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Artificial intelligence in glaucoma

Zheng, Chengjiea; Johnson, Thomas V.a; Garg, Aakritia; Boland, Michael V.a,b

Current Opinion in Ophthalmology: March 2019 - Volume 30 - Issue 2 - p 97–103
doi: 10.1097/ICU.0000000000000552
GLAUCOMA: Edited by Donald L. Budenz

Purpose of review The use of computers has become increasingly relevant to medical decision-making, and artificial intelligence methods have recently demonstrated significant advances in medicine. We therefore provide an overview of current artificial intelligence methods and their applications, to help the practicing ophthalmologist understand their potential impact on glaucoma care.

Recent findings Techniques used in artificial intelligence can successfully analyze and categorize data from visual fields, optic nerve structure [e.g., optical coherence tomography (OCT) and fundus photography], ocular biomechanical properties, and a combination thereof to identify disease severity, determine disease progression, and/or recommend referral for specialized care. Algorithms have become increasingly complex in recent years, utilizing both supervised and unsupervised methods of artificial intelligence. Impressive performance of these algorithms on previously unseen data has been reported, often outperforming standard global indices and expert observers. However, there remains no clearly defined gold standard for determining the presence and severity of glaucoma, which undermines the training of these algorithms. To improve upon existing methodologies, future work must employ more robust definitions of disease, optimize data inputs for artificial intelligence analysis, and improve methods of extracting knowledge from learned results.

Summary Artificial intelligence has the potential to revolutionize the screening, diagnosis, and classification of glaucoma, both through the automated processing of large data sets, and by earlier detection of new disease patterns. In addition, artificial intelligence holds promise for fundamentally changing research aimed at understanding the development, progression, and treatment of glaucoma, by identifying novel risk factors and by evaluating the importance of existing ones.

aWilmer Eye Institute

bDivision of Health Sciences Informatics, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA

Correspondence to Michael V. Boland, MD, PhD, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD 21287, USA. E-mail:

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