Erb Carl
Augenklinik am Wittenbergplatz, Kleiststraße 23-26, 10787, Berlin, Deutschland,
Ophthalmologe. 2015 May;112(5):402-9. doi: 10.1007/s00347-015-0005-y.
Glaucomatous optic neuropathy is a complex process, which not only leads to destruction of the retinal ganglion cells but also negatively influences the third and fourth neurons. Therefore, in histological studies of glaucoma a significant cell loss in both the lateral geniculate nucleus and in the visual cortex could be detected.
The involvement of the entire visual pathway in glaucoma leads to a variety of functional disturbances, which are presented in this overview.
Besides the well-known visual field defects in glaucomatous optic neuropathy, additional disturbances occur in contrast sensitivity, color vision, stereo vision and increased sensitivity to glare. As a result, faces are less easily recognized , the reading speed is reduced, the location of objects is more complicated and the reaction rate decreases. All these alterations are increased with the progression of glaucomatous damage.
The consequences of these visual impairments lead to an increasing social isolation and to an increased risk of falls and driving accidents, thereby significantly reducing the quality of life of glaucoma patients. Therefore, increasing awareness of these visual difficulties is necessary in the special care of patients with glaucoma and the domestic environment should be transformed accordingly.
青光眼性视神经病变是一个复杂的过程,不仅会导致视网膜神经节细胞的破坏,还会对第三和第四神经元产生负面影响。因此,在青光眼的组织学研究中,可以检测到外侧膝状体和视觉皮层中明显的细胞丢失。
青光眼累及整个视觉通路会导致多种功能障碍,本综述对此进行阐述。
除了青光眼性视神经病变中众所周知的视野缺损外,对比敏感度、色觉、立体视觉以及对眩光的敏感度增加等方面也会出现其他障碍。结果,面部识别变得更加困难,阅读速度降低,物体定位更加复杂,反应速度下降。随着青光眼损害的进展,所有这些改变都会加剧。
这些视觉障碍的后果导致社交隔离增加、跌倒和驾驶事故风险增加,从而显著降低青光眼患者的生活质量。因此,在青光眼患者的特殊护理中,有必要提高对这些视觉困难的认识,并相应地改造家庭环境。