I. Paul Singh, MD, says artificial intelligence will help glaucoma specialists make decisions

At the 2025 Glaucoma 360 conference in San Francisco, California, I. Paul Singh, MD, an anterior segment and glaucoma specialist, took time to speak with the Eye Care Network. He shared insights from a panel discussion on artificial intelligence (AI) and a symposium which focused on drug delivery methods. Here, he speaks about these two vital areas of consideration in glaucoma management.

Editor's note: The below transcript has been lightly edited for clarity.

I. Paul Singh, MD: Hey everybody! Paul Singh, I'm the president of the Eye Centers of Racine and Kenosha, out in southeastern Wisconsin. I'm an anterior segment and glaucoma specialist. I'm here at Glaucoma 360 2025, and I was on a panel with Felipe Medeiros, MD, a fantastic surgeon out in Baskin Palmer, and we had a panel session on artificial intelligence in glaucoma. And it's pretty impressive to see the new technology that's coming out, or that's already out right now. From diagnostics and helping us with flow and efficiency in the practice, helping us better understand who are progressing, who are not. I mean, we don't have a lot of time in these exam room lanes to take all the data that we have at our disposal, from fields to OCTs to history to pachymetry, you name it, and then trying to synthesise all that into a plan of action. It can be difficult, as well. But having AI to help us along the lines and taking all that data and helping us understand, is there progression? Who may be more rapidly progressing? And then, also, helping us with some of the decision-making processes, I think, is really going to help us with efficiency and flow, and really, I think, treat patients earlier.

There's also AI for research centres. Personally, I have a research centre, and we are really having a hard time keeping up with all the research projects that we have. Having AI help with some of the kind of backend issues that we face as well, with some of the protocols that we need to do—having AI help with the operations side of it as well, both from the sponsor as well as from the end user and the research centres—I think is going to help us a great deal. Then we have AI with outreach, patient education. So I think AI is not just something that we see in the future, helping us. AI is already here today, from diagnostics to treatment planning to outreach to research. So I think it's an exciting time, something that we I think all are embracing. We had a great talk this morning, showing us, from market scope data, that most doctors are utilising some form of AI now, and are very positive, [looking at] the future, of adopting more AI as well. So, exciting times ahead.

I also had a panel, along with Courtney Bovee, MD, on drug delivery. I think drug delivery is an exciting topic. We have a couple products out right now, DURYSTA and iDose, and a lot more products that are in development right now. Hopefully the next couple of years, they're going to be available to us. And I think what we're seeing with this interventional glaucoma mindset is this understanding that compliance is real. For us to treat these patients, and to not understand the impact of compliance, I think, is part of the reason why we see some of our patients progressing. The frustrations we have as physicians when a patient comes in and is progressing: Do we know if they're compliant? Is the drop working? Are they getting it in their eye? And then also understanding the decision making process. When someone is on a topical medication, and we have a patient coming in who's progressing, what do I do next? It's hard to know, because it could be a lack of compliance. Are the drops working? Are they getting them in the eye? Well, if you're not on a drop—let's say you did drug delivery—and they're still getting worse...Hey, now it's an easier decision that we can make as well.

I think we're having drug delivery in different formulations, and different delivery mechanisms and technologies, whether it's IOLs, whether it's superchoroidal space, intravitreal, in the anterior chamber. And so I think we're seeing more and more technologies coming our way. So drug delivery is no doubt here to stay, and I think it falls beautifully within this interventional glaucoma mindset, along with SLT, with minimally-invasive glaucoma surgeries, with MIBS. We're seeing, now, all of these technologies finding their places. And it's not one or the other anymore. At any given time, with a patient in my room, how do I maximise quality of life as well as be as aggressive as I can with IOP, and minimise compliance issues? All these devices and technologies all work together as well. I think drug delivery is a big part of that.

I think what's going to happen in glaucoma, first of all, is just the population is growing. We don't have a lot more ophthalmologists, especially glaucoma specialists, coming out. So we need more efficient, better ways of addressing patients, identifying those patients, and more importantly, identifying which patients are going to progress more rapidly, and which ones will not progress more rapidly. We can triage how often we have to see them in our clinics and how aggressive we have to be, I think we'll be utilising more procedures, more diagnostics as well, to allow us to understand, again, who we should be wore aggressive [when] treating as well. I think the biggest issue we face is population growth. Providers [are] not growing at the same rate. How do we take care of these patients in a way that they deserve to be taken care of, and minimise rate of progression of any of these patients? And I think someday we're going to have the ability to restore vision, which I think is something that's probably the most exciting part of all of this. It's not just neuroprotection, but can we actually restore some of the functionality? I think we're going to get there some day, too.