Ophthalmology – treatment in the Best Hospitals

Treatment of refractive errors

In people with refractive errors images are not focused sharply on the retina, as the cornea or the lens have an abnormal shape or transparency. This pathology group includes myopia (nearsightedness), hyperopia (farsightedness), astigmatism, presbyopia, and anisometropia. The simplest way to correct them is to use eyeglasses or contact lenses. However, some patients still need more invasive eye treatment, i.e., refractive surgery.

Corneal refractive surgery restores the physiological curvature of the cornea, so that light rays and images are focused on the retina again. Depending on the results of diagnostics, ophthalmologists choose one of the following interventions:

• Laser in situ keratomileusis (LASIK)
• Epi-LASIK
• Laser epithelial keratomileusis (LASEK)
• Photorefractive keratectomy (PRK)
• Small incision lenticule extraction (SMILE)
• Corneal inlays
• Phakic intraocular lenses (IOL)
• Intracorneal ring segments (INTACS)
• Clear lensectomy
• Radial keratotomy
• Astigmatic keratotomy

After surgical treatment, over 95% of patients will never need to use eyeglasses or contact lenses again.

Treatment of cataracts and glaucoma

Although cataracts and glaucoma are different pathologies with different pathogenetic mechanisms, they are somewhat common in terms of therapeutic strategy. A cataract is a clouding of the eye lens that finally makes it impenetrable to light rays. Glaucoma is a group of pathologies that cause the fluid pressure to rise inside the eyeball; left untreated, glaucoma leads to the degeneration of the optic nerve or retina and blindness.

First, both cataract and glaucoma are treated with medications – systematic and long-term administration of eye drops. In case of poor efficacy, doctors proceed with surgical treatment: implantation of artificial intraocular lenses (IOL) in cataracts; trabeculotomy, viscocanalostomy, deep sclerectomy, and trabecular stent bypass in glaucoma. Laser treatments are also used, such as laser trabeculoplasty, cyclodiode laser treatment, and laser iridotomy.

Glaucoma can also be congenital and diagnosed even in infants. It is a genetically-determined condition that requires surgery. Angle surgery is the first-line option in this case.

If glaucoma leads to the development of optic nerve atrophy, a patient suffers from progressive vision loss up to total blindness. The most efficient intervention, in this case, is stem cell therapy that restores the damaged nerve.

Treatment of eye tumors

Eye cancer is a challenging pathology that requires special skills and extensive clinical experience. There are several types of eye tumors, each of which has certain peculiarities:

• Eye melanoma
• Retinoblastoma
• Squamous cell carcinoma

Eye melanoma is a tumor from pigment-producing cells. Treatment is carried out by a tumor board, as different therapeutic options are used. Small melanomas can be removed with the help of lasers (e.g., transpupillary thermotherapy, laser coagulation), while bigger ones require surgery in combination with radiation therapy and topical chemotherapy. Hospitals abroad demonstrate the highest success rates in the treatment of this pathology.

Retinoblastoma is diagnosed in children. The pathology can be heritable or inheritable, which is determined with the help of genetic tests. Regardless of the origin, retinoblastoma requires one or several of the following interventions:

• Cryotherapy, thermotherapy
• Chemotherapy, including a high-dose one
• Radiation therapy
• Surgery (enucleation)
• Targeted therapy

Squamous cell carcinoma is the most widespread malignancy of the conjunctiva. Fortunately, local therapy is often enough. Carefully performed, local excision of a tumor with supplemental cryotherapy leads to the total cure. Additional administration of antibiotic and corticosteroid eye drops may facilitate recovery.

Leading hospitals and prices for treatment

Treatment of eye diseases is carried out in the Departments of Ophthalmology of the large multidisciplinary hospitals and smaller specialized medical centers. Both options have their  advantages: multidisciplinary hospitals offer coordinated work of different healthcare professionals; medical innovations, and participation in clinical trials; smaller centers may have more experience in the specific eye pathologies treatment.

Currently, the list of leading hospitals for eye care includes:

• University Hospital Rechts der Isar Munich
• Helios Hospital Berlin-Buch
• University Hospital Ulm
• University Hospital Frankfurt-am-Main
• Charite University Hospital Berlin

The ophthalmological clinics abroad update equipment annually, and doctors regularly improve their skills. Most departments are also keen on pediatric ophthalmology, including the treatment of infants.

In Germany, price policy is regulated by legislation. The DRG (Diagnosis Related Groups) pricing system considers the main and concomitant diagnoses, a patient's age, therapeutic interventions, etc. If you need to know the cost of treatment in advance, you can find it on the Booking Health website.

Authors: 

The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova ​and Dr. Vadim Zhiliuk. 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

International Council of Ophthalmology

MedicineNet