If an operation is necessary, it will be performed by me after a thorough consultation and explanation, depending on the individual situation and insurance status, in the Private Clinic Doebling, in the Sanatorium Hera, in the Franziskus Spital (former Hartmannspital), in the Golden Cross or in the operating room in my office in 1090 Vienna. I am also a consultant physician at the Doebling Private Clinic, the Hera Sanatorium, the Franziskus Spital, the Goldenes Kreuz and the Vienna Private Clinic.
Cataract is the clouding of the originally clear lens of the eye. Cataract is very common and almost everyone over the age of 65 is affected by clouding of the lens of the eye.
In most cases, cataract is age-related and is related to altered metabolism of the lens. Complaints include: blurred vision and glare, increased sensitivity to light, cataracts and reduced contrast vision, impaired twilight vision, reduced color perception and/ or double vision. It is also not uncommon for myopia to develop or increase.
Cataract is a clouding of the lens that increases over the years and leads to a decrease in visual performance as it progresses. At a certain point, the loss of visual acuity can no longer be corrected by glasses; the only sensible and helpful treatment option is surgery (cataract surgery), in which the clouded lens is replaced by a clear artificial lens from the eye. There are no sustainable successful conservative treatment options for cataracts – the best possible visual acuity can only be regained by cataract surgery.
The operation consists mainly of the following steps: Anesthesia of the eye region, opening of the anterior lens capsule, removal of the clouded eye lens while preserving the lens capsule (using ultrasound), insertion of the artificial lens into the original lens capsule, follow-up treatment.
Cataract surgery is one of the most frequently performed operations. Constant progress in eye surgery has contributed to the fact that cataract surgery has become a very safe procedure. Thanks to modern surgical techniques, complications during this procedure are usually very rare. Patients can enjoy improved vision only a short time after surgery. Patients can go home on the same day as the operation.
In case of an astigmatism, I can implant a toric-lens, which resolve the astigmatism.
Overview of cataract services:
- Ophthalmological examination and determination of visual acuity
- Detailed personal consultation on the course of treatment (cataract surgery, choice of appropriate lens, general risks, follow-up examinations, spectacle fitting, etc.)
- Surgical treatment (choice of hospital depends on individual situation and insurance status)
- Treatment for posterior cataract (YAG laser)
Glaucoma is an eye disease or a disease of the optic nerve, and has nothing to do with cataract. In glaucoma, increased intraocular pressure leads to damage of the optic nerve. In further consequence it comes to visual field losses and in some cases also to complete blindness.
Increased intraocular pressure is not painful, which is why the disease progresses insidiously and is often only detected when the optic nerve is already damaged. For this reason, regular ophthalmological examinations are particularly important: during the examination, glaucoma can be detected at an early stage so that the disease and subsequent damage can be counteracted in time.
The preventive ophthalmological examination, in which the visual acuity is determined, the intraocular pressure is measured and the optic nerve is checked, should be performed at least once a year from the age of 40.
Important examinations which are able to detect glaucoma at an early stage are: – measurement of intraocular pressure,- OCT (optical coherence tomography), which makes it possible to examine the back of the eye and the entire posterior segment, to visualize the fine structure of the retina very precisely and to detect any damage to the retinal fibers and the optic nerve, and- visual field examination.
The office is equipped with the most modern examination devices, so that all necessary examinations can be performed directly on site. The examination is painless for patients.
For the treatment of glaucoma there are good therapeutic options in modern ophthalmology. In most cases, drug therapy is carried out with eye drops, which is tailored to the exact diagnosis and the individual needs of the patient and aims to reduce the internal pressure of the eye and improve retinal and optic nerve blood flow. With the help of consistent treatment, it is possible in many cases to prevent further deterioration of vision.
Under certain circumstances (in patients with severe and progressive disease, in patients in whom the eye pressure cannot be sufficiently lowered despite adequate conservative therapy) laser surgery/surgery may be necessary.
Under certain circumstances (in patients with severe and progressive disease, in patients in whom the eye pressure cannot be sufficiently lowered despite adequate conservative therapy) laser surgery measures/surgery are necessary.
Due to the increasing damage to the optic nerve, glaucoma can lead to blindness if left untreated. Regular ophthalmological check-ups, even when the patient is completely free of symptoms, and early detection and early treatment are crucial, since damage to the optic nerve that has already occurred cannot be reversed. In this context, in addition to the measurement of intraocular pressure, the OCT performed in the office plays an important role, with the help of which many pathological changes in the eye can be detected at an early stage. Early detection as part of preventive care increases the chance of preserving as much vision as possible; there are also good treatment options for patients with advanced disease.
Overview of glaucoma services:
- Ophthalmologic screening including measurement of intraocular pressure, gonioscopy, OCT, and visual field examination.
