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Slit lamp examination

The ophthalmology and ophthalmology (including eye care , technical terminology also Ophthalmiatrie ; from Greek ὀφθαλμός ophthalmos, 'eye', also seeing ') is the study of the structure, function and the diseases and disorders of the visual system , its appendages and the sense of vision and their medical Treatment . It is one of the oldest medical sub-disciplines . Ophthalmologist (synonym: ophthalmologist ) is the (as an ophthalmologistfirst documented in 1401) Job title of the specialist who deals with ophthalmology. In the past, ophthalmologists were also called oculists .

The anatomical boundaries of ophthalmology are the eyelid and facial skin in front and the bones of the eye socket behind . With the examination options of the visual pathway and the visual cortex , they also extend to the back of the skull . There are close relationships with ear, nose and throat medicine , dermatology and neurology . Due to the frequent involvement of the eye in general diseases and the possibility of microscopic examinations of living tissue , ophthalmological findings are often used to make a diagnosis in internal medicine and neurology ( neuroophthalmology ).

Modern ophthalmological examination methods require extensive and expensive technical and apparatus equipment. The most important examination device is the slit lamp , a powerful stereo microscope equipped with special control and lighting mechanisms .

Ophthalmology is one of the sub-disciplines of surgery , although there are numerous, effective and highly developed drugs and aids available to it. With the operation of the cataract (cataract), ophthalmology is the most frequently performed and, in total, the most expensive medical operation worldwide.


Schematic representation of the "Starstich" (1764)
Eye surgery ( star stitch ) in the Middle Ages; the text says: "The whitish cloudiness of the eyes is removed in this way."

An ancient oriental , especially Babylonian and Mesopotamian ophthalmology is documented in Babylonian cuneiform texts . In the tablets of law of the Hammurabi over 3,600 years ago, regulations for eye operations were enacted: The Babylonian or Assyrian doctor should receive a reward of 10 shekels for a successful operation , whereas his hands should be chopped off if he failed (due to ophthalmological malpractice ).

From Egyptian medicine from 2500 to 500 BC BC, when there were already specialists for eye treatments, some papyri, such as the Ebers Papyrus or the Carlsberg Papyrus , are known with ophthalmological therapy instructions. Also around 280 BC From AD 200 to around AD 200, in Alexandria , the medical center of the Upper Egyptian, Greek, Indian and Near Eastern world at the time, collections of prescriptions for the treatment of the eye diseases common in Egypt were created. Around 500 BC The Indian doctor Sushruta also wrote ophthalmological texts.

In the works of ancient Greece (5th century before to 1st century AD) ascribed to Hippocrates , ophthalmology is not described in detail, but there are some references to ophthalmological therapies. Writings on the anatomy of the eyes were written by Alkmaion from Croton (around 500 BC), who was the first to describe the optic nerve , and Herophilos of Chalcedon (around 300 BC).

As the first optical correction, Pliny the Elder reported that Emperor Nero held a cut emerald in front of his eye because of his short-sightedness as a spectator at a fencing competition, although it remains unclear whether the emerald was more as an ornament or actually as an optical aid served and whether it was cut concave or convex. The treatment of eye diseases and injuries has been proven for ancient Rome. The then important Greek surgeon Antyllos is said to have operated on cataracts in Rome around 140 AD and performed surgical interventions to treat tear fistulas and roll-up eyelids . Around 40 AD, Aulus Cornelius Celsus described the typical coloration of the dermis of the eye in jaundice .

In the 9th century, Hunain ibn Ishāq (a Christian-Arabic doctor also called Johannitius ) created a ten-part work on ophthalmology, which was edited in Latin by Constantine of Africa in Salerno and became the basis of ophthalmology taught at Western universities as Liber de oculis Constantini Africani . Also in the 9th century Yuhanna ibn Masawaih is said to have written his ophthalmological treatise Kitāb Daġal al-ʿain ("The Defectiveness of the Eye").

