Glaucoma is one of the most frequent diseases of the visual nerves and may lead to blindness if untreated.
Video: Glaucoma description
Glaucoma is the second most cause of blindness worldwide. The term glaucoma is a summary of a group of eye diseases that damage the visual nerve and lead to blindness if untreated. Often, this is due to an increased intraocular pressure; however, other factors may also be involved and should not be neglected. Here, state-of-the-art diagnostics and innovative treatment of primary narrow-angle or open-angle glaucoma are part of our special fields. We closely cooperate with Dr. Karsten Klabe, senior physician of the Eye Clinic of the Marien Hospital Düsseldorf and internationally renowned expert in this field. Dr. Klabe performs approx. 400 glaucoma surgeries per year. One of his focuses in on canaloplasty, a minimal-invasive treatment of the open-angle glaucoma.
Glaucoma may occur if the fluid circulation in the eye is out of balance.
Fluid Circulation
Understanding the causes of glaucoma requires knowledge of the fluid circulation in the eye. The aqueous fluid, which is produced by the ciliary body, flows through the pupil into the eye and is drained off via the trabecular meshwork - the drainage system of the eye. In a healthy eye, inflow and outflow are balanced. Healthy intraocular pressure is required to ensure correct shape, nutrition and function of the eye. The balance between production and drainage can be disturbed by various factors, correspondingly resulting in damaging of the visual nerves.
Primary narrow-angle glaucoma.
Narrow-angle Glaucoma
There are two types of glaucoma, respectively with differing progress of disease. The so-called "primary narrow-angle glaucoma"(a narrow angle between posterior corneal plane and anterior iris plane) is less frequent. It may develop over years or even cause sudden and painful visual field loss (scotoma) within minutes (narrow-angle glaucoma), which may rapidly result in blindness. Far-sighted persons are more affected because their anterior eye chamber is very small.
Open-angle glaucoma.
If the Patient feels symptoms, then often it will be too late for treatment.
The "open-angle glaucoma" (an open angle between posterior corneal plane and anterior iris plane) occurs more frequently, and it is also characterised by a chronic progress which often is not noticed. In this case, the increasing eye pressure is to be attributed to the lack of drainage possibilities of the aqueous fluid in the eye. The increased intraocular pressure results in greenish discolouration of the eye's cornea. The increased intraocular pressure caused by excessive water also damages the visual nerves; finally, the visual nerve will die off, unless the disease is treated.
Open-angle Glaucoma
Also this kind of glaucoma results in visual field loss. However, this occurs at a very low speed and is often not noticed because the visual field of the other eye offsets the lacking areas. There are estimated millions of people in Germany who suffer from undiagnosed glaucoma and are threatened by loss of vision and blindness. Already at the age of 40, the Bundesverband der Augenärzte (BVA) recommends a painless examination for early glaucoma detection every three years. And starting at the age of 65, such examination is recommended every one to two years. With certain risk factors even a yearly exam may be advisable.
When do you belong to a high-risk group, and when is an immediate examination of your eyes required?
Glaucoma Risk Factors
Risk factors for getting glaucoma include a combination of advanced age, high or highly fluctuating blood pressure as well as short-sightedness / myopia (chronic progress of disease) or high far-sightedness / hyperopia (sudden visual field loss). A family history of glaucoma (disposition) as well as diabetes mellitus also belong to the known risk factors. Besides measurement of intraocular pressure and checking of posterior pole and visual field, examinations also include state-of-the-art technology, e.g retinal thickness analyser and laser scans.
Up-to-date treatment of glaucoma
Lowering of intraocular pressure is the main focus of glaucoma treatment. This can be achieved by various linked measures, e.g. treatment with drugs for lowering of eye pressure or laser-surgical intervention. Both is possible by means of several treatment options, which are respectively determined by clinical picture and course of disease.
Today, glaucoma does not necessarily result in blindness, provided that it is diagnosed and treated early.
The late stage of the open-angle glaucoma requires eye-surgical measures that create new drainage possibilities for the aqueous fluid. The canaloplasty - a minimal-invasive intervention that is performed since 2007 and that has fewer side effects as compared to other surgical techniques - is a very innovative method. This involves insertion of an implant through the natural drainage canal of the aqueous fluid (Schlemm's canal). Our cooperation partner at the Marien Hospital, Dr. K. Klabe, successfully performed this quite demanding operation several times. On the top right of this page you can find a video of an expert lecture of Dr. K. Klabe.