…welcome to the leading hospital group in Germany

Eye diseases

Diseases

The most important illnesses treated operatively and conservatively at our eye hospital are cataracts, glaucoma, vitreous flare, retinal detachment and other retinal diseases (macula degeneration), strabismus, corneal diseases and eye injuries.

Out-patient and in-patient eye operations can be carried out. 7,723 in-patient eye operations were performed at the HELIOS hospitals in 2005. In addition, there is a large number of out-patient procedures.

Of the five human sensory organs, the eye is of particular importance. It is extremely important to detect symptoms of incipient diseases at an early stage in order to prevent them from worsening and to preserve sight.

The most common eye diseases and possible treatments are outlined below:

Cataracts

Cataracts are characterized by clouding of the lens and cause increasingly blurred vision. They lead to increasingly blurred vision. Cataracts are the most common cause of blindness worldwide, and 90% of cases involve age-related cataracts. Very occasionally, cataracts form after an eye injury or radiation exposure, as a drug side-effect, with diabetes mellitus or congenitally after a prenatal infection (e.g. rubella). Symptoms are a gradual decline of visual acuity and severe glare sensitivity. In addition, patients in the advanced stage say they feel as if they are looking through frosted glass. The therapy of choice is an operation under local anesthetic with removal or replacement of the natural lens, which these days achieves extremely good results with a low operational risk.

Glaucoma

Glaucoma refers to impaired drainage of the inner eye fluid (the ocular humor) causing increased intraocular pressure and subsequent damage to the optiv nerve. This can result in visual field loss and blindness if not treated properly. Overall, around 1% of the population suffer from glaucoma, with the risk rising significantly in old age. The main danger is that the vision field loss initially progresses stealthily and unnoticed. Regular glaucoma checks are therefore recommended for people aged 40 or over.

The most common form is primary open-angle glaucoma, which causes no problems for a long time, but can be treated very well with eye drops if detected early enough. Other forms are acute glaucoma, which constitutes an ophthalmologic emergency and can very quickly lead to blindness, as well as congenital glaucoma and secondary glaucoma as a result of another eye disease. If eye drops are not sufficient, laser treatment or an operation is carried out.

Strabismus

Strabismus refers to a positional disorder of the eyes that can lead to double vision, visual impairment of one eye and inadequate spatial vision. There is a distinction between the following:

• Latent strabismus (heterophoria), which is only noticeable in stressful situations (e.g. tiredness, influence of alcohol)
• Concomitant strabismus (Strabismus concomitans), which mostly occurs up to the age of three
• Paralytic strabismus (Strabismus paralyticus, Strabismus incomitans) due to eye muscle paralysis with various causes (diabetes mellitus, circulatory disorders, inflammations or injuries)

Concomitant strabismus affects 3% of children; heredity is a factor in 60% of cases. Overall, 7% of the German population suffer from a positional disorder of the eye. Early diagnosis and therapy are crucial to preventing further damage such as lasting visual impairment. In children, conservative strabismus treatment is carried out over several years. Another possible treatment is surgery. With the other forms of strabismus, the treatment is geared towards the underlying cause.

Retinal Detachment

Retinal detachment involves a lifting of the receptor layer of the retina from the underlying pigment epithelium. The disease affects around one in 10,000 people. The main risk factors are near-sightedness, previous cataract operations, diabetes mellitus and inflammatory processes. Early symptoms are seeing flashes of light or a host of black dots. This is followed by increasing visual field restriction similar to a dark curtain. As the prognosis depends on the degree of retinal detachment and there is a threat of blindness in the worst case, early diagnosis and therapy are crucial. Depending on the extent of the retinal detachment, treatment must be carried out by laser or an operation.

With known risk factors, regualr ophthalmic exams will detectand treat the preliminary stages of retinal detachment before irreversible damage occurs.


Diagnosis and Therapy
Diagnosis  

• Determination of visual acuity
• Measuring of intraocular pressure and the refractivity error (spectacle index)
• Evaluation of the visual field and the optic nerve papilla
• Slit lamp examination of the anterior segment of the eye as well as the chamber angle
• Examination of the ocular fundus
• Fluorescence angiography
• Ultrasound, electrophysiology, visual training institute examination
• Refraction determination
• Direct/indirect funduscopy
• Tonometry
• Perimetry (kinetic/static)
• Keratometry and retinal topography
• Fluorescein angiography
• Ultrasound diagnosis
• Electrophysiology (EOG, ERG, VEP)
• Visual training institute examination (including Hess screen, Harms' tangent scale)
• Laser scanning tomography (HRT)
• Optical pachymetry
• Scheimpflug videography
• Examination of color vision (anomaloscope)
• Nyctometry
  

Therapy

• Intracapsular and extracapsular cataract operation
• Laser treatment (e.g. argon laser treatment)
• Treatment of diabetic retinopathy and maculopathy
• Retinal changes as a result of vascular diseases, degenerative retinal changes
• Plastic reconstructive surgery (e.g. blepharoplasty, blepharochalasis operation)
• Nasolacrimal duct surgery (e.g. operation to create artificial drainage for tears in cases of glaucoma) 
• Surgical procedures on the vitreous body in cases of retinal detachment (vitrectomies) 
• Eye muscle operations
• Visual training institute (Orthoptics department)
• Orbital surgery, partly in collaboration with the ENT and Neurosurgical Hospital
• Injury surgery including iris reconstruction                                                   
• Retina transplants