Diagnosis and treatment of glaucoma in Germany

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Glaucoma is the “silent” disease that is connected with risk of the persistent blindness due to the optic nerve damage. The disorder arises when the watery fluid inside the eye is not able to drain away properly, which leads to the intraocular pressure increasing.

Glaucoma is the “silent” disease that is connected with risk of the persistent blindness due to the optic nerve damage. The disorder arises when the watery fluid inside the eye is not able to drain away properly, which leads to the intraocular pressure increasing. Treatment of glaucoma in Germany includes pharmacotherapy, laser treatment and surgical interventions aimed at normalization of the pressure inside the eyeball. Treatment is performed in accordance with the requirements of international Guidelines for glaucoma eye care, which are updated annually.

Early and threatening symptoms

Being the second leading cause of blindness in the world, most glaucoma types typically cause no pain or other inconveniences until the optic nerve is damaged. The only exception is the acute angle-closure glaucoma. This is an acute condition that reveals itself with intense eye pain, blurry vision, nausea and vomiting, halos around lights, reddening of the eyeball. Symptoms arise suddenly and are considered as the medical emergency.

Manifestations of the chronic angle-closure and open-angle glaucoma include bilateral loss of peripheral vision with gradual progressing and, at the advanced stages, the tunnel vision (this means that only a small central area of vision is left). It also should be noted that the risk of blindness development depends significantly on the height of intraocular pressure, rate of the disease progression, and age of onset. Family history of glaucoma is important as well for the symptoms assessment and diagnostic planning.

Diagnostic procedures

Routinely, glaucoma is revealed during the regular ophthalmological check-up, as the tonometry (intraocular pressure measurement) is its obligatory part. If the intraocular pressure (IOP) exceeds 21 mmHg, further tests are performed, including:
• Visual acuity assessment.
• Checking refraction with autorefractor.
• Checking reaction of pupils with pen light.
• Assessment of the anterior eye segment with corneal pachymetry.
• Checking angle structures with optical coherence tomography or ultrasound biomicroscopy.
• Assessment of the optic nerve state with optical coherence tomography or scanning laser polarimetry.
• Checking the fundus state with direct ophthalmoscopy.
• Visual fields assessment.

Importance of the intraocular pressure measurement is confirmed by the simple fact: people with IOP higher than 30 mmHg have 40 times higher risk of blindness from glaucoma than people with IOP of 15 mmHg or lower.

Conventional and surgical treatment

Pharmacotherapy, laser techniques and surgical treatment can potentially be used for treatment of glaucoma at different disease stages. Medications can either decrease production of the aqueous humor inside the eyeball or increase its outflow through the natural drainage pathways. The following drugs are used for these purposes:
• Prostaglandin analogs (e.g. latanoprost, bimatoprost, travoprost).
• Beta blockers (e.g. timolol, levobunolol, metipranolol).
• Alpha adrenergic agonists (e.g. brimonidine, dipivefrin, apraclonidine).
• Carbonic anhydrase inhibitors (e.g. dorzolamide, acetazolamide, methazolamide).
• Cholinergic agents (e.g. pilocarpine, echothiophate).
• Combination medications.

Laser and surgical interventions are the types of curative treatment of glaucoma. They eliminate cause of the disease, while pharmacotherapy can only alleviate symptoms or slow down the disease progression. Invasive therapy includes the following options:
• Selective laser trabeculoplasty.
• Higher-powered argon laser trabeculoplasty.
• Micropulse laser trabeculoplasty.
• Conventional trabeculectomy, including surgeries with Trabectome using.
• Canaloplasty.
• Implantation of the drainage implant devices.

In addition, the combined glaucoma and cataract surgery may be performed in eligible patients.

Treating glaucoma in Germany with Booking Health

Treatment of glaucoma in Germany attracts both German citizens and foreign patients due to high success rates, availability of novel medications and low surgical risks. Those patients who do not have sufficient experience of receiving treatment abroad may use help of Booking Health.

Booking Health professionals offer all-inclusive support during the whole program of treatment in Germany:
• Choosing the most suitable clinics or departments of university hospitals.
• Establishing the preliminary communication directly with your doctor.
• Elaborating the basic medical program in advance.
• Taking care about favorable therapy costs, without overpricing (saving up to 50%).
• Booking the outpatient appointment or room in the hospital.
• Independent monitoring of all therapeutic stages.
• Help in buying and forwarding of the required medicines.
• Communication with the doctor after treatment completion, arranging distant consultations, if necessary.
• Organization of additional and follow-up examinations, if necessary.
• Assistance in the financial issues.
• Offering the highest level service: booking plane tickets and hotels, transfer organization, services of interpreter.

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Start: 2019-07-01 End: 2019-07-31