glaucoma

Information on glaucoma

Are you looking for information on glaucoma and specialists for treatment or surgery? Here you will find only experienced specialists and clinics in Germany, Switzerland or Austria. Find out about causes, diagnosis and therapy or contact our glaucoma experts.

What is glaucoma?

GlaucomaGlaucoma is an eye disease that leads to damage to the optic nerve. This causes loss of vision in the field of vision, i.e. the area that is visually perceived when the head is held straight. Once damage to the nerve cells has occurred, it is irreversible.

Glaucoma can remain undetected for a long time, as the first noticeable symptoms only appear in the advanced stages of the disease. Untreated glaucoma can lead to complete blindness. Glaucoma is one of the most common causes of blindness in industrialized countries. The risk of the disease increases with age.

What are the causes of glaucoma? The occurrence of glaucoma is usually due to increased intraocular pressure. However, there are forms of the disease in which the intraocular pressure can also be within the normal range. The increase in pressure is due to an imbalance between the formation and drainage of aqueous humor.

The aqueous humor is a clear fluid that is formed in the eye by the so-called ciliary body and contains nutrients and substances for immune defense. It flows out again through the chamber angle, an anatomical structure consisting of the cornea and the iris.

If more aqueous humor is formed than can drain away, the pressure in the anterior chamber of the eye increases. The increased intraocular pressure leads to disruptions in the blood flow to the nerve cells, which damages them.

What are the symptoms of glaucoma?

Glaucoma is usually painless and goes unnoticed for a long time. Headaches can only occur if the intraocular pressure increases very sharply. The first symptoms only appear when the disease has already reached an advanced stage.

When the field of vision is lost, a third of all nerve fibers are often damaged.
The losses in the field of vision are called scotomas. The field of vision narrows in an arc shape from the outside to the inside. Losses in the center of the field of vision are rare. Other symptoms can include increased sensitivity to light and colored rings around bright light sources, as well as problems with orientation.

What is a glaucoma attack?
The disease usually develops over a longer period of time. Sometimes, however, an acute attack of glaucoma can occur. The sudden, strong increase in pressure interrupts the blood supply to the eye. This can even lead to sudden loss of vision. Such an attack is always an emergency. The intraocular pressure and thus the blood supply to the nerve cells must be normalized as quickly as possible.

Glaucoma diagnosis: How is glaucoma diagnosed?

Glaucoma can develop unnoticed over years. When the first symptoms appear in the form of losses in the field of vision, these are irreversible. The damage can then only be stopped or the progression of the damage slowed down.

Glaucoma early detection from the age of 40
For these reasons, the focus is on the early detection of glaucoma. From the age of 40, the intraocular pressure should be checked at regular intervals. In cases of glaucoma or diabetes in the family, the examinations should be carried out from the age of 35.

The following examinations are usually carried out as part of the early detection of glaucoma. The examinations described are also used to diagnose existing glaucoma.

An eye test is part of the standard program in every ophthalmological examination. In addition, both severe farsightedness and nearsightedness increase the risk of glaucoma.

An examination of the intraocular pressure (tonometry) should also be included in the early detection.

Using ophthalmoscopy, the ophthalmologist examines structures that are affected by glaucoma, namely the retina and the optic nerve.
Other structures inside the eye can be made visible using a slit lamp examination. The doctor examines the eye as if under a microscope. A narrow slit-shaped beam of light from the slit lamp allows an optical section through the transparent sections of the eye. This makes fine structures in the front section of the eye visible and allows pathological changes to be identified.
The crucial examination is the visual field examination (perimetry). If necessary, other methods can also be used.

Glaucoma treatment: How is glaucoma treated?

The most important approach in treating glaucoma is to reduce the intraocular pressure. The optimal intraocular pressure should be determined individually for each patient.

Eye drops as glaucoma treatment
Glaucoma is treated with eye drops. The eye drops either increase the drainage or reduce the formation of aqueous humor.

Glaucoma surgery: laser treatment
In severe cases, intraocular pressure can be reduced with the help of laser treatments or surgical procedures. Laser procedures are constantly being developed to ensure gentle treatment with optimal reduction of intraocular pressure.

Laser treatments, like drug therapy, follow two approaches. On the one hand, the formation of aqueous humor is influenced by the sclerotherapy of the ciliary body, and on the other hand, the resulting scars enable additional drainage for the aqueous humor.

The aim of laser treatments of the chamber angle is to improve the drainage of the aqueous humor and thus reduce the intraocular pressure.

Laser iridotomy can be used for special forms of glaucoma. In this treatment, a small hole is lasered into the iris. The iris separates the anterior and posterior chambers of the eye. Laser iridotomy creates a pressure equalization between the two chambers of the eye, thereby improving the flow of aqueous humor.

Glaucoma operations: trabeculotomy, goniotomy, microimplants, canaloplasty
The surgical treatments for glaucoma also aim to enable improved drainage of the aqueous humor and thus reduce the intraocular pressure.

The two classic glaucoma operations are trabeculotomy and goniotomy. An opening to the anterior chamber of the eye is created in the tissue of the chamber angle, the trabecular meshwork, thus creating an artificial drainage route for the aqueous humor.

A newer method for the surgical treatment of glaucoma is canaloplasty. A catheter is placed in the central drainage channel of the aqueous humor, the Schlemm canal. This catheter keeps the canal permanently open and thus allows the aqueous humor to drain.

Another new, innovative surgical method is the use of microimplants to ensure the drainage of the aqueous humor. This treatment option reduces the healing phase and is comparable to the results of canaloplasty.

What is the prognosis for glaucoma?

If left untreated, glaucoma leads to total blindness, as more and more optic nerve cells are damaged over time. For this reason, early detection of glaucoma is of central importance.

However, appropriate treatment, which should be determined individually for each patient, makes it possible to stop the disease from progressing. The nerve cells that have already been damaged cannot be repaired, but new damage can be prevented. Do not hesitate to contact one of our glaucoma specialists to stop the disease from progressing steadily.

Which specialists and clinics are glaucoma specialists in Germany and Switzerland?
If you need glaucoma surgery, you want the best medical care for yourself. That is why patients ask themselves, where can I find the best eye clinic for glaucoma surgery? Bonn University Hospital is one of the best hospitals in Germany.