Important medieval authors of further Arabic ophthalmological texts were Rhazes (9th / 10th century), who mentioned the pupillary reaction when exposed to light, and Jesu Haly (11th century) as the author of a three-part textbook on ophthalmology, as well as Avicenna in the 11th century and Averroes , the in the 12th century recognized that the light is absorbed by the retina, and the 13th century ophthalmologist and medical biographer Ibn Abī Uṣaibiʿa .

In the 12th century, a Jewish author named Benevenutus Grapheus who was active in Italy and Occitania ( Languedoc ), possibly from Jerusalem, wrote the ophthalmological text Practica oculorum , which appeared in several languages, initially in the Provencal dialect . Around 1250 the also widespread Liber de oculo was created by Petrus Hispanus , who later became Pope.

In the Middle Ages , ophthalmology was mostly practiced by surgeons , and since the Middle Ages, eye operations have been performed by specialized craft surgeons (known as star technicians or oculists), whose most famous doctor was Eisenbarth . The cloudy lens of the eye (" cataract ") was pressed into the eye using a special knife . The word "ophthalmologist" is first used in 1401 (as an ophthalmologist ).

The "Pommersfeldener Augenbüchlein" ( buchlin from the wetages of the eyes and penance dar mede ), which (as one of two to three authors, a master Johannes is named), is an important German-language work of ophthalmology in Silesia the authors Arnold von Villanova ( Libellus regiminis de confortatione visus ) and Jesus Haly ( Kitāb Taḍkirat al-kaḥḥalīn from “iesu uz Gelrelant geborn”) cited as well as the contemporary traveling ophthalmologist Pankraz Sommer, who traveled from Hirschberg to Silesia and Bohemia, and “quite a few Jewish ophthalmologists ”mentioned. The little eye book in a collective manuscript (from the Pommersfeld Palace Library ) is also linked to the announcement of the establishment of the traveling oculist and ophthalmologist Lorenz Thüring (or Doring) from Vienna, who was the personal physician of Emperor Sigismund and King Albrecht II .

After the Pommersfeldener Augenbüchlein from the first third of the 15th century and an anonymous booklet from 1538, an appendix to the Practica copiosa by the surgeon Caspar Stromayr published in 1559 and the teaching and manual eye service published by Georg Bartisch in 1583 are among the first more extensive German-language textbooks on ophthalmology . Bar table was also the first to surgically perform an enucleation of the eyeball. Ophthalmology was initially part of surgery and only emerged as an independent subject in the course of the 18th century, but especially in the 19th century, and the traveling oculists were finally ousted from the medical field from the 18th to the 19th centuries. Until the 18th century, the anatomy and function of the eye was unclear. From the 19th century onwards, with the advent of the microscope, details became known and systematically made usable for therapy. 1800 coined Carl Gustav Himly the name of Ophthalmology , the same year described Thomas Young the astigmatism .

The traditional star stitch for treating cataracts was replaced in the middle of the 18th century ( Jacques Daviel ) by removing the clouded lens from the eye.

The first private eye clinic in Germany was set up in Dresden in 1782 by the Saxon court oculist Giovanni Virgilio Casaamata (1741–1807) . Further clinics were opened in Erfurt and Budapest at the beginning of the 19th century . The first chair for ophthalmology occupied Georg Joseph Beer (1763-1821), who in 1818 had become professor for ophthalmology in Vienna . He had previously opened the first university clinic for eye patients there in 1813 .

The surgeon and ophthalmologist George James Guthrie (1785-1856) gave the first lectures on ophthalmology in Great Britain at the Royal Westminister Ophthalmic Hospital, which he founded in 1816 .

