Worsening despite normal eye pressure
| The literature on glaucoma is very large. It is not our intention to give a complete overview of this literature on this webpage. Rather, we focus on the question why glaucoma damage (GON) can occur and progress despite normal or well-controlled eye pressure. We show on this webpage which answers our research has provided and how we evaluate and treat such patients. | |
 J Flammer: What have cold hands to do with glaucoma? (Video) |
In this video, Josef Flammer explains how he originally noticed, based on visual field research, that blood flow plays a role in the development of glaucoma damage in addition to intraocular pressure. Subsequently, he, along with his team, found a correlation of ocular blood flow with peripheral blood flow and as the main cause of the disorder, primary vascular dysregulation (PVD). PVD can be associated with a number of symptoms and signs, such as frequently cold hands and low blood pressure. Since a publication by K. Konieczka et al, this combination has been called Flammer syndrome. This video explains why Flammer syndrome is a risk factor for glaucoma, especially normal-pressure glaucoma, and the therapeutic consequences for physician and patient. |
 X Wu, K Konieczka, X Liu, M Chen, K Yao, K Wang, J Flammer: Role of ocular blood flow in normal tension glaucoma |
This website describes the influence of blood flow on the development of glaucoma damage. In terms of IOP in glaucoma, there is the whole spectrum, from very high to low normal values. The lower the IOP at which damage occurs or progresses, the greater the likelihood that other factors are involved. Normal-tension glaucoma is therefore particularly suitable for studying such factors. While there are ethnic differences in incidence, there are also basic similarities and these are described here in this Chinese-Swiss review. |
 J Flammer: Visual field progression in glaucoma (Video) |
We need to separate risk factors for an increase in eye pressure from risk factors that increase the likelihood of the occurrence or progression of glaucoma damage at a given eye pressure. At a 2011 web conference, risk factors for progression of visual field damage were discussed. We show you here a recording of the presentation by Josef Flammer. He talked about causes, disease mechanisms and therapies. |
 J Flammer, K Konieczka: Diagnosis and therapy of primary vascular dysregulations and Flammer syndrome in glaucoma patients |
Physicians and patients are often confronted with the problem that glaucoma damage occurs or progresses although the intraocular pressure was never elevated or although the intraocular pressure was reduced to normal values. A common cause is primary vascular dysregulation. This is usually inborn. If it occurs along with other signs and symptoms, we refer to it as Flammer syndrome. This review explains why and how impaired blood flow leads to glaucoma damage and explain the diagnosis and treatment of these circulatory disorders. |