Pediatric Glaucoma

Primary Congenital Glaucoma
Primary congenital glaucoma is the most common form of childhood glaucoma and accounts for up to 18% of blindness in children. It can present as early as birth with aversion to light, and excessive tearing and blinking. Some cases run in families, but most cases are not passed down. The natural drain of the eye appears to malfunction in most cases of pediatric glaucoma. If eye pressure increases as a baby, the eyes can become large. The prognosis for vision can depend on how advanced the disease is when it is diagnosed. Learn more.

Juvenile Open Angle Glaucoma
Juvenile open angle glaucoma presents between the ages of 4 and 35 years. Many cases are due to a genetic mutation, but sometimes juvenile glaucoma can occur randomly. The eye pressure is elevated, but the eye does not grow abnormally large as it does in primary congenital glaucoma.

Ocular Abnormalities Resulting in Pediatric Glaucoma
Some ocular abnormalities that lead to glaucoma include aniridia, Axenfeld-Rieger syndrome, Peter’s anomaly, and more.

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Aniridia is a congenital disorder occurring in both eyes. Most of the iris is not formed in this condition, and the drainage system of the eye does not work properly. It is passed down in families in 2/3 of cases, and randomly occurs in 1/3 of cases. When there is no family history, aniridia can be associated with other systemic disorders.

Axenfeld-Rieger is a group of disorders with abnormal development of the iris and drainage system of the eye, and can also be associated with systemic signs such as an abnormal jaw. About half of cases develop glaucoma.

Peters anomaly is a developmental condition in which abnormal corneal tissue affects the drainage system of the eye. About half of cases develop glaucoma.

Aphakic glaucoma is a condition that occurs in 15-50% of children who undergo surgery for congenital cataracts. This may be due to alteration of the normal anatomy of the eye’s drainage system or inflammation after surgery.

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Systemic Disease Resulting in Pediatric Glaucoma
Many systemic disorders can lead to pediatric glaucoma. Two of these include Sturge-Weber syndrome and neurofibromatosis.

Sturge-Weber syndrome includes an abnormal vascular lesion in 3 areas: the skin on one side of the head, in the blood supply of the eye, and in the brain. This condition usually occurs on one side (but can occur on both sides), and glaucoma results in 30-70% of cases.

Neurofibromatosis I is associated with glaucoma. Other ophthalmic and systemic findings of neurofibromatosis I include spots on the iris, tumors on the optic nerve, tumors of the eyelid and other places on the skin, light brown spots on the body, and freckles in the underarms.