The primary open-angle glaucoma is a disease of the optic nerve damage, which with an open anterior chamber angle and an increased or sometimes average intraocular pressure (IOP) is associated. The symptoms are a result of visual field loss. Diagnosis is made by ophthalmoscopy, gonioscopy, visual field examination and the measurement of the central corneal thickness as well as the IOP. The treatment includes topical medications (eg. B. prostaglandin analogues, ?-blocker) and often requires laser or scars surgery (incisional surgery) to increase aqueous drainage.

The primary open-angle glaucoma is a disease of the optic nerve damage, which with an open anterior chamber angle and an increased or sometimes average intraocular pressure (IOP) is associated. The symptoms are a result of visual field loss. Diagnosis is made by ophthalmoscopy, gonioscopy, visual field examination and the measurement of the central corneal thickness as well as the IOP. The treatment includes topical medications (eg. B. prostaglandin analogues, ?-blocker) and often requires laser or scars surgery (incisional surgery) to increase aqueous drainage. Etiology Although open-angle glaucoma can have many causes (see table: open-angle glaucoma: classification based on mechanisms of outflow obstruction *), is found in 60-70% of cases in the United States no identifiable cause what is referred to as primary open-angle glaucoma. Usually both eyes are affected, typically but not symmetrical. Risk factors for primary open-angle glaucoma include Older age Positive family history of African descent Thinner central corneal thickness systemic hypertension diabetes myopia in people of African ethnicity to glaucoma develop at an earlier age, the course is more difficult and blindness 6 to 8 times more likely. Pathophysiology IOP may be increased or the average range. Glaucoma with elevated IOP Two thirds of patients with glaucoma have increased IOP (> 21 mmHg). The aqueous humor drainage is inadequate, while production is normal by the ciliary body. Visible mechanisms (. D. H secondary open-angle glaucoma) are not present. Secondary mechanisms include developmental disorders, scarring due to trauma or infection and the clogging of the channels (eg. B. Pseudoexfoliation) by peelings iris pigment (ie, pigment dispersion syndrome) or abnormal protein deposits .Normaldruckglaukom or low-pressure glaucoma At least one third of patients with glaucoma is the IOD in normal range and still are a typical glaucomatous optic nerve damage and visual field defects exist. These patients have a higher incidence vasospastic diseases (eg., Migraine, Raynaud’s syndrome) than the general population, which suggests that a vascular disorder that impairs blood flow to the optic nerves, could play a role. The incidence of glaucoma in an IOD within the average range is more prevalent in Asians. Symptoms and signs Early primary open-angle glaucoma symptoms are rare. The typical asymmetric deficits contribute to delayed perception. In most cases, the patient noticed the visual field loss only if the optic nerve damage is already pronounced. However, some patients complain of discomfort, such as the oversight of stairs when the inferior visual field is down about missing parts of words when reading or difficulties while driving in the early course of the disease. Examination findings are an open chamber angle at gonioscopy, a characteristic optic disc as well as typical visual field defects. IOP may be normal or increased, but is almost always higher in the eye with the stronger optic nerve damage. Optic disc The optic nerve head (i. E. The optic disc) is normally a slightly vertically plated circle with a central depression, which is referred to as cupping. The neuroretinal rim is the tissue between the edge of the cup and the disc margin, and consists of the axons of the retinal ganglion cells. Characteristic changes in the optic nerve include Increased Cup / disc ratio (including an increasing ratio over time) narrowing of the neuroretinal rim notches in neuroretinal rim bleeding in the nerve fiber layer in the area of ??Papillenrandes (ie optic disc or splinter hemorrhages) Vertical enlargement of the excavation Sharp kinking of emerging from the optic disc vessels (called bajonettierend) Regardless of the IOP or visual field is enough alone to dilute the neuroretinal rim (optic nerve or retinal nerve fiber layer) over time for the diagnosis of glaucoma. and is the first sign of damage in 40 to 60% of cases. In other cases, the first signs of damage is a change of the visual field. Glaucoma (normal eye) Image courtesy of the University of California at San Diego via the Online Journal of Ophthalmology (www.onjoph.com). var model = {thumbnailUrl: ‘/-/media/manual/professional/images/glaucoma_normal_eye_high_de.jpg?la=de&thn=0&mw=350’ imageUrl: ‘/-/media/manual/professional/images/glaucoma_normal_eye_high_de.jpg?la = en & thn = 0 ‘, title:’ glaucoma (normal eye) ‘description:’ u003Ca id = “v37894262 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “”para “” u003e u003cp u003eDer optic nerve is normally a slightly vertically plated circuit (papilla) with a central indentation (cupping). . To the cells of the optic nerve of neuroretinal rim

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