- Pachymetry (corneal thickness measurement) in addition to intraocular pressure measurement to improve the accuracy of glaucoma diagnostics
- Individual drug therapy
- Treatment in case of glaucoma (“acute” glaucoma, acute deterioration of vision) by means of laser therapy (YAG laser)
- Treatment in case of insufficient effect of eye drops by means of laser therapy (SLT laser)
3. Diabetic retinopathy (DRP)
Diabetes mellitus can cause various secondary diseases. One of these is diabetic retinopathy, a disease of the retina that can lead to blindness if left untreated. The worse the blood sugar control, the higher the risk of diabetic retinopathy.
What happens in the eye in diabetic retinopathy? High blood sugar damages the small blood vessels in the area of the retina. There is an undersupply of oxygen to the eyes, fluid leakage/accumulation/edema, hemorrhage, and deposits in the retinal tissue. As a result of the vascular damage, new inferior blood vessels form, accompanied by bleeding and other changes.
Different stages of the disease are distinguished. In the early form (non-proliferative diabetic retinopathy), changes such as small vascular bulges, hemorrhages, and fatty deposits occur, but new blood vessels are not yet present. These changes also do not cause visual impairment or pain. After some time, non-proliferative diabetic retinopathy can change into proliferative diabetic retinopathy, in which new vessel formations occur. The changes can go unnoticed for a long time and, if left untreated, can lead to blindness. If the retina is damaged in the area of the macula (centr of the retina), this is called diabetic macular edema, which can lead to a rapid decline in vision.
Prevention and treatment: Diabetic retinopathy can occur in patients with type 1 and type 2 diabetes. The dangerous thing about the disease is that it does not cause any symptoms for a long time. If symptoms occur, then the disease is often already advanced. For this reason, regular eye control is of great importance in patients with diabetes. An ophthalmological check-up should be performed in patients with diabetes immediately after diagnosis.
In addition to a detailed medical history and an examination of visual performance, a thorough examination of the fundus of the eye with dilated pupil is performed. Furthermore, OCT (optical coherence tomography) is performed in the office, which makes it possible to examine the fundus and the entire posterior segment of the eye, to visualize the fine structure of the retina very precisely and to detect any damage to the retinal fibers and optic nerve. The ophthalmic examination is painless for patients. If necessary, OCT angiography can also be performed.
The fundamental pillar of treatment is the correct and consistent therapy of diabetes. In addition to blood glucose control, blood pressure control and treatment of any other risk factors play an important role in preventing diabetic retinopathy or slowing the progression of the disease. I can treat advanced diabetic retinopathy with injections of medication into the eye (intravitreal injection) as well as laser therapy (laser coagulation) or vitreous or retinal surgery (vitrectomy).
In the office, I offer patients with diabetes mellitus comprehensive personalized care that is entirely focused on detecting diabetic retinopathy early and preserving eye health and vision in diabetes.
Overview of services offered diabetic retinopathy:
- Ophthalmic screening including OCT and OCT-angiography.
- Information and counseling about diabetes and its effects on eye health/diabetic retinopathy
- Education about risk factors and preventive measures
- Intravitreal injections
- Laser coagulation
- Vitreous and retinal surgery
4. Age-related macular degeneration (AMD)
Age-related macular degeneration (AMD) is a common cause of permanent significant visual deterioration in people over 60 years of age. It is a disease of the central retina of the eye. Affected is the center of the retina and thus the area of sharpest vision (macula), which serves to recognize details and is the center of our vision. The rest of the retina is mainly used for orientation, perception of outlines and light-dark contrasts. These abilities are preserved in AMD, and the disease leads to increasing vision loss or significant impairment of central vision, but not to complete blindness.
Most patients suffer from dry AMD, in which there are initially deposits of metabolic products (“drusen”) in the area of the macula and, over time, the death of cells in the area of sharpest vision. The dry form progresses slowly and is associated with gradual visual deterioration. Wet AMD can develop from dry AMD and progress rapidly. Low-quality vessels develop, leading to bleeding and fluid accumulation around the retina. If left untreated, wet AMD can quickly lead to significantly noticeable visual deterioration.
One of the ways macular degeneration is detected in the office is by looking at the back of the eye and performing an OCT (optical coherence tomography). An OCT makes it possible to examine the entire posterior segment of the eye, to visualize the fine structure of the retina very precisely and to detect any damage in the retinal area. If necessary, OCT angiography can also be performed. The examinations are painless for the patient.
The therapy of wet AMD consists in the administration of substances (anti-VEGF blockers) directly into the eye, which inhibit the formation of blood vessels (intravitreal surgical drug application “IVOM”). For patients with dry AMD, a variety of conservative treatment approaches/lifestyle modifications can influence disease progression.
Overview of services offered macular degeneration:
- Comprehensive ophthalmologic examination including OCT and OCT-angiography.
