Glaucoma or “green star” is still a common cause of blindness in Germany. Anyone over the age of 40 should therefore have their intraocular pressure checked every two years, as well as the condition of their optic nerve. People with additional risk factors should go for an examination every year. Because: only regular examination by an ophthalmologist detects the disease in time.
Glaucoma: who is affected?
Glaucoma is not a rare disease: in Germany there are about 1 million glaucoma patients, however, only 600,000 know the diagnosis and are treated accordingly. One quarter of all blind people in Germany are blinded by glaucoma. The frequency increases with age: While only about one percent of 40-year-olds are affected, 18 percent of 85-year-olds suffer from it. The following risk factors increase the likelihood of developing glaucoma:
- Age over 40 years
- First-degree relatives with glaucoma, as the predisposition to glaucoma is hereditary
- Nearsightedness
- Diabetes mellitus
- Cardiovascular disease
- Heart failure, high or low blood pressure.
Detect eye diseases: These pictures will help!
Glaucoma: no symptoms at first
Glaucoma is the name given to a variety of eye diseases that – if not detected and treated in time – lead to a sad outcome: They destroy the optic nerve. The fatal thing is that since glaucoma usually does not cause any symptoms at first, the person affected does not notice the insidious disease at first. If parts of the visual field become blurred or dark, it is already too late and the optic nerve is damaged. Therefore, to detect glaucoma in time, regular preventive examinations at the ophthalmologist are crucial.
Development of glaucoma
Intraocular pressure plays a crucial role: a certain pressure inside the eye is necessary for the eye to maintain its spherical shape. The so-called aqueous humor, which carries nutrients for the cornea and lens into the eye, is responsible for maintaining the pressure. However, if the outflow of the aqueous humor is impeded, the aqueous humor can no longer drain away – the intraocular pressure rises. The pressure on the sensitive fibers of the optic nerve causes it to gradually die.
Consequences of increased intraocular pressure
The consequences of too much pressure inside the eye are failures in the visual field, and in the long term, blindness is imminent. When there are failures or limitations in the visual field, one simply no longer perceives certain areas – they are like a blind spot. However, the visual field is at least as important as central vision for our orientation, especially in road traffic. But: increased intraocular pressure does not necessarily lead to the development of glaucoma.
Normal-pressure glaucoma: eye pressure not elevated
Moreover, glaucoma is not always accompanied by increased intraocular pressure. In so-called normal-pressure glaucoma, the eye pressure is in the normal range, i.e., at a value of 21 mmHg or below. In this case, other risk factors are decisive, such as circulatory disorders. This is because the condition of the optic nerve is also influenced by blood flow. It has long been suspected that, in addition to eye pressure, pathological circulatory disorders are also responsible for glaucoma. These become noticeable outside the eye as chronically cold feet and cold hands.
Early detection of glaucoma
Only an early glaucoma screening exam by an ophthalmologist will detect the disease in early stages, consisting of a measurement of intraocular pressure And an examination of the optic nerve condition. Optic nerve damage is critical to the diagnosis of glaucoma. The advantage of early detection of glaucoma: if detected in time, eyesight can be saved by drug treatment. From the age of 40, screening should be performed every two years, then every one to two years from the age of 60. Patients at risk are best advised to have them annually. Glaucoma screening does not harm the eye and costs patients about 15 to 40 euros. As a rule, the statutory health insurance funds do not cover the costs of early detection; it is a so-called iGeL examination (individual health service). Nevertheless, it is an investment that is worthwhile for the sake of your health.
Diagnosis of glaucoma: typical examinations.
The ophthalmologist first takes a detailed medical history and checks for possible risk factors. He examines the back of the eye to check the optic nerve and retina. He also measures intraocular pressure after anesthetizing with a local anesthetic. If glaucoma is suspected, the visual field is then determined. The measurement of the visual field gives the ophthalmologist precise information about the progression of the glaucoma disease. Further examinations may also be required.
Treatment of glaucoma
Well over nine percent of glaucoma patients can be treated medicinally with eye drops. These often contain beta blockers or prostaglandins. The goal, lowering intraocular pressure, can be achieved in two ways:
- Slow down the production of aqueous humor or
- Increase the outflow of aqueous humor.
In addition, the eye drops improve blood flow to the optic nerve and retina and are therefore also used in the case of normal pressure glaucoma. Often, lowering blood pressure is also part of the therapy.
Timely therapy is crucial
The most important thing is regular use of the medication according to the ophthalmologist’s instructions – even if you do not notice any symptoms yourself. Of the glaucoma patients diagnosed early, almost none go blind. In this way, the course of the disease can be delayed – however, glaucoma is not curable. Patients who cannot be treated with medication can be treated with laser therapy or surgery. Whether a patient with elevated intraocular pressure should receive glaucoma prophylaxis must be decided on a case-by-case basis. One study showed that of patients not treated, ten percent developed glaucoma in five years.
