Glaucoma is often taught as a disease of measurable thresholds – clinicians are educated to consider intraocular pressure (IOP) levels, optical coherence tomography (OCT) parameters, and visual field indices. Yet in real-world practice, it rarely behaves so neatly. An upcoming conference in Auckland, New Zealand, led by Professor Dame Helen Danesh Meyer, will bring together leading clinicians to explore the ambiguity that defines modern glaucoma care.
‘The grey zones of glaucoma: uncertainty, judgement, and decision making in everyday practice’, will take place on 2 August this year.
The concept of the ‘grey zone’ resonates with every optometrist involved in glaucoma care. Whether it is the patient with suspicious discs but no definitive change, discordant OCT and field results, or apparent progression despite ‘good’ pressures, uncertainty is not the exception – it is the rule.
This conference reframes uncertainty not as a failure of knowledge, but as an intrinsic part of clinical practice. The emphasis will be on sharpening judgement: how to interpret imperfect data, when to intervene, and when restraint is the safer course.
A PROGRAM BUILT AROUND DECISION MAKING
A keynote from Professor Keith Martin (University of Melbourne) will examine how emerging technologies – artificial intelligence, home monitoring, and advanced imaging – are reshaping glaucoma care while simultaneously introducing new forms of uncertainty.
From there, the program is structured into three core domains: diagnosis, testing, and management.
A highlight of the program is the ‘Case Battles’ session, where complex, ambiguous cases will be dissected in real time. Five patients, five decisions – each illustrating that even among experts, there is often more than one defensible approach.
Prof Danesh-Meyer will then lead a rapid-fire session, designed to mirror the pace and complexity of clinical practice, reinforcing pattern recognition, and decision making under pressure.
These sessions will underscore a central theme: good glaucoma care is not about certainty, but about making the best possible decision in the face of incomplete information.
Further sessions will examine diagnostic dilemmas, interrogate areas where the evidence base remains incomplete or evolving, and discuss the optimal window for surgical referral. Throughout, the emphasis will remain firmly pragmatic, focusing on how to balance risk, patient-specific factors, and the realities of everyday clinical practice.
For optometrists committed to delivering high-quality glaucoma care, this conference offers something rare: not just answers, but better questions.
The one-day hybrid conference will take place at the Aotea Centre, Auckland and online.
Visit: glaucoma.org.nz/get-involved/ professionals.