Recent Advances in the Pathophysiology, Diagnosis and Therapeutic Management of Glucoma: A Comprehensive Review

Abstract

Glaucoma is one of the leading causes of irreversible blindness worldwide. The disease is commonly associated with elevated intraocular pressure [IOP], although optic nerve damage can occur even at normal pressure levels. Glaucoma encompasses a heterogeneous group of disorders, including primary open-angle glaucoma, angle-closure glaucoma, congenital glaucoma, and secondary glaucomas caused by trauma, medications, or systemic diseases. Recent developments in the understanding of ocular physiology, genetics, and neurodegeneration have shown new insights into the pathophysiology of glaucoma. Dysregulation of aqueous humour dynamics, oxidative stress, mitochondrial dysfunction, neuroinflammation, and impaired ocular blood flow contribute to optic nerve damage.
Early diagnosis using advanced imaging techniques such as optical coherence tomography [OCT], tonometry, and visual field analysis is critical for preventing disease progression.
Current management strategies focus on reducing intraocular pressure through pharmacological therapy, laser treatment, and surgical interventions. Emerging therapies, including neuroprotective agents, gene therapy, stem cell therapy, and sustained drug-delivery systems, are under investigation for improved disease control. This review summarises recent developments in the epidemiology, pathophysiology, classification, diagnostic strategies, and therapeutic management of glaucoma, highlighting current challenges and future research directions in glaucoma treatment.