Glaucoma is a disease characterized by optic nerve damage due to high eye pressure. It is a relatively rare disease in children.
Fluid is continuously made in the eye by a structure called the ciliary body, and fluid flows of of the eye through a drainage canal called the trabecular meshwork. This balance between fluid that is made and fluid that isdrained create s the eye pressure. A nomral eye pressure inside the eyeball helps the eye maintain its spherical shape and provides nutrition to its various structures. In glaucoma patients there is an imbalance between the amount of fluid produced and the amount drained out of the eye–which leads to a high eye pressure.
Children of all ages can develop glaucoma. Primary glaucoma (such as congenital glaucoma) is caused by a congenital problem in the development of the trabecular meshwork. It is present at birth and is the most common form of pediatric glaucoma. In other cases of glaucoma, increased eye pressure is caused by another eye problem (secondary glaucoma) such as inflammation, infection, trauma, steriod use, or after cataract surgery. Other rare causes of secondary glaucoma include Sturge Weber syndrom and neurofibromatosis. Finally, some genes have been identified that cause glaucoma in families (hereditary glaucoma).
Symptoms of congenital glaucoma include:
• Excessive tearing
• Light sensitivity
• Cloudy appearance of the cornea (which is normally clear and transparent)
• Enlargement of the eyeball
If you notice any of these signs in an infant, they should be seen by a pediatric ophthalmologist as soon as possible. Ohter forms of glaucoma have no symptoms, and signs can remain undetected for a long time.
In the clinic, your eye doctor may perform several tests, including the measurement of eye pressure, size of cornea, thickness of cornea, length of the eyeball, an eye examination using a microscope, and assessment of the optic nerve after giving dilating eye drops Other tests may include OCT (ultrasound) imaging and Visual Field (peripheral vision) testing in order children. Other children may be able to perform all the tests in the clinic satisfactorily. Younger children may require an examination under general anesthesia for a thorough and accurate assessment.
Similar to diabetes or hypertension, glaucoma is a lifelong disease with ups and downs along the course. Regular follow ups are vital to keep the eye pressure controlled and prevent blindness.
The goal of glaucoma treatment is to lower the eye pressure into a normal range, by medical or surgical means. Medical treatments include eye drops and oral medicine. Surgery for glaucoma involves creating an outflow pathway forthe fluid to drain out of the eye. There are several different procedures; your eye doctor will recommend the appropriate procedure tailored to your child's type of glaucoma.