Early detection of Glaucoma
A new scoring system
By
 Prof.
Dr. Sayed S E H Saif
Ex Dean Of NILES
Prof of Ophthalmology
Cairo University
 Dr.
M Yasser S Saif
Lecturer of Ophthalmology
Beni Sueif University
 Dr. Ahmed
T S Saif
Lecturer of Ophthalmology
Fayoum University

Table 1: the combined probability of IOP with C/D ratio which
predicts the probability of glaucoma in the next 5 years
How to use this table
 Measure
the IOP
 Examination
of fundus for C/D ratio
 Look
in the table for the corresponding
probability
 Then
see the color of the probability
 Manage
the patient according to the
probability
then
 See
the Target IOP for each CD ratio
C/D ratio
0
Target IOP
20
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
18
17
16
15
14
13
10-12
10
9
8
Management

Normal: nothing to be done

Possible :
observe

Probable:
treat and observe

Highly probable: treatment vigorously & observe

Definite: full tolarable treatment, laser or surgery
& observe
Example
 Measure
the IOP
 Examination
example 0.5
example 25 mmHg
of fundus for C/D ratio
 Look
in the table for the corresponding
probability (0.22)

Then see the color of the probability

yellow

Manage the patient according to the probability
(yellow color is for observation)
Target IOP
 There
is no target IOP for this patient
because he is under observation not
treatment
Other examples
 The
following table contain several
examples with their probability at the
bottom row
Case
The color of
the column
indicate the
management
according to
table
Probability
from the table
Target IOP to
be reached
for patients
on
Sex
Age
History
1
2
3
Male
55
DM 5yrs
Female
62
+ve
Male
58
family history
IOP
Fundus
Field
Hypotension
Hyperlipidemia
Smoker
31
0.3
Normal
540
27
0.4
Normal
520
26
0.1
Normal
510
Probability
-6.0
0.480
-3.0
0.304
0.215
Target IOP
16
15
observe
Corneal
thickness
refraction
Case
4
5
6
Sex
Male
Male
Female
Age
22
70
52
DM 5yrs
+ve FH
-
IOP
22
25
12
Fundus
0.6
0.5
0.7
Normal
Normal
Normal
Corneal
thickness
560
510
500
refraction
-6.0
-
-7.0
Probability
0.217
0.220
0.265
Target IOP
observe
observe
10
History
Field
Case no
7
8
9
10
Sex
Male
Female
Male
Female
Age
8
45
54
62
Steroids
drops
+ve family
history
+ve family
History
+ve family
history
Black
IOP
Fundus
42
0.6
32
0.7
20
0.9
26
0.8
Extensive field
loss in the
central 10
degree of
fixation
Supperior and
inferior
arcuate
scotomas
555
540
Field
Corneal
thickness
refraction
Early field
changes
490
Loss above
and below
the central
fixation
510
Mild myopia High myopia Mild myopia
history
Obese
Smoker
Moderate
myopia
Probability
Table 1
> 0.7
0.710
0.415
0.475
Target IOP
13
12
9
10
Acknowledgement:

Prof Dr Kamal Hamouda: prof of mathmatics,
Cairo Universirty

Prof Dr Essmat Tharwat : prof of Bio-statistics,
Cairo Universirty

Dr Wesam Salah: lecturer of mathmatics,
NILES, Cairo Universirty

Dr Hamadan A. S. El Shemairy: Researcher of
Physics, NILES, Cairo Uni
For more information :
 Web
Page: www.sayedsaif.com
 Email:
[email protected]
[email protected]
 Tel:


010 66 99 288 ,
012 34 56 757