HAP Glaucoma Staging (Hodapp-Anderson-Parrish)
HAP (Hodapp-Anderson-Parrish) classification stages glaucoma severity into Early, Moderate or Severe using visual-field mean deviation (MD) on 24-2 SITA-Standard fields. Used to stratify follow-up and treatment intensity.
Score interpretation
→ Confirm with repeat field (≥2 reliable). 6-monthly fields and OCT-RNFL. Treat to 25–30% IOP reduction (NICE NG81 — first-line 360° SLT or PGA). Lifestyle counselling, family screening.
→ Treat to 30–40% IOP reduction. Add adjunctive drops or repeat SLT. 4-monthly fields. Counsel re: progression risk and surgical options (trabeculectomy, MIGS, tube).
→ Aggressive IOP target (<14 mmHg or 50% reduction). Specialist glaucoma service. Urgent surgical intervention (trabeculectomy with mitomycin C, glaucoma drainage device) if uncontrolled. DVLA notification if visual field loss meets failure criteria. Low-vision rehabilitation; CVI registration if eligible.
Interpretation bands for the HAP. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Netarsudil 0.02% Eye Drops · Rho-kinase (ROCK) Inhibitor — Glaucoma
- Tafluprost 0.0015% Eye Drops · Prostaglandin Analogue — Glaucoma (Preservative-Free)
- Dorzolamide / Timolol Fixed Combination (Cosopt) · Fixed Combination Glaucoma Treatment — CAI + Beta-blocker
- Latanoprostene Bunod 0.024% Eye Drops · Nitric Oxide-donating Prostaglandin Analogue — Glaucoma
- Brimonidine / Timolol Fixed Combination · Fixed Combination Glaucoma Treatment — Alpha-2 Agonist + Beta-blocker
- Betaxolol 0.5% Eye Drops · Cardioselective Beta-1 Blocker — Glaucoma
- Acute Red Eye / Vision Loss Screen · RCOphth 2020; NICE CKS
- Idiopathic Intracranial Hypertension · ABN; consensus 2018
- Acute Red Eye Assessment · RCOphth / AAO
- Acute Angle Closure Glaucoma · RCOphth / EGS Guidelines
- Retinal Detachment · RCOphth Guidelines / EURETINA
- Diabetic Retinopathy — Screening and Management · NICE NG28 2016 / NHS DES Programme
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.