Glaucoma – how can I recognize changes in my pet's eyes early on?

Glaucoma describes a condition of increased intraocular pressure (physical pressure on the inner wall of the eye, leading to a constant, smooth curvature of the cornea), which causes damage to the retina and optic nerve. The medical term glaucoma comes from Greek and means "sea-colored," because the cornea turns blue due to the increase in pressure in the eye.

INHALT
Causes and development Symptoms Diagnosis Treatment Forecast Prophylaxis
Causes and development

The clear fluid produced inside the eye, known as aqueous humor, nourishes various structures in the eye and removes metabolic waste products. The steady flow of aqueous humor creates a dynamic balance that maintains constant intraocular pressure. If the outflow through the chamber angle (the angle between the cornea and the iris) is impaired and the production of aqueous humor remains constant, the pressure increases, leading to glaucoma. A distinction is made between primary glaucoma and secondary glaucoma, depending on the cause of the outflow obstruction.

The increase in intraocular pressure in primary glaucoma occurs without any previous disease or immediate causes. Congenital malformations of the chamber angle are usually the cause of the drainage disorder, and the disease occurs in both eyes. Certain dog breeds (e.g., Bouvier de Flandres, Chow Chow, Leonberger, Siberian Husky, Magyar Viszla) have a predisposition to developing primary glaucoma.

Secondary glaucoma develops as a result of a previous or existing eye disease. In most cases, these are displacement of the lens (= lens luxation), inflammation of the uvea (= uveitis), bleeding, or tumors. These acquired increases in pressure are caused by inflammatory products or cells that increase the resistance to drainage in the angle of the chamber. If left untreated, the increased pressure in the eye chamber quickly causes destruction of nerve fibers and the death of nerve cells in the retina, ultimately resulting in permanent loss of vision.

Schematic diagram of the eye
1 Chamber angle | 2 Iris | 3 Pupil | 4 Anterior chamber | 5 Cornea | 6 Vitreous body | 7 Posterior chamber
Symptoms

Regardless of the cause, increased intraocular pressure is always extremely painful for the affected animal. Glaucoma is therefore always considered an absolute emergency due to the acute risk of blindness and must be treated immediately.

The first signs of glaucoma are often indistinguishable from those of other eye diseases. A special veterinary eye examination should therefore be carried out as soon as possible to avoid confusion or underestimation.

At the onset of the disease, there is usually a more or less severe reddening of the eye on one side, accompanied by increased tearing, nictitating membrane prolapse, and clouding of the normally transparent cornea. A characteristic feature that is also recognizable to dog owners is a permanently dilated pupil that no longer reacts to light. In some cases, owners also describe general symptoms such as loss of appetite and drowsiness, which are attributable to the pain caused by the disease.

If chronic glaucoma has already developed, a significant enlargement of the eyeball can be seen. At this stage, vision is usually already completely lost.

Diagnosis

After recording the preliminary report and performing a clinical examination, the veterinarian will measure the intraocular pressure using a special device. The measurement takes only a few seconds and is completely painless for the patient. In addition to measuring the eye pressure, another examination technique is used to view the chamber angle, known as gonioscopy. This allows conclusions to be drawn about the cause of the drainage disorder.

Treatment

Before treating the underlying disease, the top priority in glaucoma treatment is always to reduce pressure in order to counteract the threat of vision loss and preserve the eye. In dogs in particular, pressure can increase within hours, which is why rapid diagnosis is particularly important.

Intraocular pressure can be reduced by improving drainage or reducing the production of aqueous humor. Veterinarians have both medication and surgical treatment options available for both methods. Depending on the cause and progression of the disease, different methods or a combination of different methods may be used. If there is no prospect of restoring vision, surgical removal of the eye may be the best option for pain relief. Nowadays, the insertion of modern implants can also provide a cosmetically satisfactory result.

As the owner, it is crucial to know that glaucoma is always a chronic disease and must be treated for life, despite its acute onset.

Forecast

The earlier glaucoma is detected, the better the chances of recovery and restoration of vision. The prognosis also depends on the cause and any complications that may arise.

Prophylaxis

Complete protection against the disease is not possible. However, dogs of predisposed breeds should be examined by a veterinary eye specialist at regular intervals in order to detect signs of glaucoma at an early stage and initiate treatment in good time.