As a representative optic degenerative condition, glaucoma has been a threat to millions due to its irreversibility and severe impact on human vision fields. Mainly characterized by dimmed and blurred visions, or peripheral vision loss, glaucoma is well known to occur due to damages in the optic nerve from increased intraocular pressure (IOP) or neovascularization within the retina. Traditionally, most glaucoma related works and clinical diagnosis focused on detecting these damages in the optic nerve by using patient data from perimetry tests, optic papilla inspections and tonometer-based IOP measurements. Recently, with advancements in computer vision AI models, such as VGG16 or Vision Transformers (ViT), AI-automatized glaucoma detection and optic cup segmentation based on retinal fundus images or OCT recently exhibited significant performance in aiding conventional diagnosis with high performance. However, current AI-driven glaucoma detection approaches still have significant room for improvement in terms of reliability, excessive parameter usage, possibility of spurious correlation within detection, and limitations in applications to intervention analysis or clinical simulations. Thus, this research introduced a novel causal representation driven glaucoma detection model: LightHCG, an extremely lightweight Convolutional VAE-based latent glaucoma representation model that can consider the true causality among glaucoma-related physical factors within the optic nerve region. Using HSIC-based latent space disentanglement and Graph Autoencoder based unsupervised causal representation learning, LightHCG not only exhibits higher performance in classifying glaucoma with 93~99% less weights, but also enhances the possibility of AI-driven intervention analysis, compared to existing advanced vision models such as InceptionV3, MobileNetV2 or VGG16.

Objective: To develop an explainable multimodal large language model (MM-LLM) that (1) screens optic nerve head (ONH) OCT circle scans for quality and (2) generates structured clinical reports that include glaucoma diagnosis and sector-wise retinal nerve fiber layer (RNFL) thinning assessments. Design: Retrospective cohort study of 1,310 subjects contributing 43,849 Spectralis ONH OCT circle scans (1,331 glaucomatous and 867 healthy eyes) from the DIGS and ADAGES cohorts. Methods: A MM-LLM (Llama 3.2 Vision-Instruct model) was fine-tuned to generate clinical descriptions of OCT imaging data. Training data included paired OCT images and automatically generated, structured clinical reports that described global and sectoral RNFL thinning. Poor-quality scans were labeled as unusable and paired with a fixed refusal statement. The model was evaluated on a held-out test set for three tasks: quality assessment, glaucoma detection, and RNFL thinning classification across seven anatomical sectors. Evaluation metrics included accuracy, sensitivity, specificity, precision, and F1-score. Model description quality was also evaluated using standard text evaluation metrics. Results: The model achieved 0.90 accuracy and 0.98 specificity for quality triage. For glaucoma detection, accuracy was 0.86 (sensitivity 0.91, specificity 0.73, F1-score 0.91). RNFL thinning prediction accuracy ranged from 0.83 to 0.94, with highest performance in global and temporal sectors. Text generation scores showed strong alignment with reference reports (BLEU: 0.82; ROUGE-1: 0.94; ROUGE-2: 0.87; ROUGE-L: 0.92; BERTScore-F1: 0.99). Conclusions: The fine-tuned MM-LLM generated accurate clinical descriptions based on OCT imaging. The model achieved high accuracy in identifying image quality issues and detecting glaucoma. The model also provided sectoral descriptions of RNFL thinning to help support clinical OCT evaluation.

Glaucoma is an eye condition that damages the optic nerve, which can lead to vision loss or blindness. This condition affects individuals worldwide, but early glaucoma detection can help diagnose the condition faster and enhance patient treatment. Traditional diagnostic methods, such as Tonometry, Ophthalmoscopy, and Gonioscopy are costly, invasive to the eye, and require a medical specialist. However, non-invasive methods such as deep-learning approaches based on fundus images of the eye show promising results but such architectures are typically trained on single datasets, which limits their practical generalizability to different patients. In this project, we develop a convolutional neural network (CNN) model based on the EfficientNet architecture, trained sequentially across the ACRIMA, ORIGA, and RIM-ONE datasets of fundus images, to enhance diagnostic accuracy and model generalizability. By conducting experiments on the trained model and evaluating metrics such as accuracy, sensitivity, specificity, and AUC-ROC, we demonstrate this method's capability for improved glaucoma detection and its potential use in clinical data for early detection. Ultimately, our work aims to deliver an accurate, easy-to-use, and scalable model for non-invasive early glaucoma screening, which contributes to better patient treatment through timely clinical intervention.

The diagnosis of glaucoma plays a critical role in the management and treatment of this vision-threatening disease. Glaucoma is a group of eye diseases that cause blindness by damaging the optic nerve at the back of the eye. Often called "silent thief of sight", it exhibits no symptoms during the early stages. Therefore, early detection is crucial to prevent vision loss. With the rise of Artificial Intelligence (AI), particularly Deep Learning (DL) techniques, Computer-Aided Diagnosis (CADx) systems have emerged as promising tools to assist clinicians in accurately diagnosing glaucoma early. This paper aims to provide a comprehensive overview of AI techniques utilized in CADx systems for glaucoma diagnosis. Through a detailed analysis of current literature, we identify key gaps and challenges in these systems, emphasizing the need for improved safety, reliability, interpretability, and explainability. By identifying research gaps, we aim to advance the field of CADx systems especially for the early diagnosis of glaucoma, in order to prevent any potential loss of vision.

