Early detection of glaucoma in outreach and primary health care units in Egypt

Mohamed Yasser Sayed Saif; Ahmed Tamer Sayed Saif; Passant Sayed Saif; Wesam Salah

doi:10.4103/1858-6538.205797

REVIEW ARTICLE

Year : 2017 | Volume : 4 | Issue : 1 | Page : 1-3

Early detection of glaucoma in outreach and primary health care units in Egypt

Mohamed Yasser Sayed Saif¹, Ahmed Tamer Sayed Saif², Passant Sayed Saif³, Wesam Salah⁴
¹ Department of Ophthalmology, Beni-Suef University, Beni Suef, Egypt
² Department of Ophthalmology, Fayoum University, Fayoum, Egypt
³ Department of Ophthalmology, Misr University for Science and Technology, 6^th of October City, Giza, Egypt
⁴ Department Environment, National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt

Date of Web Publication

8-May-2017

Correspondence Address:
Mohamed Yasser Sayed Saif
Saif, Beni-Suef University, 5 Sherif Street, Babel Louk Sq, Cairo 11111
Egypt

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/1858-6538.205797

Abstract

The risk factors for getting glaucoma will channel into the resultant level of IOP and disc damage. The probability was calculated by the equation Y1 = Y0 + A1e X/T1 using the IOP and cup disc ratio. Accordingly people are classified into: Normal, Ocular hypertension, Possible, Probable, Highly probable and Definite glaucoma. In this way the clinical entities of normal, ocular hypertension, and glaucoma suspect, low tension glaucoma and definite glaucoma cases are precisely digitized and diagnosed. The target IOP is calculated according to the cup disc ratio. The details of combined probability of IOP, C/D ratio and the target IOP will be presented in details.

Keywords: Glaucoma suspect, ocular hypertension, target intraocular pressure

How to cite this article:
Saif MY, Saif AT, Saif PS, Salah W. Early detection of glaucoma in outreach and primary health care units in Egypt. Albasar Int J Ophthalmol 2017;4:1-3

How to cite this URL:
Saif MY, Saif AT, Saif PS, Salah W. Early detection of glaucoma in outreach and primary health care units in Egypt. Albasar Int J Ophthalmol [serial online] 2017 [cited 2023 Sep 27];4:1-3. Available from: https://www.bijojournal.org/text.asp?2017/4/1/1/205797

Introduction

For early diagnosis of glaucoma or glaucoma suspect in absence of stigmata of one or more of the triads (intraocular pressure [IOP], field changes, and cupping), we introduce the solution.^{[1],[2],[3],[4],[5],[6],[7],[8],[9],[10],[11],[12],[13],[14]}

The risk factors for getting glaucoma include age, race, sex, heredity, family history, systemic (diabetes, obesity, hypertension, hypotension, arteriosclerosis, and smoking) and socioeconomic factors as well as local factors (myopia, corneal thickness, and scleral rigidity); all will channel into the resultant level of IOP and disc damage. Hence, calculation of the combined probability of getting glaucoma for these two factors alone will include all the above-mentioned variables [Figure 1] and [Figure 2].^{[1],[2],[3],[4],[5],[6],[7],[8],[9],[10],[11],[12],[13],[14]}

Figure 1: The probability of getting glaucoma (Y1) in relation to the intraocular pressure (X) and its derived equation

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Figure 2: The probability of getting glaucoma (Y2) in relation to the C/D ratio (X)

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The combined probability will take into consideration the IOP (Y1) and the C/D (Y2) ratio as the resultant outcome [Table 1].

Table 1: The combined probability between the IOP (Y1) and the C/D (Y2) ratio. Normal: (Green) Possible: (Yellow) Probable (Light blue), Highly probable (Dark blue) and Definite (Red)

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[INLINE: 1]

Early Diagnosis

Based on the calculation of the probability of getting glaucoma, people are classified as follows:

Normal up to 0.10 on the probability scale with normal IOP up to 21 mmHg and C/D ratio up to 0.5 (nothing to be done)
Ocular hypertension in whom the rise of IOP above 21 mmHg is the only sign with normal C/D ratio and their management will follow the general scheme of possible, probable, or definite as will be demonstrated
Possible up to 0.20 on the probability scale with rise of IOP more than 21 mmHg and increase of C/D ratio, but the combined probability will not exceed 0.20 (observation)
Probable up to 0.30 on the probability scale (these has to be treated and observed), a monotherapy may be sufficient to achieve the target IOP
Highly probable up to 0.40 on the probability scale (treatment vigorously and observe), a bitherapy may be needed to achieve the target IOP
Definite more than 0.40 on the probability scale (full tolerable treatment, laser or surgery, and observe to achieve the target IOP).

Target Intraocular Pressure

In cases that required medical treatment we have to achieve the target IOP.^[15]

Our target IOP is to reduce the pressure to a probability of 0.10 or maximally 0.20 if it is possible taking into consideration that the IOP has to be corrected for any change in the corneal thickness or scleral rigidity. The target pressure in our study is related to the C/D ratio (corrected) [Table 2].

Table 2: Target IOP

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Management

Normal : Nothing to be done

Possible : Observe

Probable : Treat and observe

Highly probable : Treatment vigorously and observe

Definite : Full tolerable treatment, laser or surgery, and observe.

Acknowledgment

We would like to acknowledge Dr. Kamal Hamouda, prof of Mathematics, Cairo University; Dr. Essmat Tharwat, prof of Biostatistics, Cairo University; and Dr. Hamadan A. S. El Shemairy, Researcher of Physics, NILES, Cairo University.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

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