Childhood Glaucoma

Childhood glaucoma is a progressive eye disease that affects a child's normal vision. It should be treated as soon as possible, as failure to treat it may result in irreversible damage to the optic nerve, leading to blindness.
Childhood Glaucoma

Last update: 01 April, 2021

Childhood glaucoma, also known as congenital, or pediatric glaucoma, is an eye disease that affects very young children. The diagnosis is usually during the first year of life. It’s a rare disease, which may or may not be hereditary.

In 66% of cases, infantile glaucoma affects both eyes, and in 34% it affects only one eye. This health issue is almost always primary, i.e. it isn’t determined by another disease. The main characteristic of this disorder is an increase in intraocular pressure above normal values.

If you don’t adequately treat childhood glaucoma, it could damage the optic nerve, resulting in blindness. Therefore, it’s important to be aware of the symptoms of this disease, so that it can be controlled in time.

What is childhood glaucoma?

Aqueous humor is a colorless liquid that nourishes and oxygenates various parts of the eye. It’s produced in the inner part of the eyeball called the ciliary body, behind the iris. This fluid flows through the pupil into the anterior chamber, which is an area between the cornea and the iris.

In the anterior chamber there are evacuation channels that must drain this liquid – the aqueous humor – into the veins. Sometimes, if the drainage system is obstructed, the fluid cannot be evacuated. This causes it to concentrate there, resulting in increased pressure in the eye.

That pressure can damage the optic nerve, which is a complex structure composed of a million nerve fibers that connect the retina to the brain. If this happens, the child can lose their vision.

Strictly speaking, childhood glaucoma is glaucoma that affects children over the age of 3. Glaucoma that affects children from 0 to 3 years of age is called infantile or congenital glaucoma.

A baby getting their eyes cleaned
In neonates, up to 3 years of age, doctors call it congenital glaucoma. For those older than 3 years, it’s called juvenile or childhood glaucoma.

How it manifests

There are many factors that can cause childhood glaucoma. In most cases it’s hereditary. Hereditary means that the structure of the eye has this abnormality from birth. On other occasions, the problem derives from another eye disease, but this is rare.

Someone with glaucoma has reduced peripheral vision, that is, they see clearly in front, but lose the details of what’s in the lateral areas. This increases gradually. Sometimes there’s also blurred vision, fog, or black spot vision.

A child with glaucoma usually feels that light bothers them, often has watery eyes and also prefers to keep them closed. As the disease progresses, their eyes appear duller and larger than normal. It’s common for them to stumble over small objects that are to the side or very low.

blue eyed baby
Large, centrally opaque eyes are characteristic of childhood glaucoma.

How to detect childhood glaucoma

If your child has symptoms, an ophthalmologist should examine them. Typically, the child will first have a visual acuity test to measure their ability to see at different distances. Then the doctor will dilate the pupils with eye drops and check the retina and optic nerve. 

The next step is a visual field test to determine the state of your peripheral vision. Similarly, specialists will perform a test called tonometry, which measures the pressure in the eye.

All these tests can be very uncomfortable and intimidating for a child. Therefore, it’s important that they feel the support and understanding of their parents. Sometimes it’s necessary to sedate them in order to examine them, especially if they’re very young.

Is it curable?

It’s very important to begin treatment for childhood glaucoma as soon as possible. The sooner you treat this problem, the better the chances of overcoming it completely. The specialist is the one who determines which treatment to follow, based on the child’s health condition, the characteristics of the glaucoma and the available options.

In general terms, treatment for childhood glaucoma may include medication and surgery. Doctors prescribe medications to decrease the production of fluid in the eye, or to improve the passage of fluid. In both cases the goal is to reduce the pressure.

Likewise, the doctor will perform microsurgery or laser surgery to create an orifice for the fluid to drain properly. These types of surgeries are safe and have minimal risks.

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