Glaucoma
Also known as: elevated intraocular pressure · open-angle glaucoma
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Primary Open-Angle Glaucoma Preferred Practice Pattern (PPP) 2025
American Academy of Ophthalmology (AAO) · 2025
The AAO's Preferred Practice Pattern for primary open-angle glaucoma, produced by its Glaucoma Committee. It summarises prevalence and risk factors, population screening, diagnostic evaluation, ongoing management and patient counselling, and is updated on a periodic evidence-review cycle. Companion PPPs address glaucoma suspects and primary angle-closure disease.
- Covers prevalence, risk factors, population screening, diagnosis, management and counselling for primary open-angle glaucoma. source
- Notes that many patients with the disease have untreated intraocular pressure consistently in the normal range (normal-tension glaucoma). source
- Sits alongside separate AAO Preferred Practice Patterns for primary open-angle glaucoma suspect and primary angle-closure disease. source
European Glaucoma Society - Terminology and Guidelines for Glaucoma, 6th Edition
European Glaucoma Society (EGS) · 2025 · 6th Edition
The European Glaucoma Society's book-length reference combining standard glaucoma terminology with evidence-based and consensus guidance. The sixth edition covers patient examination, disease classification, treatment options and cost-effectiveness, adds an evidence-based question-and-answer section, incorporates patient input, and introduces a 'Choosing Wisely' section on interventions of low value. Published as a British Journal of Ophthalmology supplement in 2025.
- Published in 2025 as British Journal of Ophthalmology volume 109 supplement 1, running to over 200 pages. source
- Incorporates patient perspectives through the EGS Patient Involvement Project and includes physician communication guidance. source
- Distributed by the EGS in several languages including English, Spanish, German, French and Portuguese. source
US vs EU key differences
- Both sides refreshed their guidance in 2025: the American Academy of Ophthalmology issued a 2025 Primary Open-Angle Glaucoma Preferred Practice Pattern and the European Glaucoma Society published the 6th edition of Terminology and Guidelines for Glaucoma in September 2025, so neither is materially out of date. source
- The US Preferred Practice Pattern states a numeric starting goal, describing a reasonable initial treatment target of lowering intraocular pressure 20% to 30% below baseline and then adjusting up or down according to disease course and severity. source
- The European 6th edition adds structural sections with no counterpart in the US practice pattern: a 'Choosing Wisely' section naming low-value interventions to avoid, and an expanded 'What matters to patients' section co-developed with Expert-by-Experience patient advisors that includes eight communication tips for doctors. source
What changed recently
- EU5th Edition → 6th Edition2025-09-08
The 6th edition refreshes the evidence-based chapter with a new set of clinical questions and GRADE-style answers, and substantially rewrites the 'what matters to patients' material using direct input from patient advisors in the EGS Patient Involvement Project, including eight practical communication tips for clinicians.
source ↗curation confidence 90% - US2020 (published 2021) → 20252025-01-01
The 2025 POAG PPP strengthens the endorsement of selective laser trabeculoplasty as an initial rather than merely adjunctive therapy, drawing on the LiGHT trial's six-year extension data, and newly incorporates evidence on sustained-release drug delivery and minimally invasive glaucoma surgery, macular and ganglion-cell-layer imaging, corneal hysteresis as a risk metric, and more intensive monitoring for rapid progressors.
source ↗curation confidence 90%
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