Groundbreaking inventions in the field of diagnostics were those of the ophthalmoscope by Hermann von Helmholtz (1821–1894) in 1851 and the perimeter by Richard Förster (1825–1902). Major advances were the surgical treatment of glaucoma by Albrecht von Graefe (1828–1870), who is considered the "father of ophthalmology", the introduction of anesthesia into ophthalmology by Henry W. Williams (Boston, 1850) and the first successful transplant of the cornea ( keratoplasty ) in 1905 by Eduard Zirm (1863–1944). The Copenhagen doctor and lecturer in microscopic anatomy, Adolf Hannover (1814–1894), who was awarded the Montyon Prize of the Paris Academy in 1856 and 1878, also contributed to the knowledge of the precise structure of the eye, its functions and its diseases in the mid-19th century. In 1928, the then fundamental monograph Syphilis und Auge by the Frankfurt , Istanbul (1933-1939) and Boston professor of ophthalmology Josef Igersheimer (1879-1965) appeared in its second edition (the important Ophthalmological Congress in Vienna in 1937 was organized by Igersheimer).

For cataract surgery, the Polish ophthalmologist T. Krawitz developed cryoextraction in 1961 , in which the eye lens, hardened by the cold, could be removed without bursting (intracapsular technique in which the lens capsule is also removed), which is then carried out by extracapsular extraction was replaced. In contrast to the intracapsular technique, this technique made it possible to preserve the lens capsule for placing the intraocular lens . The nucleus of the lens was initially delivered through a wide incision, and since the 1970s it has been smashed by ultrasound ( phacoemulsification ). This became the standard practice in the 1990s. The femtosecond laser-assisted surgical technique was added later.

Further milestones in the development of ophthalmology since the middle of the 20th century are

Recently, electronically controlled laser systems have been increasingly used, for example in refractive surgery or in diagnostics of the retina and the optic nerve ( optical coherence tomography ).

Major eye diseases and disorders

Ophthalmological treatment

Eye surgery in the Centro Médico La Paz , Equatorial Guinea (2010)
  • Operations
    • Operations on the lens (cataract surgery, post-star laser)
    • Surgery on the cornea (perforating or lamellar keratoplasty) to restore the clear optical media
    • Operations on the retina and vitreous humor
      • Vitrectomy and indenting operations for retinal detachment,
      • intravitreal drug administration for age-related macular degeneration and macular edema in diabetic retinioapthia or retinal venous vascular occlusions
      • Laser and cryotherapy for ischemic retinopathies (proliferative diabetic retinopathy, vascular occlusions)
    • Lowering eye pressure in glaucoma (including MIGS )
    • Care of eyelid, conjunctiva and corneal wounds in the event of injuries
    • Removal of superficial and intraocular foreign bodies
    • Eye muscle surgery for strabismus, nystagmus and ocular constrained head postures
    • Operations on the lacrimal system (tear duct stenoses) and lids (lid malpositions)
    • Removal of diseased tissue in eyelid and conjunctival tumors and radiation therapy for malignant melanoma of the uvea
    • Correction of ametropia (and loss of accommodation ) - through refractive surgical interventions

Important ophthalmological examination procedures and devices

See also : List of ophthalmic examination devices

Eye Diagnostic Center

In order to be able to use the large number of expensive apparatus for examination economically, a number of ophthalmologists in Germany have come together to form a device association, so-called AugenDiagnostikCenter (ADC) . Such institutions are now represented at over 100 locations in Germany. Most of the ADC are organized in the Federal Association of Eye Diagnostic Centers.



In order to work as a " specialist in ophthalmology" after completing a medical degree in Germany , you need five years of advanced training in ophthalmology, two of which may be spent with a resident doctor. In order to be admitted to the specialist examination, an operation catalog and evidence of independently performed examinations are also required.

In Austria “specialists in ophthalmology and optometry” complete a six-year specialist training after their medical degree, one year of which in “counter subjects”.

In Germany, ophthalmologists are part of the professional association of ophthalmologists in Germany . V. (BVA), the German Ophthalmological Society (DOG) and numerous other societies. On January 1, 2001, 7,980 ophthalmologists were registered there, 5,375 of whom were established in practices and 791 others were employed; 1644 were not medical. Four years later, only about 6,500 were registered. Ophthalmologists in private practice among them achieved an average of € 106,600 practice surpluses before taxes in Germany in 1998, and € 94,000 in the new federal states.


