Polygenic risk scores for glaucoma: Impact on diagnosis and disease course

Large-scale genomic studies have uncovered significant polygenic architecture of the adult-onset glaucomas, enabling the creation of polygenic risk scores (PRS). These scores show promise in improving early case detection and predicting disease trajectory, particularly when integrated with clinical parameters, signaling a new frontier for personalised glaucoma risk assessment. As accredited PRS tools enter clinical practice, their safe and equitable implementation is essential. In this review, we synthesize the evidence base for PRS in glaucoma and described the current landscape for clinical implementation. We cover the 'Who, What, When and Where' of PRS testing for glaucoma, highlighting the clinical relevance and limitations of this precision tool.