Hydrophthalmus

Classification according to ICD-10
Q15.0	Congenital glaucoma - hydrophthalmus
ICD-10 online (WHO version 2019)

Under a Hydrophthalmus ( "water eye" ) or Buphthalmus ( "bull's-eye" ) is meant in the ophthalmology a pathologically enlarged eyeball bulb ( Makrophthalmie ) of occurring by a congenital or in infancy or early childhood, partly greatly increased intraocular pressure is caused and in Associated with congenital glaucoma ( glaucoma ). The disease occurs on one or both sides, is often hereditary and usually leads to blindness . It is named after the fact that an excessive amount of aqueous humor accumulates in the eye due to the closure of the drainage pathways.

Clinical signs

Hydrophthalmos in congenital glaucoma

In addition to the "big eyes" are often found further evidence in the form of photophobia and lacrimation , blepharospasm , myopia , corneal opacities and Descementeinrisse, a deep anterior chamber with narrowing of the chamber angle , iris atrophy , unrounding the pupil with pathological reaction and a bluish shimmering uvea . Increased intraocular pressure values ​​up to 60 mmHg are possible. An elongation of the anterior sections is the rule with a sustained increase in pressure up to the first year of life, but afterwards this only affects the optic nerve due to the loss of elasticity of the sclera and cornea and leads accordingly to papilla excavation and optic atrophy . When both sides act, it is not uncommon for parents to be happy about their child's “beautiful big eyes” without realizing that they are threatened with blindness .

examination

If there is the slightest suspicion, an intraocular pressure measurement ( tonometry ) and an inspection of the anterior, middle and posterior sections are carried out immediately . The examination is carried out under anesthesia , otherwise the results are often of little use. Since the pressure values ​​often fluctuate, they must be checked at intervals. Other triggers, such as space-consuming or inflammatory processes, should be ruled out accordingly, and the hereditary causes should also be determined.

therapy

Conservative treatments are possible locally with medication, but often ineffective. In this respect, operative interventions are the most promising approaches. The methods of trabeculotomy and goniotomy are ideal (see eye operations ).

Web links

• Guideline No. 15b of the Professional Association of Ophthalmologists in Germany (BVA) and the German Ophthalmological Society (DOG): Early childhood glaucoma

literature

• Theodor Axenfeld (founder), Hans Pau (ed.): Textbook and atlas of ophthalmology. 12th, completely revised edition. With the collaboration of Rudolf Sachsenweger and others Gustav Fischer, Stuttgart and others 1980, ISBN 3-437-00255-4 .
• Albert J. Augustin: Ophthalmology. 3rd, completely revised and expanded edition. Springer, Berlin et al. 2007, ISBN 978-3-540-30454-8 .

Individual evidence

1. ↑ Wolfgang Hammerstein, Walter Lisch: Ophthalmologische Genetik. Diagnostics - prevention - rehabilitation (= library of the ophthalmologist. Vol. 105). Enke, Stuttgart 1985, ISBN 3-432-94941-3 , pp. 67, 380.
2. ↑ Duden online, keyword "Hydrophthalmus"

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !