The importance of early eye examinations: A case study on undiagnosed glaucoma

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Australia is seeing an alarming increase in the incidence of a range of debilitating eye conditions, a trend predicted to continue over the course of this decade.¹ Most vision loss can be averted if these conditions are diagnosed and managed in a timely manner.² However, there are several eye conditions that, if left undetected, can have deleterious effects on an individual’s vision.

One such condition is glaucoma, a leading cause of vision impairment worldwide.³ Early intervention is crucial, yet most patients with glaucoma remain asymptomatic until the disease reaches an advanced stage.⁴ Current therapeutic approaches cannot reverse structural or functional vision loss, making early detection and treatment essential to reducing the individual and societal burden of the disease.⁵

A routine eye examination uncovers asymptomatic glaucoma

Optometry Australia recently spoke with Jarryd, a young father who received an unexpected glaucoma diagnosis during a routine eye examination. With no noticeable symptoms present, Jarryd had visited his local optometrist to simply update his sunglasses.

‘The optometrist did all the usual checks but obtained a high [intraocular] pressure reading,’ Jarryd recalled. ‘They double-checked with a different device, and the same high reading was recorded.’

Concerned by these results, the optometrist advised Jarryd to return the next day for a visual field test. While his right eye showed no abnormalities, testing of his left eye revealed reduced peripheral vision—an early sign of glaucoma. Following further testing, Jarryd was diagnosed with pigment dispersion glaucoma and referred to a glaucoma specialist, who confirmed the diagnosis. He was immediately prescribed pressure-lowering eye drops and scheduled for a six-week follow-up.

Alarmingly, situations like Jarryd’s are not uncommon, with one in seven healthy working-age adults having an undiagnosed eye condition, such as ocular hypertension, glaucoma, or hypertensive retinopathy, all of which require treatment.⁶ Research indicates that longer intervals between eye examinations are associated with higher rates of eye care referral in both non-Indigenous and Indigenous populations (Odds Ratio = 1.15 per year and Odds Ratio = 1.10 per year, respectively).⁷

Modelling from Vision 2020 Australia suggests that approximately 840,000 Australians are currently living with vision loss, a number that could exceed 1.04 million by 2030.⁸ Despite this significant increase, 90% of blindness and vision impairment in Australia can be prevented or treated if detected early.⁸

For Jarryd, the glaucoma diagnosis came as a shock. ‘I’m in my 30s, and I was stressed out of my mind for days when I found out. I have a young family – initially [the news of this diagnosis] was quite challenging and I was pessimistic about treatment. It took me a week to fully calm down. This is my life now— [taking drops every day]—but I want to be able to see my kids.’

Despite the initial disbelief of his diagnosis, Jarryd expressed his relief in the fact that the [intraocular] pressure measurement was done as a routine test: ‘Had it not been that way, it would have impacted things a lot more. I felt I was in the right place at the right time – [otherwise] I could have gone blind.’

A call for action: Reinforcing the importance of regular eye checks

Jarryd shared his advice for anyone who hasn’t had their eyes checked in a while: ‘Just do it. Book an exam. Eye exams are usually bulk-billed, and your vision depends on it. You don’t need to have symptoms for something serious to be detected.’

He also emphasised the importance of accessible, government-subsidised eye care.

‘Regular eye tests provide important knowledge – it is empowering. But in the complete off chance [the eye test] becomes bigger than nothing, you’ll be grateful [a diagnosis] was caught early. If there were no regular checks, you may never know about something until it’s too late. Medicare-subsidised eye exams allow me to receive that care, and they should be scheduled according to the best evidence.’

Consequently, Optometry Australia is advocating for the Federal Government to reinstate two-yearly Medicare-subsidised eye examinations for Australians under 65. More frequent eye examinations increase the likelihood of detecting asymptomatic eye conditions earlier, enabling timely intervention. Early detection not only preserves vision but also helps Australians maintain their ability to work, study, care for their families and participate fully in life.

Optometry Australia Chief Clinical Officer Luke Arundel said, ‘An estimated 90 per cent of blindness or vision loss is preventable or treatable if detected early. More frequent eye examinations increase the likelihood that a range of asymptomatic eye conditions in Australians aged under 65 will be identified earlier, enabling early intervention to reduce the risk of vision loss and impairment. Two-yearly eye exams are what is clinically recommended, and this makes up the basis of Optometry Australia’s ‘Eyes on Medicare’ campaign.’

All Australians aged under 65 stand to benefit from being able to access Medicare subsidised eye examinations once every two years rather than once every three years. Read more about Optometry Australia’s Federal Election Campaign, ‘Eyes on Medicare,’ here.

References

1. Australian Institute of Health and Welfare. (2025). Eye health – How common is visual impairment? Retrieved February 2025 from https://www.aihw.gov.au/reports/eye-health/eye-health/contents/new
2. Burton, M. J., et al. (2021). The Lancet Global Health Commission on Global Eye Health: Vision beyond 2020. The Lancet Global Health, 9(4), e489–e551. https://doi.org/10.1016/S2214-109X(20)30488-5
3. Sun, Y., Chen, A., Zou, M., et al. (2022). Time trends, associations, and prevalence of blindness and vision loss due to glaucoma: An analysis of observational data from the Global Burden of Disease Study 2017. BMJ Open, 12, e053805. https://doi.org/10.1136/bmjopen-2021-053805
4. Ekici, E., & Moghimi, S. (2023). Advances in understanding glaucoma pathogenesis: A multifaceted molecular approach for clinician scientists. Molecular Aspects of Medicine, 94, 101223. https://doi.org/10.1016/j.mam.2023.101223
5. Dietze, J., Blair, K., Zeppieri, M., et al. (2024). Glaucoma. In StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK538217/
6. Grau, E., et al. (2019). OCT and IOP findings in a healthy worker cohort: Results from a teleophthalmic study in occupational medicine. Graefe’s Archive for Clinical and Experimental Ophthalmology, 257(11), 2571–2578.
7. Keel, S., et al. (2017). Participant referral rate in the National Eye Health Survey (NEHS). PLOS ONE, 12(4), e0174867. https://doi.org/10.1371/journal.pone.0174867
8. 2022-2023 Pre-Budget Submission, Vision 2020. [cited 2024; Available from: https://treasury.gov.au/sites/default/files/2022-03/258735_vision_2020_australia.pdf.