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How Do Children Get Glaucoma?

Glaucoma refers to a group of eye diseases that damages the optic nerve. This usually occurs when the pressure inside your eyes or the intraocular pressure is high. It can result in severe loss of vision if it is not treated immediately.

Glaucoma is often associated with old age. Unknown to many, however, it can also affect children. Pediatric or primary infantile or primary congenital glaucoma is a rare condition that occurs one in every 10,000 births. Here are some relevant information about this condition.

Types Based on Age

  • Congenital. The condition is present the moment a baby is born. About 10% of children infected with this type of condition inherited the same. There are certain gene mutations that are linked to this disease.
  • Infantile. This develops when the baby is between 1 to 24 months.
  • Juvenile. The condition occurs after age 3.

Types Based on Cause

  • Primary. This type of pediatric glaucoma does not have a specific identifiable cause.
  • Secondary. This is associated with other medical conditions like neurofibromatosis, prior eye surgery, trauma or use of medications like steroids.

Symptoms

  • Excessive tearing of the eye. While the tears may come with a discharge, the latter is not caused by glaucoma. It is a result of congenital nasolacrimal duct obstruction.
  • Large and cloudy cornea that causes the iris of the eyes to appear dull
  • Sensitivity to light
  • The juvenile type does not usually exhibit obvious symptoms.

Detection

If your child shows some of the signs and symptoms of pediatric glaucoma, you should bring him to an ophthalmologist immediately. The doctor will examine your child’s eye under anesthesia. The following shall be evaluated:

  • Diameter of the cornea to check if its size increased
  • Axial length to determine elongation of the eye
  • Optic nerve to see if there is abnormal cupping that infers optic nerve damage
  • Intraocular pressure to check if it is elevated
  • Clarity of the cornea to determine if there is cloudiness and Haab striae that breaks in the back surface of the cornea
  • Refractive error to see if there is myopia.

Treatments

Here are some procedures that may be undertaken to treat pediatric glaucoma:

  • Trabeculectomy. This surgical procedure is performed to open the drainage canal in the eye. A guarded opening is created from the front part of the eye to a space underneath the conjunctiva.
  • Tube Shunt. This device is a tube which may be inserted in the front part of the eye or in the vitreous cavity. Fluid from the eye will be drained to a reservoir located outside the eyes.
  • Goniotomy.  This procedure is quite specific to congenital glaucoma. It clears the blockage that can rarely occur due to a abnormal development of the filtering structures of the eye called the trabecular meshwork.
  • Laser procedure
  • Eye drops
  • Oral medications
  • Treatment of underlying medical condition. This condition can include myopia, lazy eye, crossing eye or wandering eye.

 

These treatments aim to lower the intraocular pressure and to create a bypass route for the aqueous fluid from the eye. Early detection and treatment are necessary to avoid vision loss.

About the Author

Dr Jim Kokkinakis (Optometrist) graduated in 1983 from the Optometry School University of NSW. He is currently a Senior Lecturer there and regular speaker to both Optometrists and Ophthalmologists in Australia and Internationally. He has a specialist clinical practice in the Sydney CBD with interests in Eye Strain, Computer Vision problems, Treatment of Eye Diseases and complex Contact lens Fittings.

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