  • Wilhelm Asher: Repetitorium der Augenheilkunde, presented in connection with the more recent textbooks. 2nd Edition. Leipzig 1906, pp. IX – XLII: Brief outline of the history of ophthalmology .
  • Marc-Adrien Dollfus: History of Ophthalmology. In: Illustrated History of Medicine. German arrangement by Richard Toellner a . a. Special edition. Volume III, Salzburg 1986, pp. 1176-1215.
  • Annelie Burk, Reinhold Burk, Reinhard Kaden: Differential Diagnosis in Ophthalmology - From Finding to Diagnosis. Kaden Verlag, Heidelberg 2018. ISBN 978-3-942825-73-3 .
  • Frank Krogmann: Ophthalmology. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , pp. 1069-1075.
  • Julius Hirschberg : History of Ophthalmology. I – X (= handbook of the entire ophthalmology. Founded by A. Graefe and Theodor Saemisch , continued by Carl Hess, 2nd edition, volumes 12–15). Leipzig 1899-1918; Reprint (in three volumes) Hildesheim / New York 1977.
  • Huldrych M. Koelbing : Renaissance of ophthalmology 1540-1630. Huber, Bern / Stuttgart 1967.
  • John Lascaratos, Spyros Marketos: A historical outline of Greek ophthalmology from the Hellenistic period up to the establishment of the first universities. In: Documenta opthalmologica. Volume 68, 1988, pp. 157-169.
  • Wolfgang Leydhecker: Outline of ophthalmology. Founded by Franz Schieck, continued by Ernst Engelking. 18th edition. Springer, Berlin / Heidelberg / New York 1975. (25th edition. Wolfgang Leydhecker, Franz Grehn: Augenheilkunde. Ibid 1993; 26th to 29th edition: Franz Grehn, Wolfgang Leydhecker: ibid 1995 to 2006, ISBN 3-540-25699 -7 )
  • Wolfgang Münchow: History of ophthalmology. (= The ophthalmologist. Edited by Karl Velhagen . IX). 2nd Edition. Leipzig 1983.
  • Anthony Pane: Practical Ophthalmology. Urban & Fischer, Munich 2007, ISBN 978-3-437-41521-0 .
  • Carl Hans Sasse: History of Ophthalmology in Brief. (= Library of the ophthalmologist. 18). Stuttgart 1947.
  • Markus Vieten: career planner doctor. 5th edition. Thieme, Stuttgart 2003, ISBN 3-13-116105-1 .
  • Brigitte Lengersdorf, Detlef Rose: Ophthalmology (ophthalmology). In: Margret Liehn, Brigitte Lengersdorf, Lutz Steinmüller, Rüdiger Döhler (eds.): OP manual. Basics, instruments, surgical procedure. 6th, updated and expanded edition. Springer, Berlin / Heidelberg / New York 2016, ISBN 978-3-662-49280-2 , pp. 705–718.

Web links

Commons : Ophthalmology  - Collection of images, videos, and audio files
Wiktionary: Ophthalmology  - explanations of meanings, word origins, synonyms, translations
Wiktionary: Ophthalmologist  - explanations of meanings, word origins, synonyms, translations
Wikibooks: Ophthalmology  - Learning and Teaching Materials


