Causes

As already mentioned, the measurement of intraocular pressure is carried out as an early detection examination in case of suspected glaucoma (regular from a certain age). This is because with glaucoma the balance between production of aqueous humor and outflow of aqueous humor described above is disturbed and the intraocular pressure increases. A moderate increase in intraocular pressure goes unnoticed by the patients themselves, as it neither causes pain nor leads to loss of the visual field or other visual impairments.

Only when the optic nerve has already been damaged by a prolonged increase in intraocular pressure does discomfort occur, but then it is already too late to restore the affected optic nerve and one can only try to keep the damage as small as possible. However, the measurement of intraocular pressure is not exclusively suitable for early glaucoma detection. It is also advisable to have it checked at regular intervals after any other injury to the eye, as there is generally a risk of so-called secondary glaucoma developing after an injury to the eye. The use of cortisone-containing medication, especially eye drops containing costison, can also lead to the development of cortisone glaucoma. Even in this case, regular monitoring of intraocular pressure can reveal damage at an early stage.

Coverage of costs

However, since 2015 there has been a certain conflict with the statutory health insurance companies in Germany. Their representatives do not believe that the measurement of intraocular pressure as an early preventive examination to detect increased intraocular pressure, which in most cases leads to glaucoma, is of sufficient benefit and have therefore decided to charge for tonometry as an individual health service (IGeL services). Recognized ophthalmologists recommend an annual measurement and control of the intraocular pressure values for every patient who has reached the age of 40. In this way, a beginning glaucoma can be detected and treated early and major damage to the optic nerve and thus to the vision can be avoided. However, if there is already a well-founded suspicion that a patient is suffering from glaucoma and tonometry is therefore used as a kind of follow-up examination, the statutory health insurance also pays for the examination.

Risk of increased intraocular pressure

If the intraocular pressure rises, this leads to a pressure gradient being passed on via the vitreous body inside the eye, which in turn passes the pressure on to the back of the eye with the retina and optic nerve. The optic nerve tolerates only a certain pressure without damage. Increased intraocular pressure is usually painless, and damage to the optic nerve is often only detected at a late stage. This makes it urgently necessary to have the intraocular pressure checked regularly by measuring the intraocular pressure.