Schuman flags home tonometry, portable OCT

Glaucoma slowly damages the optic nerve, usually without symptoms at first, so doctors rely on repeated pressure checks, scans and vision tests to catch change early. Joel S. Schuman, MD, said tools that move some of that monitoring into patients’ homes are getting closer to routine use in 2026. (ophthalmologytimes.com) Schuman, vice chair for research innovation and co-director of the glaucoma service at Wills Eye Hospital in Philadelphia, told Ophthalmology Times that home tonometry, virtual visual fields and portable optical coherence tomography are the devices he is watching most closely. He also said artificial intelligence for imaging and risk prediction is already edging into practice. (ophthalmologytimes.com) Home tonometry means patients measure intraocular pressure themselves instead of relying on a single clinic reading every few months. Virtual visual fields use a headset or portable display to test side vision at home, while portable optical coherence tomography, or OCT, aims to bring the cross-sectional eye scan out of the imaging suite. (ophthalmologytimes.com) (pmc.ncbi.nlm.nih.gov) The appeal is more data. A 2024 Stanford-led pilot study of unsupervised home testing used the iCare HOME tonometer four times daily for three days and a virtual reality visual field test once daily, then compared those results with standard clinic testing. (pmc.ncbi.nlm.nih.gov) That study enrolled 15 participants, but only nine completed it because six could not self-measure with the iCare HOME device. Among completers, average home visual field results correlated with in-clinic Humphrey testing, and home tonometry captured higher maximum intraocular pressure values than clinic Goldmann applanation tonometry. (pmc.ncbi.nlm.nih.gov) Schuman said three obstacles still stand in the way of broader adoption: whether the data are reliable enough for treatment decisions, whether patients will keep doing the tests, and whether insurers will pay for the equipment and review time. He also pointed to workflow integration, generalizability and liability as open questions for artificial intelligence tools. (ophthalmologytimes.com) Siamak Yousefi, PhD, put the adherence problem at the center of the discussion in a separate Healio report from the American Glaucoma Society annual meeting on April 27, 2026. He said glaucoma patients often stop taking drops because the disease is asymptomatic, and he described automated systems and chatbots as possible ways to detect or reduce nonadherence. (healio.com) Portable OCT is less established in glaucoma than home pressure or field testing, but the broader imaging trend is moving toward smaller and more patient-operated devices. A 2025 review of remote OCT said standard OCT has been tied to clinic settings and technician operation, while newer designs aim to widen access and support remote surveillance. (pmc.ncbi.nlm.nih.gov) The near-term picture is not that clinic glaucoma care disappears. It is that doctors may get more frequent readings between visits, if patients can use the devices correctly, keep using them, and get coverage for the work. (ophthalmologytimes.com) (pmc.ncbi.nlm.nih.gov)