Can a new eye scan spot glaucoma getting worse earlier?

By Abhay Kumar, founder of ORINvue · 2026-10-16

Can a new eye scan spot glaucoma getting worse earlier?

Possibly. A study published in JAMA Ophthalmology in October 2026 found that OCT angiography (OCT-A), a scan that maps the tiny blood vessels around the optic nerve, was more often the first test to show glaucoma getting worse than standard OCT or a visual field test. But it also raised more false alarms, so experts see it as an extra tool alongside the usual tests, not a replacement.

Why glaucoma monitoring matters

Glaucoma slowly damages the optic nerve, the cable that carries images from the eye to the brain. Lost vision cannot be brought back, and early glaucoma usually has no pain and no symptoms. That is why people already diagnosed with glaucoma need regular check-ups: the aim is to catch worsening early and adjust treatment before more sight is lost.

Doctors usually track glaucoma with two tests:

  • OCT (optical coherence tomography), a painless light scan that measures the thickness of the nerve fibre layer around the optic nerve
  • Visual field test, where you press a button each time you see a small light, to map any blind areas in your side vision

The problem is that these two tests do not always show worsening at the same time.

What the new study found

Researchers at the Shiley Eye Institute in California looked back at the records of 180 eyes from 116 people with glaucoma in the long-running Diagnostic Innovations in Glaucoma Study. They checked when each eye first crossed a set threshold for worsening on three tests: OCT-A, standard OCT and visual field testing.

  • At least one test detected progression in 107 eyes.
  • OCT-A (loss of small blood vessels around the optic nerve) was the first sign in 40 eyes (37.4%).
  • Standard OCT (nerve fibre thinning) was first in 32 eyes (29.9%).
  • The visual field test was first in 26 eyes (24.3%).
  • In eyes where both changed, OCT-A changes came on average 2.3 years before visual field worsening, and OCT changes about 1.5 years before.

In very early glaucoma, nerve fibre thinning on OCT was more often the first signal. In more established glaucoma, OCT-A blood vessel loss was more often first.

The limits you should know

This is useful research, but it is not a breakthrough treatment and it does not change what most patients need to do today.

  • More false alarms. In 45 eyes that were clinically stable, OCT-A flagged "progression" in 31.1%, compared with 24.4% for standard OCT.
  • One machine, one group. The results came from one OCT-A platform and one US study group. Vessel density numbers are not interchangeable between machines.
  • Looking back, not a trial. The study reviewed past records. It did not test whether adding OCT-A improves long-term vision.
  • Expert caution. An independent glaucoma expert quoted by Healio said a drop in vessel density should, for now, be a reason for closer follow-up rather than proof of worsening.

The researchers themselves say OCT-A may add information when other tests disagree, and that more work is needed before it becomes routine.

What this means for people in Lucknow and India

India has a large number of people with glaucoma, and many do not know they have it. The biggest gap is not fancy scans; it is people never getting checked at all.

  • If you are over 40, have a family history of glaucoma, diabetes, high myopia, or have used steroid drops or tablets for a long time, ask for a full eye examination that includes eye pressure and an optic nerve check.
  • If you already have glaucoma, never stop your drops on your own, and keep every follow-up visit. Ask your ophthalmologist which tests (OCT, visual field, and possibly OCT-A) are right for you.
  • Some eye hospitals in India already have OCT-A machines. Whether you need one is your ophthalmologist's decision.
  • See an eye doctor urgently if you have sudden eye pain with redness, headache, nausea, or seeing haloes around lights. This can be acute angle-closure glaucoma, an emergency.

Sources

FAQ

What is OCT angiography?

It is a non-invasive scan, similar to a normal OCT, that shows blood flow in the tiny vessels of the retina and optic nerve without any dye injection.

Does this mean glaucoma can now be cured?

No. Glaucoma damage cannot be reversed. This study is about detecting worsening earlier so treatment can be adjusted sooner.

Should every glaucoma patient get OCT-A?

Not necessarily. The researchers say it is an add-on, especially when other tests disagree. Your ophthalmologist will decide.

Can a spectacle shop detect glaucoma?

An optical store cannot diagnose glaucoma. A good eye test can pick up warning signs and lead to a referral to an ophthalmologist, who does the pressure, nerve and field tests.

How often should I get my eyes checked after 40?

Most adults over 40 should have a full eye check every one to two years, or as advised by their eye doctor, even if they see clearly.

How ORINvue can help

Every eye test at ORINvue is done by our qualified optometrist, Khushboo Gangwar: a complete vision and eye-health check in 10-15 minutes. If your eyes need medical treatment or surgery, she guides you to a trusted eye specialist.

  • A qualified optometrist eye test, free with every spectacle package
  • Clear-priced glasses from ₹999, with most single-vision glasses ready in 24 hours, and Progressive lenses at ₹4,999 for over-40s

Read more in our guide: https://orinvue.netlify.app/eye-health/glaucoma.html .

ORINvue opens in December 2026 in the Kalyanpur / Vikas Nagar area of Lucknow, open daily from 10 AM to 10 PM.

Information only, not medical advice.

About ORINvue

ORINvue is a new optical store in Lucknow founded by Abhay Kumar, built to make good eye care simple and affordable: honest eye tests, clear prices and glasses made fast. Visit https://orinvue.netlify.app to learn more.

Read this on the ORINvue website (with video and reader Q&A): https://orinvue.netlify.app/blog/oct-angiography-glaucoma-progression.html

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