As India faces a rising burden of lifestyle and age-related eye diseases, glaucoma has emerged as a silent but significant public health challenge, often progressing undetected until irreversible vision loss occurs. Despite advances in diagnostics, low awareness and limited routine screening continue to delay early detection across large segments of the population. In this exclusive conversation, Dr. Kamal B Kapur, Co-founder & Medical Director, Sharp Sight Eye Hospitals, a leading expert in ophthalmology care, shares with Dr. Asawari Savant, from Elets News Network (ENN), critical it is to understanding gaps, innovations, and the path forward for preventing avoidable blindness. Edited excerpts 

Glaucoma continues to be one of the leading causes of irreversible blindness globally. How significant is the glaucoma burden in India today, and what do current estimates suggest about the number of people affected?

We say twelve million, but I honestly think the real number is higher because we’re only counting the people we’ve found. The ones we haven’t found are living perfectly normal lives right now, completely unaware. And that’s the cruelty of glaucoma – in most of the cases it doesn’t warn you. There’s no headache, no sudden blur, nothing that says go see a doctor.

The optic nerve just slowly loses its fibres, and slowly shuts down, and your brain fills in the gaps so well that you genuinely don’t notice. People come to us after years of damage and say they had no idea. That’s not negligence on their part. That’s just how this disease works. Which is why I keep telling anyone who’ll listen, if you’re over forty, get your eyes checked. Not because something feels wrong. Precisely because nothing does.

What kind of technologies and clinical capabilities has Sharp Sight Eye Hospitals invested in to improve early glaucoma diagnosis and patient outcomes?

Good glaucoma care lives or dies on how early you catch it, so the equipment we invest in isn’t about appearances. OCT imaging lets us look at the optic nerve in a level of detail that simply wasn’t possible before, we’re identifying structural damage months, sometimes over a year, before a patient would notice any change in how they see. Pachymetry tells us about corneal thickness, which affects how we interpret pressure readings. Visual field testing maps out functional vision loss over time so we can track whether the disease is stable or progressing. Even before the patient notices subtle changes, other tests like corneal hysteresis, etc. None of this is glamorous. But it means that when a patient sits in front of one of our specialists, we’re working from a complete picture, not guesswork. That changes what we can offer them.

Several diagnostic technologies are now available for glaucoma detection. How have these technologies improved early diagnosis and disease monitoring in recent years?

For years, a glaucoma diagnosis basically meant one thing: check the eye pressure. And that worked for many patients, but it missed a significant group entirely — people whose pressure reads normal but who are quietly losing optic nerve tissue anyway. It’s called  Normal tension glaucoma.

Once we understood that pressure alone wasn’t telling the whole story, diagnostic approaches had to change. OCT became the real game-changer for us. You can see the nerve fibre layer thinning before any visual symptom appears. Combined with visual field testing that tracks how the eye is actually functioning, we now catch patients at a point where we can genuinely slow things down and protect what’s still there. That’s a different conversation than the one we were having twenty years ago.

As a leading eye care network in North India, how is Sharp Sight Eye Hospitals contributing to glaucoma detection and management through specialised diagnostics, treatment protocols, or screening initiatives?

The patients who worry us the most are the ones who don’t come. Someone over forty with a family history of glaucoma, maybe a diabetic, and hypertension going on for years without a proper eye examination, because nothing hurts and their reading glasses are working fine. That’s who we’re trying to reach. At Sharp Sight, we’ve made glaucoma screening a standard part of comprehensive eye care for at-risk groups rather than something that only happens when someone specifically asks for it. And beyond our hospitals, we run screening camps and awareness drives specifically because waiting for patients to walk in on their own isn’t enough. The disease doesn’t give people a reason to come. So we go to them.

Despite the availability of advanced diagnostic tools, glaucoma is often described as a largely underdiagnosed condition. What are the key reasons behind this gap in detection?

I’ll tell you exactly why glaucoma stays hidden. The eye is remarkably good at compensating. When peripheral vision starts going, it’s usually missed because the central field of vision may remain unaffected, which is usually where glaucoma hits first. The brain quietly adjusts your perception so you don’t register the loss. You might lose thirty percent of your visual field before you notice anything unusual in daily life. By then, we’re looking at damage that won’t come back. And most people visit an eye clinic for one of two reasons — their glasses prescription has changed or something is visibly wrong. Glaucoma ticks neither box until very late. Add in the fact that a standard vision check doesn’t include the tests needed to detect it, and you have a condition that is almost engineered to stay undetected.

What role can government policies, national screening programmes, and public health initiatives play in addressing the glaucoma burden and improving early diagnosis in India?

The numbers we’re dealing with in India are too large for any hospital network to address alone, however good the clinical care. Reaching people before they have symptoms requires the kind of infrastructure and community presence that only public health programmes can build. If glaucoma testing became a routine component of the vision screening already happening in national health camps, the detection picture would change significantly within years, not decades. What matters is also what happens after detection — training primary care doctors to recognise risk factors and refer appropriately, making sure the pipeline from community screening to specialist care actually works. The clinical piece is solvable. The access and awareness piece needs a policy behind it.

If India aims to significantly reduce glaucoma-related blindness in the coming years, what systemic changes across awareness, screening infrastructure, and clinical care will be most important?

I don’t think there’s a shortcut here. Awareness matters, but awareness without access doesn’t help the person in a tier-two city who’d take a glaucoma diagnosis seriously but can’t find the right specialist nearby. Access matters, but access without awareness means people don’t use the infrastructure that exists. And both of those things fall apart if the patient gets diagnosed, starts treatment, feels stable, and then quietly stops coming because nobody conveyed clearly enough that stable doesn’t mean cured in glaucoma. It means the treatment is working and the moment you stop, the disease resumes.

Long-term patient engagement is genuinely one of the hardest parts of glaucoma care, and it’s probably the least discussed.

Managing glaucoma at scale requires collaboration across the healthcare ecosystem. What kind of partnerships could help strengthen glaucoma detection and management?

No single institution can solve this, and I think the ones that try to work alone are limiting what they can achieve. Hospitals bring clinical depth and technology. Research institutions bring the epidemiological data we honestly still need more of in India — accurate numbers on how this disease is actually distributed across populations, which risk factors matter most here, and how our patients respond to different treatment approaches. Technology companies can extend the reach of diagnostics in ways that fixed hospital infrastructure cannot. The government brings scale. When those four things are aligned toward the same goal, which is finding patients before their vision is gone, the results are categorically different from what any of them achieve separately.

Also read: Why Should I Attend India Pharma Expo 2026? 

Is Sharp Sight Eye Hospitals currently exploring collaborations with other healthcare institutions, technology providers, or government programmes to expand glaucoma screening and awareness initiatives?

Yes, and it’s not something we treat as an add-on to the main work. Community partnerships are part of how we think about our responsibility to patients who may never walk through our doors on their own initiative. We utilise social media main stream media to spread awareness

Also, the screening and awareness camps we run, the awareness programmes we participate in — these aren’t PR exercises. They come from a real understanding that the patients who need us most are often the least likely to seek specialist care unprompted. We’re open to every collaboration that extends our clinical reach or brings more at-risk people into early detection. Because if we only serve the patients who already know to come, we’re doing good medicine for a small fraction of the people who need it.

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