Glaucoma in general practice: An updated framework for Australian general practitioners

Glaucoma is a leading cause of irreversible blindness in Australia, with over half of cases undiagnosed. General practitioners (GPs) have a central role in early recognition, risk stratification and coordination of care.

This article aims to provide a practical framework for GPs to identify glaucoma risk, recognise red-flag presentations and support long-term management by providing a narrative review of contemporary guidelines, systematic review and key clinical trials relevant to primary care, with emphasis on referral pathways and shared-care models.

Glaucoma is best conceptualised as a progressive optic neuropathy, with intraocular pressure a modifiable risk factor. Acute angle-closure glaucoma requires same-day referral, while most open-angle disease is asymptomatic and detected through opportunistic screening. Risk-based referral thresholds and medication considerations are outlined. Timely referral, reinforcement of treatment adherence and shared care with optometry and ophthalmology are critical to preventing avoidable vision loss in general practice.