact that glaucoma affects both the eye and the brain.

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