Glaucoma is a pathological change in eye pressure that can lead to irreversible damage of the optic nerve and loss of vision. At early stages, the increased eye pressure will usually go unnoticed.

Glaucoma is one of the leading causes of blindness worldwide. The damage is often caused by increased eye pressure, but there are also glaucomas with low or normal eye pressure. These types of glaucomas cause damage to the optic nerve despite the fact that the intraocular pressure is low. Optic nerve damage caused by glaucoma is irreversible. Early detection and treatment are therefore crucial.

Symptoms

The main symptom of glaucoma is visual field loss, which patients will only notice once it has become widespread. A visual field test can detect visual field loss early on in order to initiate treatment. In rare cases, increased eye pressure can cause blurred vision or reddened and aching eyes or headaches and a pressure sensation in the eyes and/or the head.

In most cases, however, glaucoma does not cause any symptoms at all and is therefore all the more dangerous, since the damage it causes will be irreversible by the time it is diagnosed.

For this reason, regular preventive screening is important.

This includes measuring the intraocular pressure and the corneal thickness (pachymetry).

However, as there are also types of glaucoma in which the intraocular pressure is normal or even low, it is very important to also measure the shape and thickness of the optic nerve.

In our practice, we do this by means of an OCT (optical coherence tomography) test.

This involves measuring the optic nerve without touching it, and only takes a few seconds. Since most patients develop glaucoma gradually over many years, these tests should be repeated at certain intervals to compare the results. This makes it possible to assess whether the optic nerve is losing nerve fibres as a result of excessive pressure and is becoming thinner in the process.

The loss of one nerve fibre equals the loss of one pixel in our visual field. If several nerve fibres are destroyed, the patient will suffer increasing visual field loss. As a rule, visual field loss proceeds slowly (over the course of months or even years) and is often not recognised as such by the patient. Visual field testing is therefore necessary to ensure early detection of glaucoma. On the basis of this test, the function of the optic nerve can be assessed and appropriate treatments (pressure-lowering eye drops, laser, surgery) can be initiated at an early stage.

Prevention

Since glaucoma usually does not cause any pain and the visual field loss it induces can go unnoticed for a long time, the only way to prevent it is to see an ophthalmologist regularly for testing. Since the incidence of glaucoma increases significantly from the age of 40, regular preventive screening is recommended starting from this age. If your family is known to have a history of glaucoma, it is advisable to start preventive screening at an earlier point in time, as a predisposition to glaucoma may be inherited.

Treatment

Glaucoma treatments aim to reduce the intraocular pressure and improve the blood flow to the optic nerve. The treatment options range from the administration of eye drops or – more rarely – tablets to laser treatment and surgery.