[Life satisfaction in patients with chronic glaucoma-An overview]. / Lebenszufriedenheit im Umgang mit chronischen Glaukomerkrankungen ­ eine Übersicht.

How do patients perceive fear and psychological challenges emerging from a chronic disease and how does this influence their commitment to treatment? Treating patients suffering from glaucoma requires not only medical knowledge but also empathy, communication skills and a positive valuing doctor-patient relationship, thus, having a good eye for the challenges in the treatment of patients with glaucoma. Supplementary, a method and a case study for the measurement of satisfaction with life in patients with glaucoma is introduced. The results and the benefits of an individual evaluation and analysis of the results with each patient are discussed in this article. To make the patients aware of possible psychological challenges and to address possible solutions, ophthalmologists should use and analyze questionnaires with their patients individually. The relationship to the patient and a valuing guidance of the patient are essential to the promotion of the effectiveness of treatment and adherence of the patient.

[Psychosomatics in ophthalmology]. / Psychosomatik in der Augenheilkunde.

A patient who presents to undertake an examination and treatment in the eye clinic or the ophthalmologist's practice, comes not only as a "sick eye", but as a human being with a genetic predisposition, socialization, life experiences and individual behaviors. These influence not only the disease of the eye but also the communication with the patient, the patient-doctor relationship and the implementation and success of the treatment. In our ophthalmological practices, a psychosomatic approach means accepting the patient in his/her entirety and building a trusting patient-doctor relationship through adequate communication. With a resource-oriented approach the patient can be supported in coping with the illness and can be guided towards self-responsibility and self-efficacy. The skills for psychosomatically oriented work can be acquired through the training in basic psychosomatic care.

[Operationalized psychodynamic diagnostics (OPD) in patients with central serous chorioretinopathy]. / Operationalisierte psychodynamische Diagnostik (OPD) bei Patienten mit Chorioretinopathia centralis serosa.

Central Serous Chorioretinopathy (CSC) is a degenerative retinal disease still considered within ophthalmology as being of psychosomatic origin. Psychotherapeutic treatment of CSC patients has been demanded by several authors who, however, have failed to investigate the relevant preconditions. The present study examined subjective illness experience, treatment preconditions, and psychodynamic conflicts in 31 patients with CSC by means of axes I and III of the Operationalized Psychodynamic Diagnostics (OPD). Illness experience, psychological symptoms, capacity for insight into psychodynamic contexts and motivation towards psychotherapy were but slight. The conflicts of one half of the patients was evaluated as important. Predominant conflicts were dependency vs. autonomy, submission vs. control, providing vs. autarchy and self-esteem conflicts. All in all, the patients examined were more or less clinically inconspicuous, giving rather few reasons for psychotherapy. In order to control the results, further studies with higher case numbers are required.

[Ocular syphilis]. / Augenbefunde bei Syphilis.

BACKGROUND: Syphilis has distinctly increased in the last decades. It is necessary to know the different eye changes in syphilis. PATIENTS: In four patients, between 34 and 71 years of age, typical as well as unusual syphilitic eye changes were found. In three patients diagnosis was made due to the inflammatory eye changes. RESULTS: An iritis was found in two patients (62 and 34 years old). In addition, the 62-year-old patient showed the unusual fundus picture of both vasculitis and neuroretinitis, with macular exudates and swelling of the optic disk. A venous occlusion, a rare sign in syphilis, was diagnosed in a 55-year-old patient. A 71-year-old patient revealed the characteristic finding of a placoid chorioretinitis. All four patients showed a swelling of the optic disk. CONCLUSION: Syphilis should be suspected even in older patients with an uncertain origin of uveitis, optic nerve disease, pupillary changes, or eye motility disturbances giving rise to carry out serologic tests in patients with the suspected diagnosis.