Glaucoma is one of the primary causes of vision loss around the world, necessitating accurate and efficient detection methods. Traditional manual detection approaches have limitations in terms of cost, time, and subjectivity. Recent developments in deep learning approaches demonstrate potential in automating glaucoma detection by detecting relevant features from retinal fundus images. This article provides a comprehensive overview of cutting-edge deep learning methods used for the segmentation, classification, and detection of glaucoma. By analyzing recent studies, the effectiveness and limitations of these techniques are evaluated, key findings are highlighted, and potential areas for further research are identified. The use of deep learning algorithms may significantly improve the efficacy, usefulness, and accuracy of glaucoma detection. The findings from this research contribute to the ongoing advancements in automated glaucoma detection and have implications for improving patient outcomes and reducing the global burden of glaucoma.

Glaucoma is the leading cause of irreversible blindness worldwide and poses significant diagnostic challenges due to its reliance on subjective evaluation. However, recent advances in computer vision and deep learning have demonstrated the potential for automated assessment. In this paper, we survey recent studies on AI-based glaucoma diagnosis using fundus, optical coherence tomography, and visual field images, with a particular emphasis on deep learning-based methods. We provide an updated taxonomy that organizes methods into architectural paradigms and includes links to available source code to enhance the reproducibility of the methods. Through rigorous benchmarking on widely-used public datasets, we reveal performance gaps in generalizability, uncertainty estimation, and multimodal integration. Additionally, our survey curates key datasets while highlighting limitations such as scale, labeling inconsistencies, and bias. We outline open research challenges and detail promising directions for future studies. This survey is expected to be useful for both AI researchers seeking to translate advances into practice and ophthalmologists aiming to improve clinical workflows and diagnosis using the latest AI outcomes.

Glaucoma is the second driving reason for partial or complete blindness among all the visual deficiencies which mainly occurs because of excessive pressure in the eye due to anxiety or depression which damages the optic nerve and creates complications in vision. Traditional glaucoma screening is a time-consuming process that necessitates the medical professionals' constant attention, and even so time to time due to the time constrains and pressure they fail to classify correctly that leads to wrong treatment. Numerous efforts have been made to automate the entire glaucoma classification procedure however, these existing models in general have a black box characteristics that prevents users from understanding the key reasons behind the prediction and thus medical practitioners generally can not rely on these system. In this article after comparing with various pre-trained models, we propose a transfer learning model that is able to classify Glaucoma with 94.71\% accuracy. In addition, we have utilized Local Interpretable Model-Agnostic Explanations(LIME) that introduces explainability in our system. This improvement enables medical professionals obtain important and comprehensive information that aid them in making judgments. It also lessen the opacity and fragility of the traditional deep learning models.

Ophthalmic images and derivatives such as the retinal nerve fiber layer (RNFL) thickness map are crucial for detecting and monitoring ophthalmic diseases (e.g., glaucoma). For computer-aided diagnosis of eye diseases, the key technique is to automatically extract meaningful features from ophthalmic images that can reveal the biomarkers (e.g., RNFL thinning patterns) linked to functional vision loss. However, representation learning from ophthalmic images that links structural retinal damage with human vision loss is non-trivial mostly due to large anatomical variations between patients. The task becomes even more challenging in the presence of image artifacts, which are common due to issues with image acquisition and automated segmentation. In this paper, we propose an artifact-tolerant unsupervised learning framework termed EyeLearn for learning representations of ophthalmic images. EyeLearn has an artifact correction module to learn representations that can best predict artifact-free ophthalmic images. In addition, EyeLearn adopts a clustering-guided contrastive learning strategy to explicitly capture the intra- and inter-image affinities. During training, images are dynamically organized in clusters to form contrastive samples in which images in the same or different clusters are encouraged to learn similar or dissimilar representations, respectively. To evaluate EyeLearn, we use the learned representations for visual field prediction and glaucoma detection using a real-world ophthalmic image dataset of glaucoma patients. Extensive experiments and comparisons with state-of-the-art methods verified the effectiveness of EyeLearn for learning optimal feature representations from ophthalmic images.

In this paper, we present a self-training-based framework for glaucoma grading using OCT B-scans under the presence of domain shift. Particularly, the proposed two-step learning methodology resorts to pseudo-labels generated during the first step to augment the training dataset on the target domain, which is then used to train the final target model. This allows transferring knowledge-domain from the unlabeled data. Additionally, we propose a novel glaucoma-specific backbone which introduces residual and attention modules via skip-connections to refine the embedding features of the latent space. By doing this, our model is capable of improving state-of-the-art from a quantitative and interpretability perspective. The reported results demonstrate that the proposed learning strategy can boost the performance of the model on the target dataset without incurring in additional annotation steps, by using only labels from the source examples. Our model consistently outperforms the baseline by 1-3% across different metrics and bridges the gap with respect to training the model on the labeled target data.

Glaucoma leads to permanent vision disability by damaging the optical nerve that transmits visual images to the brain. The fact that glaucoma does not show any symptoms as it progresses and cannot be stopped at the later stages, makes it critical to be diagnosed in its early stages. Although various deep learning models have been applied for detecting glaucoma from digital fundus images, due to the scarcity of labeled data, their generalization performance was limited along with high computational complexity and special hardware requirements. In this study, compact Self-Organized Operational Neural Networks (Self- ONNs) are proposed for early detection of glaucoma in fundus images and their performance is compared against the conventional (deep) Convolutional Neural Networks (CNNs) over three benchmark datasets: ACRIMA, RIM-ONE, and ESOGU. The experimental results demonstrate that Self-ONNs not only achieve superior detection performance but can also significantly reduce the computational complexity making it a potentially suitable network model for biomedical datasets especially when the data is scarce.