The eye is one of our most important sensory organs – and it’s as complex as it is sensitive. A number of eye diseases can affect our vision – with dire consequences for the perception of the surrounding world. Eye diseases range from harmless conditions such as chronic dry eyes, vitreous opacities and squint to more serious cataracts, glaucoma and macular degeneration. BETTER VISION explains: What are the most common eye diseases and how do we recognize them? A brief overview of symptoms, causes, treatment and prevention.

Glaucoma

Symptoms:

Apart from a glaucoma attack, when there is a sudden increase in intraocular pressure, glaucoma can only be recognized when it causes significant damage to the optic nerve and/or retina. Typical symptoms include wet eyes and visual impairment such as bending and extreme narrowing of the field of vision. You can see such an area without moving your head. Sometimes glaucoma causes failure of the center of the field of vision or the appearance of colored rings when looking at bright light sources. Individuals affected by certain types of glaucoma suffer from a total loss of visual acuity and limited contrast perception.

Acute glaucoma or a glaucoma attack occurs when there is a sudden and sharp increase in pressure inside the affected eye. This can be accompanied by symptoms such as red and “hard” eyes, eye and headache pain, nausea, vomiting, immobile pupils (when the pupils do not respond to light) and sudden vision loss.

Cause:

Glaucoma is the superordinate term for several types of this disease, most of which are characterized by an increase in intraocular pressure and/or a circulatory disorder affecting the optic nerve. In rarer cases, glaucoma also occurs with low intraocular pressure. The increase in intraocular pressure is supported by certain risk factors, which also increase the likelihood of one of the types of glaucoma. These factors include diabetes, cardiovascular disease, eye infections, nearsightedness, frequent cortisone administration, possible family history, and age over 65.

Therapy:

Treatment depends on the type of glaucoma. Eye drops can often lower intraocular pressure. The desired result can also be achieved with laser treatment or surgery. Cataract surgery is usually performed under local anesthetic.
Acute glaucoma requires urgent medical attention and must be treated immediately or it could lead to blindness. The patient is given medication to lower intraocular pressure before surgery.

Prevention:

Glaucoma cannot be prevented, only its risk factors can be reduced. The risk of developing glaucoma can be effectively reduced by careful management of diabetes and cardiovascular diseases such as high blood pressure.

Cataract

Symptoms:

The symptoms of cataracts can be different depending on its stage. Typical symptoms include fading of colors and contrasts, difficulty seeing at dusk or in low light, increased glare, and reduced ability to adapt to light and dark. Disabled people suffer from serious visual limitations: spatial vision, near vision (e.g. when reading) and distance vision (e.g. when watching TV).

Typical symptoms include fading of colors and contrasts

Cause:

Cataracts have several causes. Among the most common ones is the natural aging of the eye. Diabetes (type 1 and 2), skin diseases, e.g. neurodermatitis, tobacco consumption, eye injuries, medications (e.g. all types of cortisone), nutrient deficiencies, chronic inflammation of the choroid and radiation (e.g. UV radiation, X-rays or infrared radiation). Cataracts can also be hereditary. In this case, it usually has non-hereditary factors, such as a previous measles infection of the mother and subsequent damage to the fetus during intrauterine development.

Therapy:

Cataracts can only be properly cured by surgery. The clouded lens is replaced with an artificial lens (usually made of acrylic or silicone). The operation is usually performed on an outpatient basis under local anesthetics. The most affected eye is operated on first, and the other eye is usually treated a few days or weeks later – it all depends on the speed of healing.

Prevention:

Age-related cataracts are a result of the natural aging process and therefore cannot be prevented. However, this is not the case if the cataract is caused by other factors. A link has been established between smoking and cataracts – so the disease can be prevented if you stop smoking. Key measures to prevent diabetes include a balanced diet, adequate sleep and regular exercise. The risk of eye damage can be prevented by wearing glasses whenever you perform dangerous tasks (eg drilling or polishing). To prevent damage caused by UV rays, always wear glasses with the appropriate coating. On vacation or in the solarium, for example, you should reach for sunglasses, and in the mountains, on the contrary, for ski goggles.

Macular Degeneration (AMD)

Symptoms:

There are two types of macular degeneration: dry and wet. Dry macular degeneration is usually evident through reduced visual acuity in the center of the visual field. When reading, the letters are sharp at the edges but blurry in the middle. Disabled people often have problems recognizing faces. With the development of macular degeneration, vision gradually deteriorates until there is either significant damage to the center of the visual field, or its total loss.

