Frequently Asked Questions
Frequently Asked Questions
Even conditions that appear harmless and localised can quickly affect vital areas of the eye. We have assembled answers to the most frequently asked questions in our practice.
Routine eye check-ups are essential for early diagnosis and prevention of various illnesses. Many eye diseases begin without perceptible symptoms, e.g., glaucoma. Other medical conditions like e.g., multiple sclerosis (MS) sometimes manifest themselves at first in the eyes. Diagnosing these conditions early on often allows for a broader range of treatments and can reduce the risks of afflicting further damage. After the age of 40, the risk of developing glaucoma rises substantially. Regular eye check-ups therefore become more important. Typically, we recommend preventive examinations for adults once a year.
Watery eyes can be caused either by excessive production of tear fluid (lacrimal fluid) or by inefficient discharge of the tear fluid. The latter can be caused either by malposition of the eyelids or an obstruction of the lacrimal duct. Treatment options consist of eyelid surgery and probing and irrigation or surgery of the lacrimal duct. The main cause of excessive production of tear fluid is dry eyes.
There are two main reasons for dry eyes: either a reduced production of tear fluid; or an alteration in the composition of the tear fluid that leads to a reduced capacity to wet the eye surface. The latter can be caused by issues with eyelids or blinking, medication (e.g., anti-histamins, contraceptives, anti-depressants, beta blockers), climatic conditions (dry air, wind, dust), injuries, and a variety of medical conditions like arthritis or the Sjogren syndrome. Dry eyes are also a common effect in the natural aging process. Dry eyes can cause the following typical symptoms:
- Foreign body sensation
- Itching / burning
- Redness
- Blurry vision
Dry eyes are not merely uncomfortable but can cause severe damage of the ocular surface.
Dry eyes lead to an irritation of the ocular surface, which subsequently leads to an increase in the production of tear fluid. In general, this however does not solve the underlying problem of an inadequate chemical composition of the tear fluid.
Treatment options are as plentiful as the causes of dry eyes and involve more frequent blinking, improvement of air conditioning, use of artificial tears (lubricating eye drops) and ointments, and lacrimal duct surgery.
Misalignment of the eyes (strabism) can lead to impairment of visual acuity and of three-dimensional vision. Both eventually lead to amblyopia (weak-sightedness), which cannot be corrected in adult age anymore. It is therefore essential to train both eyes during childhood to develop maximum acuity.
Glaucoma is a damage of the optic nerve caused by intraocular pressure. It is one of the main causes of blindness worldwide. The damage is most frequently caused by elevated intraocular pressure, but low pressure and normal pressure glaucoma are also known. In these conditions, the optic nerve is damaged in spite of low intraocular pressure. Damage to the optic nerve caused by glaucoma is irreversible. Early diagnosis and treatment are therefore crucial.
The main symptom of glaucoma is the deterioration of the visual field. Patients will typically be unaware of these until an advanced stage. A visual field test helps to detect a deterioration of the visual field at an early stage allowing early treatment. In rare cases, elevated intraocular pressure can lead to blurry vision, irritated or red eyes, headaches, and a sensation of pressure in the ocular region or the head. In most cases, however, glaucoma does not cause any discomfort. This is particularly dangerous as it can prevent early diagnosis and any damage already done is not reversible. Therefore, regular preventive medical check-ups are essential.
Glaucoma therapy aims at lowering the intraocular pressure and improving the blood flow of the optic nerve. Therapies include application of eye drops or, more rarely, tablets, as well as laser treatment and surgery.
Since glaucoma causes no pain and deterioration of the visual field can remain undetected for a long time, regular medical check-ups are the only option for glaucoma prevention. After the age of 40, the risk of developing glaucoma rises substantially. Regular eye check-ups therefore become more important. We recommend preventive examinations for adults once a year. If you have known cases of glaucoma in your family, preventive examinations are recommended already at a younger age, since glaucoma can be inherited.
Cataract is a clouding of the lens, which is part of the normal aging process. However, several conditions exist that can lead to a clouding of the lens at a younger age as well.
