**7. Conclusion**

In conclusion, the future of glaucoma treatment is in understanding disease mechanisms of glaucoma viewed with an interventional mindset. Increasingly, the safety and efficacy of drug delivery allows better control of IOP. Medical management shortly seeks to improve sustainability through products like Durysta and iDose. Innovation of medical management is in progress with formulations of *N*-acetylcysteine or ciliary neurotrophic factor, as mentioned. It is speculated that glaucoma is headed in a direction of earlier detection, earlier intervention, and chronic modulation, potentially even with tools to adequately assess pressure from home (even 24/7), and to address it with telehealth resources. Technology may permit detection of resistance sites, which allows specification of procedures specific to the individual patient. Largely, it is evident that there is a gap in the treatment of glaucoma with non-IOP-related modalities. This supports the need for animal models in developing further understanding of the pathophysiology of glaucoma, but also in studying the efficacy of present treatment mechanisms (such as IOP-lowering) as well as novel ones (*N*-acetylcysteine, ciliary neurotrophic factor, molecular mapping with animal models, CRISPR-CAS9).

Something to consider with the current information-driven culture, are mechanisms to objectively quantify the degree of pathophysiology present in these animal models, particularly when they are used to examine the efficacy of treatment modalities. Currently, a particular BXD strain which spontaneously develops glaucoma is being used to observe optic nerve pathology (including axonal degeneration and glial scarring) and objectively quantify glaucomatous degeneration. This, as well as the potential of an automated system to carry out this task, has the ability to revolutionize this field. A deep neural network is being developed to reliably assess the progression of axonal degeneration in glaucoma. It provides an opportunity to automate this process to better understand the mechanism of

*An Overview of Glaucoma: Bidirectional Translation between Humans and Pre-Clinical… DOI: http://dx.doi.org/10.5772/intechopen.97145*

glaucoma—etiologically and clinically—and to assess the efficacy of treatment trials. By using a uniform stratification of disease progression, large volume studies can be conducted with greater precision, efficiency, and less bias. This will allow for exponential growth in the understanding and treatment of glaucoma as the knowledge of pathophysiology is enhanced. It showcases the use of artificial intelligence to autonomously convert subjective data to an objective form of precise stratification.

To summarize, this chapter makes one thing clear. The "virtuous cycle" of bidirectional translation is essential to further understanding of the pathophysiology of glaucoma. It is the common tool necessary to further observe disease advancement, design more molecular models, identify disease modulators, and discover new therapeutics. Moreover, this chapter reveals that pre-clinical models illuminate this path forward.
