Glaucoma: screening and treatment in Luxembourg

Glaucoma is a chronic eye disease that gradually damages the optic nerve, most often because the pressure inside the eye is too high. It progresses silently for years, without pain or any noticeable change in vision, which is why it is known as the “silent thief of sight”. In Luxembourg, glaucoma is screened for, monitored and treated by an ophthalmologist, and a regular eye examination from the age of 40 onwards is the only reliable way to detect it before vision is permanently affected.

Why you feel nothing for years

The eye constantly produces a clear fluid, the aqueous humour, which drains away through a natural outflow system. When that drainage stops working properly, the intraocular pressure rises and slowly compresses the optic nerve — the cable of roughly a million fibres that carries images from the eye to the brain. Once those fibres are destroyed, they never grow back.

The trap lies in how the loss develops. Glaucoma erodes peripheral vision first, the part that sees off to the sides. The brain is remarkably good at compensating: it fills in the missing areas, and each eye covers for the other. A person can therefore lose a substantial part of their visual field without noticing anything at all. By the time they start bumping into things or sensing that something is wrong, the disease is already advanced — and what has been lost cannot be recovered.

The most common form, open-angle glaucoma, is completely painless. There is also an acute form, angle-closure glaucoma, in which the pressure rises suddenly: a red, intensely painful eye, blurred vision, haloes around lights, sometimes nausea. This is an eye emergency — outside consultation hours, call 112.

Who is most at risk?

Glaucoma can affect anyone, but some people need closer surveillance than others:

• age: the risk rises markedly after 40 and keeps increasing with the years;
• family history: having a parent or sibling with glaucoma raises your own risk considerably;
• severe short-sightedness (high myopia), which makes the optic nerve more vulnerable;
• diabetes, an already elevated eye pressure, long-term corticosteroid treatment, or African or Asian ancestry depending on the type of glaucoma.

If any of these apply to you, mention it to your ophthalmologist, who will adjust how often you should be checked.

Regular screening: the only real defence

Because glaucoma gives no warning, waiting for symptoms is not an option. The only way to stay ahead of it is a routine eye check-up: as a general rule every two to three years from the age of 40, earlier and more often if you have risk factors. Early detection changes everything — treated in time, glaucoma stabilises in the great majority of cases and useful vision is preserved for life.

What happens during the examination?

Screening is quick, simple and painless. It rests on three complementary tests:

Measuring the eye pressure

A device measures the pressure inside the eye, either with a gentle puff of air or with a small sensor placed briefly on the cornea after an anaesthetic drop. It takes a few seconds per eye.

Examining the back of the eye

The doctor looks directly at the head of the optic nerve to spot early signs of damage to the nerve fibres. This is often completed by an imaging scan that measures the thickness of those fibres with great precision.

The visual field test

Seated in front of a dome, you fix a central point and press a button each time you perceive a small flash of light off to the side. The test draws a map of your peripheral vision and reveals blind spots you never suspected.

Treatments that stop the disease in its tracks

Glaucoma cannot be cured, but its progression can be slowed or halted very effectively by lowering the pressure inside the eye. Three main approaches exist, often combined over time:

• eye drops, the usual first-line treatment: daily drops that reduce the production of aqueous humour or improve its drainage. They only work if taken conscientiously, every day, for life;
• laser treatment, performed during an outpatient visit, which stimulates the eye’s natural drainage;
• surgery, reserved for resistant cases, which creates a new outflow channel for the fluid.

These treatments protect the vision you still have; they cannot repair fibres that are already gone. That is exactly why the timing of the diagnosis matters so much.

The pathway in Luxembourg

In Luxembourg you can book an appointment with an ophthalmologist directly, without a referral from your general practitioner. Consultations, screening and follow-up examinations as well as glaucoma treatments are covered by the National Health Fund (CNS) under the usual reimbursement conditions. Once glaucoma is diagnosed, your ophthalmologist will set a schedule of check-ups — typically once or twice a year — to confirm that the pressure remains under control and the visual field is stable. You can find an ophthalmologist near you and book an appointment directly on Doctipro.