Glaucoma

Glaucoma belongs to one of the most frequent causes of blindness, when not treated in time. Damage to the optic nerve occurs due to the increased internal eye pressure and/or circulatory problems. In the following stages of this disease, individual sensitive optic nerve fibres die. The images projected onto the retina can thus only be partially sent further to the optical center of the brain. This causes the gradual loss in one's field of vision until one is blind. For this reason glaucoma is tricky, because one doesn't notice these gradual changes. That is why regular screening examinations at your eye doctor are so important, in order to discover symptoms of glaucoma. The eye needs a certain internal pressure level to keep its form and functionality, which is provided by the production of anterior chamber fluid. In the normal eye an equilibrium exists between production and outflow of this fluid.

If the drainage apparatus of the chamber water doesn't function properly, the result is an increase in internal eye pressure. Most often, the cause is due to age-related reduction in the permeability of the trabecular meshwork, through which the chamber fluid is discharged. This altering process can begin as earlier as the age of 40. Infrequently, previous ailments and disease of the eye, for instance circulatory diseases(advanced diabetes, thrombosis) and inflammation of the inner eye, contribute to a disturbance in chamber fluid flow. In this case, it is important, that your physician recognises and treats the underlying ailments in a timely manner.

A special form of glaucoma is the primary angle glaucoma, or acute glaucoma, which is accompanied by heavy pain, substantial loss of vision and reddening of the eyes. The cause of this is the sudden blockage of the chamber fluid drainage. Only with immediate ophthalmologic emergency treatment can blindness be avoided.

Because increased internal eye pressure causes no noticeable discomfort, pre-screening treatment for glaucoma is crucial. If you are over 40 years old, you should have your eyes examined annually. If you are a diabetic or highly short-sighted, if you have an increased internal eye pressure, or if a relative already suffers or has been diagnosed with glaucoma, you should consult your eye doctor annually even before you turn 40. Unfortunately, the social medical insurance only covers and pays for services for those, who have a founded suspicion of glaucoma, for example, close relatives, who have already been diagnosed with glaucoma, or have already damaged vision from Diabetes mellitus.

In reality, several million Germans are endangered , even though they don't meet these governmental prerequisites. For this reason, we offer glaucoma pre-screening exams in our clinic, as an individual health care procedure (IGeL). Thus, you may make use of this important examination. In the case of a positive glaucoma finding from your eye doctor, the social medical insurance will, from this point in time, take care of all following procedures, including the examination.

The internal eye pressure is measured with a tonometer. This examination is rapidly and painlessly carried out. Because the eye is susceptible to changes during the day, it is advisable to have a day-night profile compiled. In order for the measurement to be as accurate as possible, it is important to know the thickness of the cornea. This is measured - again completely painless - with a pachymeter.

An examination of your field of vision is necessary in order to determine whether or not there is already existing damage. There are different devices and procedures for this: The patient looks into a half-globed screen, on which points of light of different intensity are projected, which the patient recognizes or not. The ophthalmologist has a map of this, which marks which points are perceived and which are not.

The optic nerve head can be examined using various methods. The Heidelberger Retina Tomography (HRT) is a device that is especially exact. It shows the optic nerve and retina three-dimensionally. The measured values are archived and used as a basis for comparison for later examinations. Changes of the optic nerve often occur at a much earlier stage than the actual loss of vision functionality. Thus, treatment can take place in a timely manner before further damage occurs.

Eye drops that lower the inner eye pressure are usually prescribed. One requirement for this to be successful however, is a disciplined and regular application of these drops, as well as attendance of all routine eye appointments. If it's not possible to regulate the eye pressure with medication, there is a good possibility to reduce it with the help of a laser treatment or through an operation.