Even though childhood glaucoma, or pediatric glaucoma, is a relatively rare disorder, with a prevalence of 1 in 30,000 live births, however, it has a profound effect on the quality of life of the patient. Without proper diagnosis and management by Child specialist in Lahore, there is a progressive loss of vision and even blindness. Read on to know more about childhood glaucoma and how to treat it:
What is congenital glaucoma?
Pediatric glaucoma is an eye disease, affecting children in the first three years of life, whereby the ocular abnormalities result in increased intraocular pressure and damage to the optic nerve. The optic nerve is the visual nerve carrying light impulses from the retinal layer of the eye to the optic center in the brain. In the optic center, these light impulses are converted to images. Thus, any damage to the optic nerve can cause lasting damage to the visual pathway and even blindness.
Glaucoma, which is present at birth, is referred to as congenital glaucoma; but when it occurs in the first 24 months of age, the type of glaucoma is termed infantile glaucoma. After the age of 2 years, the disease is termed juvenile glaucoma.
What is primary congenital glaucoma?
These babies are brought to the pediatricians when the parents or caregiver notice abnormalities of the eyes. If primary congenital glaucoma is suspected, the healthcare provider performs an examination under anesthesia; if need be, therapeutic surgery is performed simultaneously. Unlike glaucoma in the adults, pediatric glaucoma is mostly treatable with surgery alone, and does not respond to topical medication and laser therapy. This type of glaucoma can be associated with positive family history.
During examination under anesthesia, the ophthalmologist measures the intraocular pressure, examines the eye completely, particularly the drainage meshwork and studies abnormalities of the optic nerve. Additionally, they may check the thickness and appearance of the cornea, and the size of the eyeball, which tends to be larger in glaucoma. As the child ages, the evaluation of eye changes similar to the way adults are examined, complete with imaging of the optic nerve and visual field testing.
What is secondary glaucoma?
Secondary glaucoma, is associated with systemic disease. These may include:
These may include disorders like neurofibromatosis, congenital rubella, Stickler syndrome, Sturge-Weber syndrome, Marfan syndrome, and Axenfeld-Rieger syndrome.
Alternatively, there may be other eye disorders associated with secondary glaucomas, such as congenital cataracts. This disorder causes disease in the lens of the eye, which increases intraocular pressure. In children with ocular side-effects of juvenile rheumatoid arthritis, the use of steroid medication can result in glaucoma development.
In some cases, glaucoma can develop after traumatic injury. This may happen as the traumatic injury damages the trabecular meshwork, which interferes with the drainage of aqueous humor and increases intraocular pressure. This type of secondary glaucoma may not manifest until later in life. It is, therefore, imperative that such children undergo complete eye examinations intermittently after trauma to screen for secondary glaucoma.
What are the symptoms of childhood glaucoma?
Babies with childhood glaucoma are usually diagnosed between 3 to 6 months of age. In about 70 percent of cases, both eyes are affected.
The three most commonly observed symptoms of congenital glaucoma are excessive tearing, excessive blinking, and sensitivity to light.
When examining the baby, the pediatrician will notice the response of the baby to light. Such children avoid bright lights as they have hazy cornea (instead of the normally clear cornea), which disperses the light and causes a glare. In severe disease, the pupil is not visible due to the cloudiness of the cornea.
How is childhood glaucoma treated?
A Child specialist in Islamabad can treat childhood glaucoma with surgery. As mentioned before, this is the gold standard treatment in the pediatric population and involves trabeculotomy and goniotomy procedures. These procedures open the drainage system of the eye, allowing easy flow of aqueous humor and less pressure on the optic nerve.