Glaucoma – also known as glaucoma – is one of the most common causes of blindness in our culture. Five million people in Germany have elevated intraocular pressure, 800,000 have glaucoma and 50,000 are at risk of blindness. Glaucoma is a gradual disease. Many people suffer from it without knowing it at first, because the disease is usually completely painless. Only when the disease is already advanced do noticeable visual losses occur. Later, the field of vision narrows more and more until only a small section of the area that a healthy eye overlooks can be seen.
Causes
Individually elevated intraocular pressure stresses the highly sensitive optic nerve until it eventually dies and vision is extinguished. Even a statistically normal pressure can be the cause of glaucoma if there is insufficient blood flow to the optic nerve – high blood pressure, very low blood pressure, blood sugar elevation, nicotine, vasoconstriction due to calcium deposits, aging processes. Although, once developed, limitations of vision can not be reversed, but regular screening and timely treatment by the ophthalmologist can help to prevent the damage in most cases.
Indications (areas of application)
Regular screening examinations for glaucoma should be performed if one or more of the following risk factors are present: Biographical causes
- Genetic burden – known glaucoma in first-degree relatives (single studies only; 2.8-fold increase in risk)
- Anatomical variants – for example, shallow anterior chamber of the eye, narrowing or displacement of the so-called chamber angle; low corneal thickness.
- Ethnic origin – black race (risk increase compared to the white population by four to five times).
Behavioral causes
- Nutrition
- Micronutrient deficiency (vital substances) – see Prevention with micronutrients.
- Consumption of stimulants
- Tobacco (smoking)
- Overweight (BMI ≥ 25; obesity).
Disease-related causes
- Ablatio retinae (retinal detachment).
- Bleeding in the eyeball
- Carotid stenosis (narrowing of the carotid artery)
- Chronic intraocular inflammation – inflammation located in the eye.
- Diabetes mellitus (not an established risk factor for primary open-angle glaucoma; risk factor for secondary glaucoma)Diabetes mellitus, diabetes duration, and fasting glucose levels are associated with a significantly increased risk of glaucoma. Diabetes mellitus and fasting glucose levels is associated with slightly increased intraocular pressure
- Hypertension (high blood pressure)
- Intraocular tumors – tumors located in the eye.
- Myopia (nearsightedness) – risk increase from -5.0 D up to five times.
- Sleep apnea (respiratory failure during sleep).
- Uveitis (inflammation of the middle skin of the eye (uvea), which consists of the choroid (choroid), the ray body (corpus ciliare) and the iris).
- Injuries of the eye
- Central retinal vein occlusion – occlusion of veins supplying the eye.
Laboratory diagnoses – laboratory parameters that are considered independent risk factors.
- Hyperlipidemia (lipid metabolism disorder) – hypercholesterolemia.
- Fasting glucose (fasting blood sugar) – diabetes mellitus and fasting glucose levels is associated with mildly elevated intraocular pressure
Medication
- Antidiabetic drugs
- Biguanides (pressure increase of > 1 mmHg = 14% increased risk of developing glaucoma within five years)
- Sulfonylureas (pressure increase of > 1 mmHg = 14% increased risk of developing glaucoma within five years).
- Bevacizum – patients with age-related macular degeneration (AMD) who received seven or more intravitreal injections of this drug per year (2.48-fold increased risk)
- Cortisone (eye drops), long-term treatment.
The procedures
The following diagnostic procedures are used to diagnose glaucoma:
- Tonometry (intraocular pressure measurement)
- Slit lamp examination – general assessment of the eye, especially assessment of anterior chamber depth as a landmark parameter.
- Gonioscopy – assessment of the trabecular meshwork.
- Funduscopy (synonym: ophthalmoscopy) – examination of the fundus of the eye, that is, assessment of the optic papilla and optic nerve.
- Perimetry – objectification of visual field defects.
Benefit
Regular glaucoma screening every 2 years between the ages of 40 and 50, and annually after the age of 50, is necessary to avoid the risk of glaucoma. Your eyesight is one of the most precious things you own. Help keep your eyes healthy for as long as possible by getting regular preventive care.
