• Users Online: 1192
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 


 
   Table of Contents      
REVIEW ARTICLE
Year : 2017  |  Volume : 4  |  Issue : 1  |  Page : 1-3

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


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, 6th of October City, Giza, Egypt
4 Department Environment, National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt

Date of Web Publication8-May-2017

Correspondence Address:
Mohamed Yasser Sayed Saif
Saif, Beni-Suef University, 5 Sherif Street, Babel Louk Sq, Cairo 11111
Egypt
Login to access the Email id


DOI: 10.4103/1858-6538.205797

Rights and Permissions
  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 2017 Dec 11];4:1-3. Available from: http://www.bijojournal.org/text.asp?2017/4/1/1/205797


  Introduction Top


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

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

Click here to view


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)

Click here to view


[INLINE: 1]


  Early Diagnosis Top


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 Top


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

Click here to view



  Management Top


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 Top

1.
Saif SS, Saif MY, Saif AT. Early detection of glaucoma, a new scoring system. Bull Ophthalmol Soc Egypt 2005;98:351-8.  Back to cited text no. 1
    
2.
Saif SS, Saif MY, Saif AT. Target IOP what is new. Bull Ophthalmol Soc Egypt 2006;99:445-9.  Back to cited text no. 2
    
3.
Saif SS, Saif MY, Saif AT. Glaucoma is it still a dilemma in the 21st century. Bull Ophthalmol Soc Egypt 2007;100:395-9.  Back to cited text no. 3
    
4.
Saif SS, Saif MY, Saif AT. Early detection of glaucoma, a new scoring system. High Ophthalmol 2005. Available from: http://www.elibraryweb.net/index.php?option=com_content&task=category&sectionid=9&id=24&Itemid=59. [Last accessed 2014 Dec 15].  Back to cited text no. 4
    
5.
Saif SS, Saif MY, Saif AT. Glaucoma is it Still a Dilemma in the 21st Century, Poster Presentationin 6th International Glaucoma Symposium (I.G.S); 28-31 March, 2007.  Back to cited text no. 5
    
6.
Saif SS, Saif MY, Saif AT. Target IOP What is New. Poster Presentation in 6th International Glaucoma Symposium (I.G.S); 28-31 March, 2007.  Back to cited text no. 6
    
7.
Saif SS, Saif MY, Saif AT. Glaucoma is it Still a Dilemma in the 21st Century. Poster Presentation in World Glaucoma Congress, Singapore; 18-21 July, 2007.  Back to cited text no. 7
    
8.
Saif SS, Saif MY, Saif AT. Target IOP What is New. Poster Presentationin World Glaucoma Congress, Singapore; 18-21 July, 2007.  Back to cited text no. 8
    
9.
Saif SS, Saif MY, Saif AT. Early detection and management of glaucoma, a new scoring system. High Ophthalmol 2007;35:2-4.  Back to cited text no. 9
    
10.
Saif SS, Saif MY, Saif AT. The glaucoma suspect, the dilemma. What is new? Bull Ophthalmol Soc Egypt 2008;101:101-8.  Back to cited text no. 10
    
11.
Saif SS, Saif MY, Saif AT. The Glaucoma Suspect, the Dilemma. What is New? Poster Presentation in EGS Quadriennial Meeting 2008 – Berlin; 2008.  Back to cited text no. 11
    
12.
Saif MY, Khalil HE, El-Khalek MO, Makar A. Variations of cup-to-disc ratio in age group (18-40) years old. Res Ophthalmol 2013;2:4-9.  Back to cited text no. 12
    
13.
Saif MY, Saif AT, Saif PS, El-Den WS. The glaucoma suspect, the dilemma. What is new? Res Ophthalmol 2013;2:10-4.  Back to cited text no. 13
    
14.
Amer SA, Saif MY, Saif AT, Saif PS. Variations of cup-to-disc ratio in children. Open Ophthalmol J 2014;4:12-7.  Back to cited text no. 14
    
15.
Saif MY, Saif SS, Nassar M, Saif AT, Saif PS, Haroun HE, et al. Target IOP Update Presentation in the Fourteenth Annual Congress of the Egyptian Society for the Glaucomas (ESG), Cairo, Egypt; 30, 31 October, 2014.  Back to cited text no. 15
    


    Figures

  [Figure 1], [Figure 2]
 
 
    Tables

  [Table 1], [Table 2]



 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
Abstract
Introduction
Early Diagnosis
Target Intraocul...
Management
References
Article Figures
Article Tables

 Article Access Statistics
    Viewed336    
    Printed49    
    Emailed0    
    PDF Downloaded6    
    Comments [Add]    

Recommend this journal