Wet macular degeneration, on the other hand, is the result of dry macular degeneration. While this form is rarer, its evolution is much faster. In the beginning, there will be a radical limitation of distance and near vision, and in the end, irreversible vision loss. Common symptoms of wet AMD include limited vision of straight lines (such as frames or grooves between tiles) that appear bent.

Dry macular degeneration is usually evident through reduced visual acuity in the center of the visual field.

Common symptoms of wet AMD include limited vision of straight lines (such as frames or grooves between tiles) that appear bent.

Cause:

With dry macular degeneration, part of the retina recedes, thins and dies. This results in the destruction of photo-sensitive cells in the center of the retina. In wet macular degeneration, new blood vessels grow from the choroid into the yellow spot (the macula), where bleeding and water retention occur.

Therapy:

Although macular degeneration cannot be cured, treatment can often slow down or even stop the development of this disease.
AMD can be treated on an outpatient basis by injecting the appropriate medicine into the eye (intraocular injection), which pushes back the newly formed blood vessels, causing the macula to “dry up” again. Since this does not result in a permanent cure, the treatment must be repeated regularly over the years.

Prevention:

Because macular degeneration is a typical example of an age-related eye disease, people over the age of 55 are advised to have regular retinal examinations. In this way, the disease can be caught and treated at an early stage.

Vitreous opacities (cloudiness in the vitreous, “flashes before the eyes”)

Symptoms:

Vitreous opacities can be recognized by dark, often transparent dots, streaks or streaks in the field of vision – specifically when looking against a bright background, such as when reading, looking at the sky or snow. These dots or stripes seem to fly in the air, but when they move they copy the path of the eyes. This phenomenon is also called “flies” or “flies”.

Vitreous opacities can be recognized by dark, often transparent dots, streaks or streaks in the field of vision.

Cause:

Vitreous opacities are commonly caused by the natural aging process of the vitreous (corpus vitreum), which fills most of the eyeball. It consists of 98 percent water and 2 percent protein components and connective tissue fibers. These components are usually dissolved in water and are invisible. Over time, the vitreous shrinks and liquefies. Collagen fibers clump together and suddenly appear cloudy. Vitreous is a typical example of a disease associated with old age. About two-thirds of 65- to 85-year-olds complain of the same thing as people with nearsightedness rather than people with normal vision or farsightedness. Vitreous opacities can be promoted by metabolic disorders, such as diabetes, injury or contusion of the eye, or the use of certain medications.

Therapy:

Although “eyebrows” are usually considered annoying, in most cases they are harmless and do not require treatment. If there is a significant limitation of vision and therefore also a reduction in the quality of life, there are a number of treatment options. We are the first to present the option of removing the vitreous (vitrectomy), which involves either partial or total removal of the vitreous and filling the eye with a liquid or gaseous substitute. This treatment is not recommended by eye doctors because of the possible risk of blindness. A new and less risky procedure is laser vitreolysis. This is a non-invasive procedure intended for the treatment of vitreous opacities. Laser vitreolysis is performed on an outpatient basis under local anesthetics and is essentially painless: the laser is used to dissolve or crush vitreous opacities (photodisruption). Compared to vitreous removal, there are far fewer risks and side effects associated with this treatment.

The following exceptions require immediate intervention: if the opacities suddenly intensify and increase in number or are accompanied by flashes of light, this could indicate an early stage of retinal detachment. In this case, an immediate examination by an ophthalmologist is necessary. The same is true if it is followed by a shower of large black dots: if the patient suddenly sees in his field of vision several dots that look like rain or rising smoke, he may be experiencing a serious vitreous hemorrhage that must be immediately examined by an ophthalmologist – probably in the hospital. Please note that you will not be able to drive for several hours after the eye doctor’s examination. As part of the examination, you will be given drops to dilate the pupils.

Prevention:

A number of different factors affect the health and aging process of the eye. These include, for example, a balanced diet and a healthy lifestyle. You should also avoid excessive pressure on the eyes, such as intense rubbing.

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Squint

There are several types of squint:

Latent or hidden squinting (heterophoria)

Symptoms:

Affected persons often suffer from headaches, burning eyes or general eye strain, which is often accompanied by fatigue. In addition to this, blurred vision, eye irritation and double vision often occur.

Double vision

Cause:

In the case of latent strabismus, the patient’s eyes are not completely parallel, which impairs spatial vision. The brain and eye muscles try to avoid the double image, which can make patients very tired. The occurrence of heterophoria is influenced by a number of factors: alcohol consumption, stress, fatigue and psychological stress. Long-term computer work can also cause squinting.