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  2. Martha Haussperger (ed.): Mesopotamian medicine from a medical point of view (= DWV writings on medical history. Volume 12). Baden-Baden 2012 (= Specialized prose research - Crossing borders. Supplement 1), pp. 9 and 14.
  3. Jeanette C. Fincke: Eye disorders based on cuneiform sources. Research on ancient oriental medicine. Würzburg 2000 (= Würzburg medical historical research. Volume 70).
  4. ^ Frank Krogmann: Ophthalmology. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. Walter de Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , pp. 1069-1075, here: p. 1069.
  5. Frank Krogmann: Women in Ophthalmology. In: Andreas Mettenleiter (Ed.): Tempora mutantur et nos? Festschrift for Walter M. Brod on his 95th birthday. With contributions from friends, companions and contemporaries. Akamedon, Pfaffenhofen 2007, ISBN 978-3-940072-01-6 , pp. 363-367, here: p. 363.
  6. ^ Frank Krogmann (2005), p. 1069.
  7. John Lascaratos, Spyros Marketos: Ophthalmological lore in the Corpus Hippocraticum. In: Documenta ophthalmologica. Volume 68, 1988, pp. 35-45.
  8. ^ Frank Krogmann (2005), p. 1069.
  9. Gotthold Ephraim Lessing : All works in one volume . Letters, antiquarian content, Göschen, 1841, p. 684. Digitized August 13, 2014, original from the Austrian National Library in Google Books.
  10. ^ Harald Nielsen: Ancient ophthalmological agents. A pharmaco-historical study of the collyria and seals for collyria used during Roman antiquity, as well as of the most frequent components of the collyria . Odense 1974 (= Acta historica scientiae naturalis et medicae, 31)
  11. Ludwig Limmer: Ophthalmology in Rome in the early imperial period based on the representations of AC Celsus . Medical dissertation Würzburg 1991.
  12. ^ Frank Krogmann (2005), p. 1069.
  13. Gundolf Keil: "blutken - bloedekijn". Notes on the etiology of the hyposphagma genesis in the 'Pommersfeld Silesian Eye Booklet' (1st third of the 15th century). With an overview of the ophthalmological texts of the German Middle Ages. In: Specialized prose research - Crossing borders. Volume 8/9, 2012/2013, pp. 7–175, here: p. 8.
  14. ^ Curt Prüfer , Max Meyerhof : The ophthalmology of Jûḥannā ben Māsawaih (777-857 AD). In: Islam. Volume 6, 1916, pp. 348-356.
  15. Julius Hirschberg , Julius Lippert (trans.): The ophthalmology of Ibn Sina. Leipzig 1902; Reprinted in: Fuat Sezgin (Ed.): Studies on Ibn Sīnā (d. 1037) and his medical works. 4 volumes. Frankfurt am Main 1996 (= Publications of the Institute for the History of Arabic-Islamic Science. Ed. Von Fuat Sezgin, Volume 10-13: Islamic Medicine. ) Volume 2, pp. 161-354.
  16. Frank Krogmann (2005), p. 1069 f.
  17. ^ Bernhard D. Haage, Wolfgang Wegner: Grapheus (Grassus), Benevenutus (Graffeo, Benevenuto). In: Encyclopedia of Medical History. 2005, p. 508.
  18. Albrecht Maria Berger: The Ophthalmology of Petrus Hispanus (Liber de oculo), Petrus von Lisbon, later Pope Johannes XXI., Based on Munich, Florentine, Pariser, Roman Latin Codices for the first time published, translated and explained . Munich 1899.
  19. Jean Peyresblanques: Jehan Yperman: Pere de l'ophtalmologie Belge (1260-1312). In: Historia ophthalmologica internationalis. 1, 1979-80, pp 163-180.
  20. ^ Karl Baas: On the history of ophthalmology in the German Middle Ages. Part II. In: Albrecht von Graefe's Archives for Ophthalmology. 136, 1938, pp. 457-470.
  21. Gundolf Keil: "blutken - bloedekijn". Notes on the etiology of the hyposphagma genesis in the "Pommersfeld Silesian Eye Book" (1st third of the 15th century). With an overview of the ophthalmological texts of the German Middle Ages. In: Specialized prose research - Crossing borders. Volume 8/9, 2012/2013, pp. 7–175, here: p. 8.
  22. Early New High German Dictionary . Volume II, 1994, col. 845.
