{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:36:52Z","timestamp":1792787812956,"version":"4.5.0"},"reference-count":80,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Monbl Augenheilkd"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The prognosis of going blind is very stressful for patients diagnosed with \u201cglaucoma\u201d. Worries and fear of losing independence is a constant mental burden, with secondary risks of depression and social isolation. But stress is not only a result of glaucoma but also a possible cause (risk factor). This should not be surprising, given that chronic stress can trigger \u201cpsychosomatic\u201d organ dysfunctions anywhere in the body. Why should the organ \u201ceye\u201d be an exception? Indeed, glaucoma patients often suspect that severe emotional stress caused their visual field loss or \u201cfoggy vision\u201d. The hypothesis that stress is a possible cause of glaucoma is supported by different observations: (i) acute and chronic stress increases intraocular pressure and (ii) long-term stress can lead to vascular dysregulation of the microcirculation in the eye and brain (\u201cFlammer\u02bcs syndrome\u201d), leading to partial hypoxia and hypoglycaemia (hypo-metabolism). Even if nerve cells do not die, they may then\n\t\t\t\t\tbecome inactive (\u201csilent\u201d neurons). (iii) Degenerative changes have been reported in the brain of glaucoma patients, affecting not only anterograde or transsynaptic areas of the central visual pathway, but degeneration is also found (iv) in brain areas involved in emotional appraisal and the physiological regulation of stress hormones. There are also psychological hints indicating that stress is a cause of glaucoma: (v) Glaucoma patients with Flammer\u02bcs syndrome show typical personality traits that are associated with low stress resilience: they often have cold hands or feet, are ambitious (professionally successful), perfectionistic, obsessive, brooding and worrying a lot. (vi) If stress hormone levels and inflammation parameters are reduced in glaucoma patients by relaxation with meditation, this correlates with normalisation of intraocular pressure, and yet another clue is that (vii) visual field improvements after non-invasive current stimulation therapy, that are\n\t\t\t\t\tknown to improve circulation and neuronal synchronisation, are much most effective in patients with stress resilient personalities. An appreciation of stress as a \u201ccause\u201d of glaucoma suggests that in addition to standard therapy (i) stress reduction through relaxation techniques should be recommended (e.g. meditation), and (ii) self-medication compliance should not be induced by kindling anxiety and worries with negative communication (\u201cYou will go blind!\u201d), but communication should be positive (\u201cThe prognosis is optimistic\u201d).<\/jats:p>","DOI":"10.1055\/a-1303-8025","type":"journal-article","created":{"date-parts":[[2021,2,14]],"date-time":"2021-02-14T00:14:37Z","timestamp":1613261677000},"page":"132-145","source":"Crossref","is-referenced-by-count":24,"title":["Is Mental Stress the Primary Cause of Glaucoma?"],"prefix":"10.1055","volume":"238","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4472-5543","authenticated-orcid":false,"given":"Bernhard A.","family":"Sabel","sequence":"additional","affiliation":[{"name":"Otto-von-Guericke Universit\u00e4t Magdeburg, Institut f\u00fcr Medizinische Psychologie, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa","family":"Lehnigk","sequence":"additional","affiliation":[{"name":"Otto-von-Guericke Universit\u00e4t Magdeburg, Institut f\u00fcr Medizinische Psychologie, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,2,12]]},"reference":[{"key":"ref2","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1007\/s13167-018-0136-8","article-title":"Mental stress as consequence and cause of vision loss: the dawn of psychosomatic ophthalmology for preventive and personalized medicine","volume":"9","author":"B A Sabel","year":"2018","journal-title":"EPMA J"},{"key":"ref3","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-642-11333-8","volume-title":"Augenheilkunde","author":"F Grehn","year":"2012"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/1878-5085-4-14","article-title":"The 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