At age 50 Sara was unexpectedly diagnosed with glaucoma. She had gone for an eye check-up as she was accompanying her 75-year-old mother to a routine doctor’s visit when the ophthalmologist delivered the news—her own eye disease had been progressing, undetected. She had no symptoms, no warning.
Since then, Sara has visited the ophthalmologist twice a year to monitor her eye pressure. However, the long gaps between check-ups leave her feeling anxious—what if her condition worsens between visits? She wishes she could track her eye health more regularly. If she feels this uncertainty now, she worries about how much harder it will be as she ages. Her mother faces the same struggle.
The Prevalence and Challenge of Glaucoma
Glaucoma is the second leading cause of blindness in the world—about 90% of people in developing countries are unaware they have the disease. Even in the United States, about half of the people with glaucoma don’t know they have it. Glaucoma is hereditary, and many people don’t realize they have it until significant vision loss occurs. Because it progresses slowly and without symptoms in the early stages, it is often called the “silent thief of sight.”
People with a family history of glaucoma are at a much higher risk, yet many remain undiagnosed for years because they don’t experience noticeable symptoms until irreversible damage has already been done. In more severe cases of glaucoma, such as angle-closure glaucoma, a sudden, dramatic increase in eye pressure can occur. This is a medical emergency, and symptoms include eye pain, headaches, seeing halos around lights, dilated pupils and vision loss.
Could digital health tools offer a solution for Sara, her mother, and other older adults to detect and manage glaucoma?
Potential Ways Digital Health Can Help
To prevent the progression of early stage glaucoma, diligent at-home monitoring and consistent medication adherence are crucial. While glaucoma damage is irreversible, eye drop medications are commonly used to slow its progression by lowering intraocular pressure (IOP). However, the complexity of treatment regimens—such as determining which eye drop to use, when to apply it, and the risk of losing track of small bottles—often leads to poor adherence, especially among older adults who may be prescribed multiple medications. Studies show a nonadherence rate of 30.3% for glaucoma eye drop medications.
Many patients take multiple medications for various eye conditions.
The challenge is further compounded when patients take multiple medications for various eye conditions, increasing the chances of missed doses or improper application. Factors such as forgetfulness about timing, confusion about the regimen, and physical difficulties—like arthritis, which can make handling eye drop bottles difficult—contribute to inconsistent medication use.
Digital health tools, such as at-home IOP monitors and medication reminder apps, can help patients by streamlining their care routines and enhancing adherence.
Home Monitoring Digital Health Tools
For older adults at risk of glaucoma, at-home monitoring offers a valuable way to track symptoms and detect changes early, significantly aiding in condition management. Although glaucoma requires professional diagnosis and treatment, incorporating self-checks and lifestyle adjustments can be beneficial, thanks to recent technological advancements.
Exciting new research suggests that in the future, smartphones can measure eye pressure. This pioneering smartphone-based method uses sound waves to overcome the limitations of current devices, which are influenced by corneal thickness (CCT). It works by sending sound waves at a specific angle toward the eye and measuring how much sound is reflected. This test can be done using a smartphone, which many older adults already own, and more will in the future. Unlike other methods, this one is simple, comfortable, and doesn’t touch the eye—making it more accessible. Plus, the thickness of the eye’s surface won’t affect results, making it more accurate than current methods. Ongoing research exploring how eye shape affects sound reflection could further refine this method’s accuracy, paving the way for convenient at-home glaucoma detection using smartphones.
In addition to promising future smartphone-based monitoring apps, devices like the iCare Home tonometer already allow patients to track daily eye pressure fluctuations, helping identify unusual trends to share with ophthalmologists. Nevertheless, the device’s high cost—around $2,000—may limit accessibility for many older adults, highlighting the need for more affordable home monitoring solutions. Because eye pressure fluctuates throughout the day, taking consistent measurements can help detect unusual trends, which can then be promptly reported to ophthalmologists for further evaluation.
‘Emerging research explores digital sensor technology that verifies eye drop usage in real-time and relays data to providers.’
Many older adults face barriers to routine eye exams due to mobility, transportation, or financial issues. At-home monitoring—like self-assessing vision, tracking peripheral sight, and using a home tonometer—helps detect changes early and enables timely intervention.
Regular eye exams remain the most effective defense against vision loss, yet studies show that a-third of glaucoma patients discontinue routine eye check-ups within 10 years. Telehealth with remote IOP monitoring can further enhance care by combining medical supervision with proactive self-monitoring.
Medication Adherence Using Digital Health Methods
Effective management of glaucoma heavily relies upon strict adherence to prescribed medication regimens, particularly the use of eye drops to lower intraocular pressure. However, for many patients, especially older adults, adherence presents significant challenges. Older adults can face complex treatment schedules in glaucoma management. Taking multiple medications for various health conditions can exacerbate the likelihood of missed doses or improper application of eye drops. Factors such as forgetfulness about dosage timing or medication location, unclear understanding of the regimen, and physical challenges like arthritis, contribute to inconsistent medication adherence. Additionally, the asymptomatic nature of early stage glaucoma may lead patients to underestimate the necessity of strict adherence, as they do not immediately perceive its benefits.
Digital health technologies provide innovative solutions to enhance adherence to glaucoma medication regimens. Apps like EyeDropAlarm play a crucial role by sending timely reminders to help patients stay on track. Unlike generic medication reminder apps, EyeDropAlarm is tailored to older adults, featuring a quick setup process and an intuitive, user-friendly design. Users can effortlessly select their prescribed eye drops from the app’s comprehensive database, eliminating the need for manual entry. The alerts are crafted to clearly indicate which eye to treat and include the bottle cap color, simplifying the management of complex regimens.
In addition to smartphone apps, emerging research explores digital sensor technology that verifies eye drop usage in real-time and relays data to providers. Devices like e-Novelia not only confirm medication administration but also deliver reminders, assist with proper eye drop techniques, provide treatment information, and help locate misplaced eye drop bottles—particularly beneficial for older patients prone to forgetfulness. By integrating these digital health solutions, patients with glaucoma can experience improved medication adherence and disease progression monitoring. However, it’s important for the implementation of such technologies to be accompanied by proper education and support from healthcare providers to maximize their effectiveness.
With 86% of adults ages 50 and older owning a smartphone, it makes sense to use it to keep your vision healthy.
Note: The author has no affiliations to the companies or products referenced.
Karen Liao is earning her Master of Science in Media, Medicine and Health at Harvard Medical School, where she combines her passion for narrative medicine and medical research to drive meaningful changes in healthcare. She begins medical school in Fall 2025, focusing on chronic disease management, vision care and improving patient outcomes in underserved communities.