- Advice on preventive measures
- Therapy of wet AMD (intravitreal surgical drug application (IVOM))
5. Retinal surgeries (ERM, MF, Ablatio retinae, tractive PDRP, vitreal opacities)
Due to injury, age-related, disease-related, or simply genetic, the retina or vitreous cavity may develop neoplasms, hemorrhages, or even retinal detachment. In case of any kind of change on the retina that needs to be treated surgically, a so-called vitrectomy (removal of the vitreous body) has to be performed. The vitreous humor is located in the eye and is a gelatinous, viscous substance that stands in the way of surgical manipulation of the retina. Therefore, in any retinal surgery, the vitreous must first be removed before any surgery can be performed on the retina.
Depending on the change in the retina, there are different treatment options. In each case, accesses must be made into the eye. Usually 3 small accesses are made through which the pressure is maintained, the interior of the eye is illuminated and the retina is manipulated. After the vitreous has been removed, membranes can be removed from the retina, lasers can be placed in the eye, bleeding can be stopped, and medication can be placed in the eye.
At the end of the operation, instead of the removed vitreous body, either saline, air, a heavy gas or even silicone oil (which is usually removed in a later operation) is filled into the eye, depending on the reason for the planned operation.
Overview of services offered Retinal surgery:
- Ophthalmological examination
- Detailed personal consultation on the course of treatment (vitrectomy, general risks, follow-up)
- Surgical treatment (choice of hospital)
6. Eyelid tightening (Blepharoplasty)
With increasing age, the elasticity of the tissue in the area of the eyes decreases, which becomes noticeable through drooping eyelids and/or bags under the eyes, making the gaze tired and the facial expression all in one look exhausted. Furthermore, drooping eyelids can noticeably impair the field of vision.
Such changes in the area of the eyes can be corrected in the course of an eyelid lift (Blepharoplasty). A distinction is made between upper eyelid lifting and lower eyelid lifting. During eyelid lifting, excess fat and skin tissue is removed to a precisely defined extent so that the scar is hardly visible later.
The goals of eyelid lifting are an open and radiant look, a vital and relaxed expression and a rejuvenated eye area, always striving for a very natural-looking result. The exact nature of the treatment in each individual case, the general risks associated with the procedure and what needs to be taken into account after the operation are discussed in detail in the office.
If there is a restriction of the field of vision due to the drooping eyelids, the costs for the upper eyelid lift can be covered by the health insurance and thus also by a possibly existing supplementary insurance.
Overview of services offered for eyelid lifting:
- Ophthalmological examination and visual field examination
- Detailed personal consultation on the course of treatment (eyelid lift, general risks, follow-up checks, removal of sutures)
- Surgical treatment (surgical options depending on individual situation and insurance status)
7. Pediatric ophthalmology, Mother-Child Pass
The examination and treatment of children is an important focus of my work and one that is particularly close to my heart. I have many years of experience in various areas of pediatric ophthalmology and, as a mother myself, I am very familiar with the possible problems that can arise during a visit to the doctor with children, which is why I always try to make all necessary examinations as pleasant and uncomplicated as possible for children and parents. Children are not small adults, but patients with their own special needs, which we pay special attention to.
The office is specially equipped for pediatric ophthalmological examinations and has, among other things, a modern autorefractometer (Plusoptix), which makes it possible to measure the refractive power of both eyes simultaneously within a few seconds in order to detect any visual disorders in children at an early stage.
Please keep in mind that you will need to allow 1 hour for the office visit, since usually I do need to apply pupil-dilating eye drops and it takes a while for the drops to take effect.
Mother-Child Pass (Mutter-Kind-Pass by Austrian law)
After the pregnancy/birth of the child, the Mother-Child Pass includes two eye exams, one between the 10th and 14th month of life, and one between the 22nd and 26th month of life. The examinations are painless for the child and make it possible to detect any refractive errors and diseases in time.
In order to be able to examine the lens, the retina/back of the eye and other parts of the eye in detail and to be able to accurately measure a possible defective vision, the child’s pupils need to be dilated with special eye drops during the second mother-child-pass examination. Approximately one hour should be allowed for the total examination time in this case.
Importance of early pediatric eye examinations
Vision problems can occur as early as the first few months of life, but they often go unnoticed because they are often not cosmetically noticeable and a child does not even notice his or her own vision problems, because he or she sees the world with his or her own eyes, without any possibility of comparison.
The best time to take precautions for a child’s eye health is during infancy, because if an eye disease or visual impairment is present and is “overlooked” for a long time, not recognized and treated, it can lead to permanent visual damage. The earlier a possible visual impairment is detected and treated, the better the chances of success of correction/treatment.
Overview of services offered children’s eye examination:
- Examination of eye mobility and color vision
- Strabismus examination
- Examination of the anterior and posterior segment of the eye
- Measurement of the visual performance and the refractive power of the eyes by means of Plusoptix and retinascopy
- Possible adjustment of glasses, if necessary