Proposal of the Glaucoma Etiology Complex (GEC): A Structured Framework for Understanding the Multifactorial Nature of Glaucoma.

The Glaucoma Etiology Complex (GEC) is a conceptual framework encompassing all elements involved in the pathophysiology of glaucoma. Glaucoma is no longer understood as a disease driven solely by intraocular pressure; instead, it is increasingly recognized as a complex condition influenced by ocular, systemic, genetic, vascular, and lifestyle-related factors. The nine components of the GEC are: 1. age, 2. genetic factors, 3. intraocular pressure, 4. ocular characteristics, 5. ocular comorbidities, 6. vascular factors, 7. systemic comorbidities, 8. lifestyle factors, and 9. patient treatment attitude. These components interact with each other to dynamically shape the disease process over time. This editorial presents the structure and significance of the GEC, aiming to provide a comprehensive framework for understanding the multifactorial nature of glaucoma. This perspective may serve as a useful reference for both clinicians and researchers in pursuing individualized risk assessment, early diagnosis, and personalized management strategies for glaucoma.