  23. ^ Gundolf Keil: 'Pommersfeldener (Silesian) Eye Booklet'. In: Author's Lexicon . 2nd Edition. Volume 7, Col. 778-780.
  24. ^ Karl Sudhoff : Draft for advertisements by the master Pancratius Sommer from Hirschberg. In: Sudhoff's archive. Volume 4, 1911, p. 157.
  25. Gundolf Keil: "blutken - bloedekijn". Notes on the etiology of the hyposphagma genesis in the 'Pommersfeld Silesian Eye Booklet' (1st third of the 15th century). With an overview of the ophthalmological texts of the German Middle Ages. In: Specialized prose research - Crossing borders. Volume 8/9, 2012/2013, pp. 7–175, here: pp. 9 ff., In particular pp. 50 ff. And 123 ff.
  26. A new, highly useful little book, from Erkantnuss der Krankeyten der Augen samples a figure or anothomia of an eye […]. Strasbourg 1538.
  27. ^ Wolfgang Straub: The first German textbook of ophthalmology "Augendienst" by G (eorge) Bartisch, 1583. In: Documenta Ophthalmologia. 68, 1988, pp. 105-114.
  28. ^ Richard Toellner: Georg Bartisch von Königsbrück, eye service. Reprint of the first comprehensive German-speaking ophthalmology from 1583 with an accompanying booklet by Georg Bartisch (1535–1606). Citizen, oculist, incision and surgeon in Dresden and his work "Ophthalmodouleia that is eye service". Edition "libri rari" Th. Schäfer, Hanover 1983, ISBN 3-88746-071-5 .
  29. Doris Schwarzmann-Schafhauser: "The miraculous eye cures of the notorious oculist Michel Duchelard". On the health-political importance of traveling oculists in the reformed Bavarian medical system. In: Dominik Groß , Monika Reininger: Medicine in History, Philology and Ethnology: Festschrift for Gundolf Keil. Königshausen & Neumann, 2003, ISBN 3-8260-2176-2 , pp. 117-130.
  30. Johann Sebastian Bach may have died as a result of a cataract operation. Georg Friedrich Handel survived his operation, but remained blind until the end of his life.
  31. Axel W. Bauer : Therapeutics, Therapy Methods. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , pp. 1388-1393; here: p. 1390.
  32. ^ Wolfgang Münchow: History of ophthalmology. 2nd Edition. Leipzig and Stuttgart 1984, p. 314 f.
  33. Barbara I. Tshisuaka: Guthrie, George James. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 518 f.
  34. Christoph Weißer: Anesthesia. In: Werner E. Gerabek, Bernhard D. Haage, Gundolf Keil, Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte . De Gruyter, Berlin 2005, ISBN 3-11-015714-4 , p. 54 f., Here: p. 54.
  35. Barbara I. Tshisuaka: Hannover, Adolf. In: Werner E. Gerabek u. a. (Ed.): Encyclopedia of medical history. 2005, p. 531 f.
  36. A. Hannover: Das Auge, contributions to the anatomy, physiology and pathology of this organ. Leipzig 1852.
  37. Ali Vicdani Doyum: Alfred Kantorowicz with special reference to his work in İstanbul (A contribution to the history of modern dentistry). Medical dissertation, Würzburg 1985, pp. 50 and 64-66.
  38. Wolfgang Leydhecker: Advances in modern ophthalmology. In: Würzburg medical history reports. Volume 3, 1985, pp. 185-210, here: pp. 189-191.
  39. RD Barley: Eye disorders with tinnitus and cold extremities. In: Deutsches Ärzteblatt. February 21, 2014; Pp. A308-A309.
  40. K. Konieczka, HJ Choi, S. Koch, F. Fankhauser, A. Schoetzau, DM Kim: Relationship between normal tension glaucoma and Flammer syndrome. In: EPMA Journal , 8, 2017, p. 111. doi: 10.1007 / s13167-017-0097-3 .
  41. MG Todorova et al. a .: Endothelin-1 Plasma Levels in Patients with both Retinitis Pigmentosa and Flammer Syndrome. In: Klin Monatsbl Augenheilkd. , 232, 2015, pp. 514-518.
  42. Bundesverband der AugenDiagnostikCenter ( Memento from March 6, 2015 in the Internet Archive ) website
  43. Documentation of the advanced training according to the (sample) advanced training regulations (MWBO) on the specialist training in ophthalmology , version of June 26, 2010 and February 18, 2011. (PDF) German Medical Association