Cognitive Assessment in Glaucoma Care: A Narrative Review of Clinical Rationale, Screening Tools, and Implementation Challenges.

In recent years, increasing attention has been directed toward the association between glaucoma and cognitive impairment, with a growing number of reports highlighting their interrelationship. With the progression of population aging, the coexistence of these two conditions is expected to rise further. Cognitive impairment may influence glaucoma management in multiple ways, including difficulties in performing subjective examinations such as visual field testing, reduced adherence to topical medications, and an elevated risk of postoperative complications. Consequently, integrating cognitive assessment into glaucoma care may be particularly relevant in selected patient populations, such as older adults or those with suspected adherence or reliability issues. This narrative review aims to summarize the current evidence on the relationship between glaucoma and cognitive impairment and to provide an overview of commonly used cognitive screening tools. In addition, we discuss the clinical implications of cognitive dysfunction in glaucoma management and highlight emerging digital approaches for cognitive assessment. Given that much of the available evidence is observational and that glaucoma-specific validation of cognitive screening strategies remains limited, this review provides insights into optimizing glaucoma care in an aging society and outlines directions for future research.