Glaucoma – Causes, Symptoms & Therapy

When to the doctor?

If you have unusual vision problems, you need a doctor. If the changes appear gradually over several weeks or months, a doctor must be consulted as soon as the person concerned notices a weakening of their eyesight. If objects or people can only be recognized out of focus at a distance of a few meters, a doctor is needed.

Since early detection of glaucoma is very important for successful treatment, a doctor should be consulted as early as possible. If there is internal pressure in the eye or a headache, an examination should be initiated. If the symptoms recur or increase in intensity, you need to see a doctor. If your blood pressure fluctuates sharply or your blood pressure is noticeably low, you should see a doctor.

If there is severe nearsightedness or farsightedness, this is considered unusual. A doctor should be consulted to determine the causes of the altered vision. People who have had the disease diagnosed in their family have an increased risk of developing the disease. These people should have a check-up carried out at regular intervals, even if they have no specific complaints. Regular check-ups are also recommended for everyone over the age of 50.

symptoms and course

Possible symptoms of glaucoma:

• Visual disturbances (visual field defects)

• Light and glare phenomena

• hard and red eyes

• eye pain

• headache

• Insensitivity to light sources

• nausea and vomiting

• sensitivity to light

The first form of glaucoma is primary open-angle glaucoma – this causes little discomfort at first, but if left untreated can permanently damage the optic nerve.

The second variant of this disease is acute glaucoma – in this case, the affected eye is red and hard. Affected patients complain of severe pain and a limited field of vision . If not treated in time, this can definitely lead to blindness.

The third form of glaucoma is congenital glaucoma. Since glaucoma is quite insidious and in many cases does not cause any symptoms, you should have a check-up with an ophthalmologist from the age of 40 at the latest.

If the glaucoma is detected too late, it can have serious consequences for vision. The progressive death of the nerve fibers on the optic nerve head usually leads to loss of the field of vision, which can manifest itself, for example, in blurred vision or blind spots, which can eventually lead to so-called “tunnel vision”. This means that the person affected can only see a small section of their original field of vision. If glaucoma is not treated, it can even lead to complete and irreparable blindness.

Diagnose

The absolutely decisive factor in the diagnosis of glaucoma is early detection, since glaucoma, as glaucoma is also known, usually only causes symptoms when it is already at an advanced stage.

There are various ways to accurately determine a glaucoma, and only all of them together usually lead to a clear diagnosis. In most cases, this starts with a measurement of the intraocular pressure.

In so-called tonometry , a measuring device is briefly brought into contact with the cornea in order to be able to measure the pressure inside the eye. Another procedure is the ophthalmoscope, in which the optic nerve and the retina are checked for any abnormalities.

Furthermore, an eye test can also provide valuable information for the early detection of glaucoma. If symptoms such as impairment of the field of vision can already be observed, a field of vision measurement can provide information about how severely the eye is already restricted in perceiving differences in brightness.

The so-called pattern electroretinogram (MERG), which is still in the test phase, can show impaired photoreceptors at a very early stage. The methods for detecting glaucoma as early as possible are improving more and more from year to year, but the results are not always clear and regular visits to the ophthalmologist, even without acute symptoms, are essential.

complications

Complications in the later course of the disease with glaucoma are very common. The reason for this is the initially rather inconspicuous development of the early stages. Visual disturbances and other symptoms only occur more frequently after it has existed for a long time. Accordingly, patients are usually already affected by damage to their optic nerves. Therapy with an increase in eye drops is often sufficient. If treatment is postponed for too long, there is a risk of total loss of vision in the eye.

In some cases, the intraocular pressure cannot be reduced to a satisfactory extent despite countermeasures. Depending on the severity of the disease, surgery may then prove necessary. The purpose of the intervention is to create an optimal pressure equalization, which is to be achieved via an artificially laid drain.

Serious complications are not to be expected, but pronounced blood accumulations can occur in the eye as a result of the operation. As a rule, these disappear by themselves after a while and are therefore no longer considered to require treatment. In the case of the congenital variant of glaucoma, typical signs generally appear earlier and allow a timely diagnosis.

Intense tearing of the eyes, increased sensitivity to light and the clouded cornea indicate a disease. However, inherited cases cannot be corrected with eye drops. An operation is mandatory. Otherwise there is a risk of severe impairment of vision in the later stages of the disease, which can lead to complete blindness.

treatment and therapy

The timely treatment of glaucoma is so important because without the right treatment it can lead to visual disturbances and, in the worst case, even blindness. In order to accurately diagnose glaucoma, the ophthalmologist will first check the patient’s intraocular pressure and visual field.In the case of primary glaucoma, eye drops usually help quite well – they help to lower the intraocular pressure. If these have no effect, the laser is often used. This lowers the pressure, but this is usually only a temporary solution.

In many patients, however, surgical intervention is necessary. During this operation, an artificial drainage for the eye fluid is created. This operation is now routine and is performed under local anesthesia without general anesthesia.

prevention

The best way to prevent cataracts is to have your eye pressure checked regularly by an ophthalmologist. Because the sooner the disease is recognized, the better the chances of recovery.

Such an examination is advisable about every three years for people over the age of 40. Those who belong to so-called risk groups can also take advantage of the examination more frequently, and the costs are then even covered by health insurance. Diabetics and people with severe short-sightedness are among the risk groups.