Current Innovations in Glaucoma Management: Digital Diagnostics, Surgical Advances, and Personalized Care

Glaucoma is a progressive optic neuropathy and a leading cause of irreversible blindness worldwide. Although lowering intraocular pressure (IOP) remains the only proven intervention that consistently slows disease progression, glaucomatous damage results from the interaction of mechanical, vascular, inflammatory, metabolic, and genetic mechanisms that affect retinal ganglion cell survival and optic nerve head integrity. This narrative review identified literature through searches of PubMed/MEDLINE, Web of Science, Scopus, and Google Scholar for English-language publications from January 2000 to May 2026, prioritizing landmark clinical trials, recent reviews, guidelines, and studies addressing diagnostic imaging, artificial intelligence, medical therapy, laser treatment, minimally invasive glaucoma surgery, neuroprotection, and personalized glaucoma care. Current management is shifting from a pressure-only model toward earlier detection and risk-based intervention using optical coherence tomography, optical coherence tomography angiography, automated perimetry, home monitoring, tele-ophthalmology, and artificial intelligence-assisted analytics. Therapeutic innovations include fixed-dose combinations, Rho-kinase inhibitors, sustained-release drug delivery systems, selective laser trabeculoplasty as an evidence-supported first-line option for selected patients, minimally invasive glaucoma surgery, and improved drainage implants. Emerging neuroprotective, regenerative, and gene-based strategies may eventually complement IOP reduction, but these approaches remain investigational until durable clinical efficacy is demonstrated. This review distinguishes established clinical practice from emerging evidence and future perspectives, emphasizing how biomarkers, treatment adherence, disease stage, life expectancy, socioeconomic barriers, and patient-specific risk should guide long-term management. Integrating validated technologies with equitable health-system delivery is essential to reducing preventable glaucoma-related blindness.