Personalized Glaucoma Care: Genetic Tools at the Forefront
San Francisco, Monday, 20 October 2025.
Dr. David Friedman’s AAO 2025 lecture highlights how genetic profiling and personalized medicine are transforming glaucoma care, promising improved patient outcomes and reshaping clinical practices.
Advancements in Genetic Profiling
At the forefront of personalized glaucoma care is the use of genetic profiling to better understand patient-specific risk factors. During his presentation at the AAO 2025 Annual Meeting, Dr. David Friedman emphasized the transformative impact of genetic tools in predicting the risk of glaucoma development and progression. A pivotal part of his lecture was dedicated to polygenic risk scores, which assess an individual’s genetic predisposition to glaucoma. For example, individuals in the highest decile of polygenic risk scores have a 15-fold increased risk of developing glaucoma compared to those in the lowest decile, with 18.8% of people in the highest decile eventually developing the disease, compared to just 4.1% of those in the lowest decile [1].
The Role of Artificial Intelligence in Screening
Artificial intelligence (AI) is revolutionizing the landscape of glaucoma detection and management. Dr. Friedman pointed out that AI models can now identify glaucoma from a single fundus image, facilitating early diagnosis and intervention. This technology is particularly beneficial when screening at-risk populations, such as family members of glaucoma patients. By leveraging low-cost cameras and AI, widespread screening becomes feasible, thereby improving early detection rates and potentially reducing the burden of the disease [1].
Integrating Technology in Treatment Strategies
In addition to screening, technological integration extends to treatment strategies. The LiGHT trial has underscored the importance of lowering intraocular pressure (IOP) as a means to slow the progression of glaucoma. Selective laser trabeculoplasty (SLT) is recommended as a first-line therapy due to its efficacy in controlling IOP without the side effects associated with traditional eye drop regimens [2]. Furthermore, new approaches such as home testing and virtual monitoring are emerging, allowing for more frequent assessments of disease progression without the need for frequent clinic visits. This shift not only enhances patient convenience but also optimizes resource use within healthcare systems [1].
Future Directions in Glaucoma Care
The future of glaucoma care is poised to be heavily influenced by personalized medicine and technological advancements. As genetic and AI tools continue to evolve, they will likely play critical roles in patient management and treatment personalization. This paradigm shift is expected to improve clinical outcomes significantly and may lead to fewer in-person consultations, with more monitoring being conducted remotely or in centralized settings. The potential for these innovations to reshape glaucoma care practices is substantial, highlighting the need for ongoing research and adaptation within clinical settings [1].