Acute angle-closure glaucoma is a sudden rise in intraocular pressure due to the pupillary block and an impaired aqueous humor outflow. It is an emergency in ophthalmology, which, without timely medical attention, may lead to irreversible vision deterioration. The main symptoms are red eyes, blurred vision, headache, and nausea. The treatment of acute glaucoma in Germany begins with rapid intraocular pressure lowering with drugs. It is followed by an operation to eliminate the pupillary block. You can undergo your treatment in one of the German Eye Centers to get rid of glaucoma once and for all and avoid the disease becoming chronic.
Content
- Emergency care
- Further treatment
Acute glaucoma is quickly eliminated with drugs, while invasive procedures are required less often. In the second stage of treatment, doctors perform an operation to eliminate the pupillary block. It is usually a laser peripheral iridotomy or a surgical iridectomy. Some patients may require phacoemulsification with intraocular lens implantation.
You can undergo your treatment in one of the following hospitals: University Hospital Rechts der Isar Munich, University Hospital Frankfurt am Main, or University Hospital Ulm.
The Booking Health company will take care of the organization of your trip to Germany. We will recommend the most suitable clinic, immediately make an appointment for your treatment, help you prepare your documents and obtain a visa, take care of your flights and accommodation, provide you with interpreting services, and coordinate all diagnostic and treatment procedures. For any questions during your stay in Germany, you will be consulted by a personal medical coordinator.
Emergency care
The two main principles of treatment for acute glaucoma are as follows:
- a rapid intraocular pressure-lowering;
- subsequent elimination of the pupillary block, if any.
Whenever required, doctors carry out symptomatic treatment with analgesics and antiemetics.
The purpose of rapid intraocular pressure lowering is, first of all, the prevention of complications and rapid symptom relief. An additional benefit is the reduction of corneal edema, which facilitates the elimination of the pupillary block.
As a rule, topical and systemic drugs are used to normalize intraocular pressure. Additional drugs can be used to reduce the volume of the vitreous body. Then, doctors give the patient miotics to relieve the pupillary block.
The medications that can be used to reduce aqueous humor synthesis include:
- topical beta-blockers;
- topical alpha agonists;
- carbonic anhydrase inhibitors, which are administered topically or systemically in the form of acetazolamide.
German doctors take into account the patient's condition, as some drugs have side effects. They are unsafe for patients with kidney failure, as they can lead to metabolic disorders. Some drugs increase blood volume and affect the function of the heart, liver, and kidneys.
Sometimes patients may need invasive treatment:
Posterior sclerotomy is invasive drainage of the anterior eye chamber, which is used as an alternative emergency manipulation for a rapid but short-term intraocular pressure lowering.
Laser peripheral iridoplasty is a procedure performed with an argon laser. It is a sparing intervention that allows specialists to lower intraocular pressure even in the event of an acute attack, although the procedure is technically more complex with persistent corneal edema.
Further treatment
As soon as acute glaucoma is relieved, the pupillary block should be eliminated to reduce the risk of repeated exacerbations or the transition of the disease to a chronic form. The following procedures and operations can be performed to achieve this goal:
- Laser peripheral iridotomy – ophthalmologists use a beam of light to burn a small hole in the iris to allow fluid to flow freely inside the front of the eye.
- Surgical iridectomy is a removal of a part of the iris, which creates an additional outflow path from the posterior chamber to the anterior one.
- Phacoemulsification with intraocular lens implantation involves the replacement of the patient's lens with an artificial one.
After surgical treatment, up to 76% of patients have normal intraocular pressure and do not need any medications. The rest still need drugs; taking into account this group of patients, complete control of intraocular pressure after the treatment of angle-closure glaucoma is achieved in 99% of those treated.
The best results and the lowest frequency of need for repeated operations are achieved in the case of phacoemulsification with artificial lens implantation. However, this operation for glaucoma is technically complicated, so it is better to undergo it in a good clinic and by experienced specialists. A shallow anterior chamber, poor visibility due to corneal edema, a small pupil, increased intraocular pressure, and lens instability increases the risk of surgical complications. The guidelines of the European Glaucoma Society direct physicians to perform an iridotomy or an iridectomy first, and the lens interventions are carried out for chronic angle-closure glaucoma.
The surgical removal of adhesions in the chamber angle is an additional step in the operation, usually in chronic angle-closure glaucoma. The goniosynechiae (adhesions) are incised to open an angle and restore the aqueous humor outflow.
To undergo your diagnostics, treatment of angle-closure glaucoma, and rehabilitation in one of the German hospitals, you are kindly welcome to use the Booking Health service. Here you can see the prices and make an appointment for your treatment at the best price. The Booking Health specialists will help you choose the most suitable clinics in Germany and organize your trip.
Authors:
The article was edited by medical experts, board certified doctors Dr. Nadezhda Ivanisova and Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
Sources:
Ophthalmology Times
Open Ophthalmology Journal
Healthline
