Glaucoma leads to blindness but there are diagnostic and therapeutic developments that aid ophthalmologists in the improved mangement of the disease compared to the past. Known risk factors such as age, myopia, dark pigmented skin, genetics, and elevated intraocular pressure play an important role for the individual patient's prognosis, and many yet unknown or not sufficiently investigated risk factors come along. The structured examination of the optic nerve head is crucial for the clincial diagnosis by the ophthalmologist. At least a photo documentation - better imaging of the optic nerve head and its retinal nerve fibers - should be performed in newly diagnosed suspect glaucoma or ocular hypertension. Visual field testing is just as important and it is recommended to perform 6 visual fields in the first two years after diagnosis. Treatment principles are evolving and minimally invasive surgery techniques are upcoming. However, trabeculectomy with mitomycin C is still superior regarding long-term results compared to microstents and minimal shunt procedures.
Das Glaukom gehört zu den häufigsten irreversiblen Erblindungsursachen weltweit und die alternde Gesellschaft in den westlichen Industrieländern impliziert ein hohes Risiko einer weiteren Zunahme. Das primäre Offenwinkelglaukom stellt den bei Weitem häufigsten Glaukomtyp des Erwachsenenalters dar. Die Therapie erfolgt zunächst konservativ mit einer Monotherapie, bei unzureichender Einstellung des Zieldruckbereichs sollte jedoch frühzeitig eine Glaukomoperation durchgeführt werden.
Georg Thieme Verlag KG Stuttgart · New York.