Glaucoma practice patterns in Australia and New Zealand: a binational survey of ophthalmologists

We surveyed contemporary glaucoma practice patterns among consultant ophthalmologists in Australia and New Zealand. An anonymous 21-question online questionnaire was distributed at the 2024 Australian and New Zealand Glaucoma Society conference and through the Royal Australian and New Zealand College of Ophthalmologists electronic newsletter. Among 135 respondents, 57% self-identified as glaucoma subspecialists. All respondents used visual field perimetry to assess progression and 98% used optical coherence tomography. Prostaglandin analogues were the most common first-line treatment for progressive primary open-angle glaucoma (59%), followed by selective laser trabeculoplasty (39%). Glaucoma subspecialists favoured SLT as first-line therapy. Among 116 respondents who performed minimally invasive glaucoma surgery (MIGS), 43% reported routinely combining MIGS with cataract surgery for primary open-angle glaucoma. Among 97 respondents who performed incisional glaucoma surgery, trabeculectomy was the preferred first-line procedure (63%) and glaucoma drainage devices the most common second-line procedure (52%). Compared with surveys conducted two decades earlier, respondents reported greater use of optical coherence tomography, selective laser trabeculoplasty and MIGS. While there is substantial agreement in many aspects of glaucoma management, certain areas exhibit variability. These insights may assist ophthalmologists in benchmarking their practices and inform strategies to enhance glaucoma care.