The increasing opacity of the lens caused by cataracts leads to a loss of acuity, blurry vision and impaired colour vision. Since the clouding of the lens can proceed very slowly, it is not unusual for patients to remain unaware of their loss of acuity. It is therefore essential to have regular eye examinations even if you do not perceive to have any issues with your eyes.
Cataracts used to be the main cause of blindness of the old. Today, however, cataracts can be treated by a standard and relatively risk-free surgical procedure. Cataract surgery removes the clouded lens from the eye and replaces it with an artificial lens. Today, cataract surgery is usually performed on an outpatient basis.
Macular degeneration refers to an alteration of the central part of the retina (the macula). It usually affects older adults and is a major cause of blindness and visual impairment. There are two forms: The “dry” (nonexudative) form is caused by deposits (“drusen”) on the macula, which leads to a slowly proceeding impairment of vision. The “wet” (neovascular or exudative) form is more dangerous and can lead to a rapid vision loss if left untreated.
Macular degeneration leads to a loss of central vision. While the peripheral visual field remains intact, loss of the central visual field makes it difficult or impossible to read or recognize faces. In an early stage, macular degeneration results in straight lines being perceived as distorted. An Amsler test is a good tool for early detection of AMD.
Intravitreal injections have proven to be an effective treatment for macular degeneration. Medication is injected directly into the vitreous body after applying numbing eye drops. Typically, several injections have to be applied over a period of time. This treatment stabilizes the retina, effectively stopping the proceeding degeneration of the macula. Damage already incurred is however normally irreversible. Therefore, early diagnosis and treatment are essential.
Many people see floaters or black spots. In most cases, these are harmless opacities in the vitreous body of the eye. However, they can also be a symptom of retinal tears or holes or even retinal detachment. If you also begin to see flashes, experience a sudden increase in floaters, these floaters move independently from your eye movements (as in a sudden shower of black dots across your field of vision), or you experience a shadow or curtain effect across part of your visual field, your should seek emergency treatment by an ophthalmologist immediately.
Diabetes can cause a variety of eye conditions. The most common and serious complication of diabetes for the eye is the development of diabetic retinopathy, which is caused by a lack of blood circulation in the retina and can lead to irreversible damage to the retina and permanent vision loss. Other common complications are early clouding of the lens (cataract), elevated intraocular pressure (glaucoma), and frequent eye infections. Patients with controlled diabetes are generally at lower risk to develop complications for the eye than those with uncontrolled diabetes. However, even diabetes under perfect control can still cause complications on the eyes. Therefore, regular eye exams are essential for diabetes patients.
Keeping blood sugar levels and blood pressure levels under control is a prerequisite for an effective treatment of diabetic retinopathy. Unfortunately, diabetic retinopathy can still develop with diabetes under perfect control. The vision loss caused by diabetic retinopathy can be slowed by intravitreal injections, surgery or laser treatment. Laser treatment of parts of the retina increases the blood flow to the remaining areas of the retina. This treatment does normally not improve vision but is rather used to slow down a further deterioration of visual acuity, which can lead to a complete loss of vision.
(Deutsch) Die Grundvoraussetzung für die Behandlung einer diabetischen Retinopathie ist die optimale Einstellung des Blutzuckerspiegels. Leider bietet diese aber keinen absolut sicheren Schutz vor der Entstehung einer diabetischen Netzhauterkrankung. Zur Behandlung der diabetischen Retinopathie ist in manchen Fällen eine Laserbehandlung der Netzhaut notwendig. Dabei werden mit dem Argon-Laser gezielt bestimmte Bereiche der Netzhaut verödet, um eine bessere Durchblutung der verbleibenden Netzhautanteile zu gewährleisten. Diese Laserbehandlung führt in der Regel allerdings nicht zu einer Verbesserung der Sehschärfe, sondern wird zur Vermeidung einer weiteren Verschlechterung, die zum kompletten Sehverlust führen kann, eingesetzt.