Therapy:

Latent strabismus is usually a symptom of eye strain and is often left untreated. If squinting results in vision impairment, it can be corrected with prismatic glasses custom-fitted to the wearer. Such glasses balance non-simultaneous vision thanks to special polishing in at least one of the lenses. This will improve the mobility and coordination of the eyes, which will bring the wearer a more relaxed and better vision.

Prevention:

While squinting cannot be prevented, steps can be taken to prevent any consequences such as vision problems. However, there are measures to prevent any consequences, such as vision impairment. Therefore, infants and young children should be checked regularly so that they can be treated as soon as possible.

Dynamic strabismus (heterophoria, concomitant strabismus)

Symptoms:

Dynamic squint most commonly affects infants and young children. In the case of concomitant strabismus, children’s eyes can move in all directions, but they do not focus on the same object. The squint angle is identical in all directions.

In most cases, dynamic squint affects infants and young children.

Cause:

Concomitant strabismus is either hereditary or brought on by farsightedness. Other possible causes include visual impairment in one eye or limited spatial perception.

Therapy:

Concomitant strabismus can be treated through occlusion therapy. The healthy eye is covered from a few hours to a few days to allow the squinting eye to practice seeing correctly. The center of vision therefore receives the impulses necessary for proper direction.

Prevention:

Concomitant strabismus cannot be prevented. However, there are measures to prevent any consequences, such as vision impairment. Infants and young children must therefore be monitored regularly so that treatment can be started early if necessary.

Paralytic strabismus (strabismus paralyticus, strabismus incomitans)

Symptoms:

In the case of paralytic strabismus, there is a sudden failure of one or more external eye muscles or the supplying nerve. Patients suddenly see double and complain of a poor perception of space, which is often accompanied by nausea, headaches or even dizziness. Patients may be hypersensitive to light, their eyes may “twitch”, their eyes may burn, or they may blink excessively. The squint angle varies depending on the line of sight. People suffering from paralytic strabismus often tilt their head to relieve the paralyzed muscle. In other words, they tilt their heads to see straight.

Cause:

Paralytic strabismus is usually brought on by injury, neurological disease, damage to the cranial nerve or inflammation of the eye muscle. Disorders of the circulatory system, e.g. in the brain or the eye socket, can also lead to paralytic strabismus.

Therapy:

Treatment for paralytic strabismus varies depending on the cause. One option is to correct the problem with prismatic glasses, which compensate for unstable perception thanks to a special polishing technique applied to at least one of the glasses’ lenses. The affected eye muscle can eventually be operated on and treated with the administration of botulinum neurotoxin. In some cases, paralytic strabismus clears up on its own after a few weeks or months.

Prevention:

Prevention options depend on the cause of paralytic strabismus, and due to their differences and diversity, there is no space for a full explanation. Your eye doctor will be happy to provide you with an appropriate diagnosis.

Keratoconus

Symptoms:

The cornea of ​​both eyes thins and acquires a conical shape. Ongoing deformation will cause a reduction in visual acuity. If the patient’s number of diopters increases significantly in a short period of time, this could indicate the onset of this disease. Both eyes are affected, but not always to the same extent. Keratoconus can occur during childhood, but most often manifests itself between the ages of 20 and 30. In addition, the progression of the disease is different for each person. Some people perceive keratoconus as a minor vision impairment, while for others surgery is necessary. After this disease, it is no longer possible to wear contact lenses. Patients with an advanced stage of this disease complain of distorted vision or circles around bright light sources, the formation of shadows on objects, double vision, increased sensitivity to light, and limited vision at dusk and in the dark.

Patients with an advanced stage of this disease complain of distorted vision or circles around bright light sources, the formation of shadows on objects, double vision, increased sensitivity to light, and limited vision at dusk and in the dark.

Cause:

Not much is known about the causes and risk factors of this disease, although many studies have been conducted on the subject. Poor functioning of the thyroid gland or a genetic predisposition may be the likely culprit, as keratoconus often appears several times within the same family. A high risk factor is strong and frequent rubbing of the eyes for a long time, e.g. due toallergy.

Therapy:

Treatment for keratoconus varies depending on the cause, but should begin as soon as possible. If it turns out that the thyroid gland is behind the disease, treatment with thyroid hormones can help. At a later stage, a corneal transplant is often the only option.

Prevention:

Keratoconus is most likely not preventable as genetic factors are behind it. However, risk factors can be minimized, e.g. in the case of an allergy, patients should not rub their eyes or take steps against itching. These steps include reducing sensitivity (desensitization) or using appropriate medications.