Pediatric Glaucoma

Disease

Eye pressure increases when the eye is able to make the required fluid, but isn't able to drain out the fluid properly. And when pressure in the eye is extremely high, it damages the optic nerve and leads to a condition called glaucoma.

Damage that is done to the optic nerve can eventually cause a severe vision loss.

Although glaucoma is more common among the elderly, it has the potential to develop at any age.

Pediatric Glaucoma is a rare condition that may either be inherited or caused due to an incorrect development of the eye's drainage system before birth. Babies and young children get pediatric glaucoma. There are different types of pediatric glaucoma and these include -

1. Congenital Glaucoma - Pediatric Glaucoma that shows up at birth

2. Juvenile Glaucoma - Pediatric Glaucoma that develops between the ages of 4 and 10

3. Juvenile Open-Angle Glaucoma - Pediatric Glaucoma that develops after the age of 10

Pediatric glaucoma leads to intraocular pressure and this, further damages the optic nerve.

Causes/Symptoms

Infants and children with pediatric glaucoma show different signs and symptoms compared to adults with glaucoma.

A lot of pediatric glaucoma cases do not have a specific identifiable cause. Such cases are normally considered to come under primary glaucoma.

On the other hand, if pediatric glaucoma is caused because of a particular condition or disease it comes under secondary glaucoma. Conditions like Axenfeld-Reiger Syndrome, Aniridia, Sturge-Weber Syndrome, Neurofibromatosis, Chronic Steroid Use, Trauma or a previous eye surgery like removal of childhood cataract are associated with it.

Children with these conditions may not necessarily develop glaucoma. However, they need to be monitored regularly; reason being, they have a higher chance of getting glaucoma as opposed to someone who doesn't have these conditions.

Following are symptoms linked to pediatric glaucoma -

1. Enlarged Eyes

2. Photosensitivity (Sensitivity related to light)

3. Enlarged and Cloudy Cornea

4. Excessive Tearing

5. Closure of either One or Both Eyes (In Light)

6. Vision Loss

Diagnosis

Pediatric glaucoma is generally diagnosed in the first year of the child's birth. Apart from a complete check of the child's medical history and an eye examination, there are various ways by which, the diagnosis is conducted. Following are these diagnostic procedures -

1. Pupil Dilation - The child's pupil is widened using eye drops. This helps to closely examine the retina of the eye and the optic nerve.

2. Visual Acuity Test - This is a common eye chart test. It measures vision ability at different distances.

3. Tonometry - This is a standard test that helps determine the pressure of the fluid inside the eye.

4. Visual Field - This is a test that is used to measure the child's peripheral or side vision, as loss of peripheral vision can be an indication of glaucoma.

5. Refraction Test - This is done to determine the suitable lens power that will be required.

6. Anterior Segment Evaluation - This can help gather information regarding alterations in the anatomy of the iris that may influence pigment dispersion syndrome.

7. Open Disc Evaluation - This will help examine the optic nerve head stereoscopically and spot early signs of glaucomatous disc damage.

Treatment

Medication and surgery are the two treatment options for pediatric glaucoma. During non-surgical treatment the child is usually provided with eye drops and oral medications.

These forms of medications help to either fasten the exit of the fluid from the eye or reduce the production of fluid inside the eye; further decreasing the existing pressure in the eye.

Surgery

Surgery is another method used to correct pediatric glaucoma. Filtering surgery is a surgical treatment for pediatric glaucoma. This type of surgery is also called Micro-Surgery. Small surgical tools are used during filtering surgery to create a drainage canal in the eye.

Takeaway

Even if an aggressive treatment is done on time, pediatric glaucoma could lead to a very significant and permanent vision loss. Hence, it becomes important to not only get it diagnosed and begin an early treatment, but also to constantly monitor it for a more successful outcome.


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