Personal Health

Grner-Star Pension: tug of war on the optic nerve

The Heimtückische on grünen Star: If the Patient is noted to suffer the eyes, it is already far advanced. In the worst case, the blindness is threatening. Many want to prevent this fate, and have to pay between 15 and 40 Euro für-Care-studies. The Früdetection of glaucoma, the term für the disease, is in Germany, the individual health service (IGeL), the häamong the most touted and.

Almost every fourth Patient was approached at the eye doctor, showed künewly, a survey of IGeL-monitor, a facility of the Medical service of the peak Association of the health insurance funds. The cost of the hedgehog münot have to reimburse the funds to its Insured. Whether the Früevaluation tatsäactually, the chances of erhöht to prevent Blindness, darüber strei­­ten experts for years.

Ambiguities üabout implementation and Use of a Screening

Augenädoctors wüa Screening w&uuml derives;want, a study of all people from the age of about 40 years, on payment of the statutory funds. Of alone the most Affected to remember spät that something is not right. Smaller Ausfäll of a eye is similar to häoften once the other or even the brain. However, the optic nerve between the retina and the brain is only zerstört, läthe sst rückgäthis depends on the make. "There can be nothing more reparieren", Professor Thomas Kohnen, Director of the University eye hospital in Frankfurt says.

The Federal Joint Committee (G-BA), political decision-making body made up of representatives of funds, Ädoctors and clinics, rejects the claim of the Augenädoctors still. The wissenschaft­data are not sufficient at the present time, the Use of a Screening einzuschäappreciate, decided by the G-BA in 2004. By a früHey treatment ließe the progression of the disease verzöbut how often blindness can be prevented, don’t be. Also is unclear what Tests are, what age you will be and in what Abstäif you should be repeated.   

These methods for glaucoma screening, there are


Usually with a slit-lamp microscope, the doctor looks at the optic nerve in the fundus of the eye and evaluated its ­Appearance and Form. 

Intraocular Pressure Measurement

With a horn gehal&shy skin;te­nen Sensor or contactless by means of Luftstoß the doctor determined the values. 10 to 21 mmHg is considered normal. 


In the case of suspicion can be measured in addition, the visual field of both eyes. In the process, points of light with varying brightness, the Patient logged by the push of a button will appear at various Points of a hollow sphere. He recognizes the signals even in the case of höthe most Lichtstärke not, is grüner Star is very likely.

Studies to evaluate the Früdetection is missing

14 years später has the Sach­location nothing geächanged. Who wants to have his eyes purely as a precautionary measure, to test, to have to pay for it myself. A worthwhile investment? No, says the hedgehog-­Monitor. His evaluation of glaucoma Screening: "tend to ­negativ". The Benefit is not used, a möacute damage but patients k&ouml: ;could be alarmed Älongest unnötig geschübe rt. The Problem with all of these reviews: Whether a Früevaluation of the Häfrequency of glaucoma and its Folgeschäthe reduced has never been investigated.

It is not auszuschließthat patients benefit, but it has not been proven. There is no corresponding study. "Such a study will never geben", Professor Claus Cursiefen, Director of the center f&uuml says;r ophthalmology of the University hospital of Köln. "The würde no ethics Commission to approve, because für a aussagekräfuture study müyou biggest a part of the potentially Affected the Früdetection to be withheld." In addition, wäre a period of many years nötig.

Augenädoctors argue that the Benefits to be demonstrated in an indirect way. The company f&uuml formulate it;r ophthalmology and the professional Association of Augenädoctors in a ­Opinion. Because the majority of glaucoma köcould clearly dia­diagnosed and the progression of the disease anschließend verzögert wer­the – by lowering of the intraocular pressure with medications. This pressure is measured in the context of the Provision.

These therapies can be when glaucoma applied

Early treatment increases the likelihood of the disease process to stop

Eye drops to lower the eye pressure

You are at the beginning of the therapy. The drugs reduce the production of aqueous humor or increase its outflow. The drops, ointments, Öle or gels to lower the intraocular pressure maßfully, but often enough.

