Risk Factors: The Risk Calculator

Abstract

Eye care providers can use calculators for determining the risk of developing glaucoma from ocular hypertension. Approximately 8% of adults over the age of 40 in the United States have ocular hypertension [1]. While ocular hypertension is a common finding, eye care providers do not know which patients to treat or which patients to monitor without treatment [2].

Trying to decide whether to treat an ocular hypertension patient is complex without a risk calculator. The newest Ocular Hypertension Treatment Study (OHTS) multivariate regression contains five variables that are predictive of developing glaucoma from ocular hypertension: age, central corneal thickness (CCT), intraocular pressure (IOP), pattern standard deviation (PSD), and vertical cup-to-disc ratio (C/D) [3]. Even if one simplifies the continuous variables of age, corneal thickness, IOP, and PSD into thirds and uses nine different combinations for C/D (0.0–0.8), 729 (3 × 3 × 3 × 3 × 9) different results exist for ocular hypertension patients. This creates a large number of different combinations, which is difficult for clinicians to decipher when deciding whether to treat a particular ocular hypertension patient.