Blood flow in high-tension and normal-tension glaucoma

What is glaucoma?

Glaucoma is not uniformly defined in the literature. In the definition, which was standard in the past, glaucoma includes all diseases associated with increased intraocular pressure (IOP). Accordingly, the classification of glaucoma is based on the etiology of the pressure increase. The most common form is primary open-angle glaucoma. This is often subdivided into high tension glaucoma and normal tension glaucoma, although the boundary between the two is blurred.
According to the newer definition, a patient suffers from glaucoma if there is glaucoma damage, whatever the cause. This glaucoma damage manifests itself in many different functional and morphologic changes, but of these only the excavation of the optic disc is specific. Clinically, this means that glaucoma includes all diseases that lead to the excavation of the optic disc. We call this glaucomatous optic neuropathy (GON).
With this new definition, elevated eye pressure is an important risk factor for GON, but it is not the only one. Also important are disturbances in blood flow. The reduction in blood flow in glaucoma may be partly secondary to GON. High eye pressure also decreases blood flow, especially if autoregulation is impaired.
However, there is also a primary component of impaired blood flow that is causally involved in the damage. Because this has therapeutic consequences, we focus here on these primary circulatory disturbances.
K Konieczka, J Flammer:
At the invitation of the editors of Swiss Medical Forum, Konieczka and Flammer have written a comprehensive overview of glaucoma for non-ophthalmologists.
The Swiss Medical Forum publishes continuing education-oriented articles from the entire spectrum of medicine and is the most widely read continuing medical education journal in Switzerland. It is the official continuing education organ of the Swiss Medical Association (FMH) and the Swiss Society of General Internal Medicine (SGAIM). The easy-to-read article is illustrated with many photos and drawings and gives an overview of all forms of glaucoma. In addition to the phenomenological aspects, risk factors and disease mechanisms are explained. Both the importance of eye pressure and the importance of blood flow are described. (English version of PDF will be available soon)
Glaucoma books by JF
J Flammer:
Glaucoma books
Josef Flammer's glaucoma book quickly became very popular with patients and physicians. The first German edition (in 2000) was sold out after a few months. Therefore, a new larger edition had to be printed already the following year. Soon after, glaucoma specialists in different countries started to translate this book into their languages. Thus, it became an international standard. We give you here an overview of the different translations and editions. The compilation is not complete, because we are only partially informed about new editions in certain countries.
Glaucoma Book
K Konieczka, K Gugleta:
Josef Flammer had written his glaucoma book for patients. Soon, however, physicians were also interested in it. At the request of Josef Flammer, Katarzyna Konieczka and Konstantin Gugleta have published a 4th revised German edition. The richly illustrated and didactically well-structured book gives an easy to read overview of all aspects of glaucoma.