However, they seem not the same for every patient. Möpossible side effects depending on the drug group burning, red eyes, falling blood pressure, Verfärbungen of the Iris or a sinking in of the eyes. Verträgt the Patient, none of the Präparate or lässt, the pressure is not aus­­reaching to an OP nötig.

Surgery lässt the chamber water abfließen

There are a variety of different methods. The most effective is the so-called Trabeculectomy is the most. A drain hole f&uuml is;r the chamber of water. Coming on strong-invasive techniques, in which at different Points of the eye tiny R&ouml are minimal;hrchen ein­set the drain the chamber of water. These methods are less effective, but also less komplikationsträpowerful. 

Möpossible complications: ­a too strong lowering of the pressure, a Ablöment of the choroid, Schäthe of the cornea, bleeding. You ­only vor&uuml usually occur;temporarily on or are easy to fix. The most serious Problem is a Entzümaking of the eye. You can reduce vision, even Blindness führen.

Erhöhter Augen­internal pressure as the main risk factor

"Erhöhter Augen­internal pressure may not be a glaucoma. He is, however, one of the main risk factors für its Arising and Vo­­ranschreiten", erläDr. Verena &shy explained;Prokosch-Willing, Oberärztin at the University eye hospital in Mainz. Is regulated by the pressure by the so-called chamber of the water that is produced in the anterior part of the eye. Without a certain amount of pressure würde as the eye can lose its spherical shape, the structures of the Vision system got confused. Up to two-thirds of the glaucoma patients but the pressure is too high, the Grenz­value of 21 mmHg (millimeters of Quecksilbersäule) is üexceeded.

Still Willing: &quot stresses Prokosch-;It makes no sense to only measure the pressure without the optic nerve." It is also glaucoma forms with normal eyes give internal pressure. The nerve has Sufferers a characteristic Einwölbung on. Then, a reduction in the Au&shy can;gen­internal pressure of the brakes on the process. In case of unclear diagnosis köcan further investigation be useful, such as visual field measurements. Other Extras such as photos, in order to follow the course, müshot patients usually pay for themselves – even if a begründeter glaucoma suspicion.

Risk factors in the treatment to berüto be taken into account

But what if the intraocular pressure erhöht is, but otherwise nothing to a vision problem suggesting? "You don’t need any of this Pa­tients to treat, but you short Abst&auml…the control lassen", rät Claus Cursiefen from Kölner center für ophthalmology. Eye drops he recommended, however, if additional risk factors are present, for example, Glaukomfälle in the case of parents or siblings, a strong short-sightedness or Diabetes.

The drops have side effects – of itching to lower blood pressure. Some of the patients verträgt individual active ingredients are not, some none at all. Or the medication may not reduce the pressure is strong enough. If the Dia­diagnosis of glaucoma is, in this Fäcases surgery nötig. It can also lead to complications. "Most of them are but only vorütemporarily and beherrschen&quot well;, soothes Ärztin Prokosch-Willing. 

Each Patient must für to decide whether he wants to Precautionary

The question remains: To Pension ­go or not? This decision must f&uuml each;r self-&ndash meeting; even if the Fund’s performance, perhaps ­at some point üscheme. As in the case of ­each Früherkennungsmaßsampling there is no one hundred percent ­Security. Augenädoctors köcould Glaukomfälle übersehen, or on suspicion of therapies not prescribe that the Patient needs. Maybe someone uses anschließend eye drops, their side effects – however, even without drug würde it is never too grüa Star will come.

The risk that these concerns gegenübersteht: glaucoma späto recognize t. And it is not a rare condition. 40. Years of age the incidence rate is in the tenths of a percent, but increases significantly with age. In Germany, it meets schäup of three percent of the Bevöpopulation at some point. The are significantly less than patients with hypertension. Clinic Director Thomas Kohnen nevertheless a comparison: "No man doubts the Usefulness of the measurement of blood pressure, although erhöexcessive blood pressure is not a disease. It only increases the ­Risk für a stroke – as well as high intraocular pressure, the risk für a glaucoma."