Childhood glaucoma refers to a group of disorders causing vision loss due to an increase of fluid pressure in the eye. Glaucoma in children is rare and is usually diagnosed shortly after birth, typically before six months of age. Glaucoma can be inherited and is often caused by improper development of the eye drainage system in utero.
Types & Causes
There are two main types of childhood glaucoma. Primary childhood glaucoma is the most common and is usually diagnosed at birth or during the first year of life. Secondary childhood glaucoma occurs as the result of an injury, underlying eye condition, or other trauma.
Whether the damage occurs during fetal development or later in life after an eye injury, the fluid pressure in the eye is then elevated due to not being able to drain properly. Instead, the fluid collects and puts pressure on the optic nerve.
Glaucoma usually occurs with a gradual onset. Common symptoms include excessive tears, cloudy eyes, and increased sensitivity to light. You may also notice that your child has unusually large eyes, or that one eye is slightly larger than the other. In some cases, there may be little to no symptoms. Permanent visual field loss can sometimes occur if glaucoma is left untreated, so it is important to get all symptoms checked out right away.
Your child’s doctor or ophthalmologist will likely perform a series of eye exams to help definitively diagnose a case of suspected glaucoma. These tests could include a visual acuity test with the common eye chart, a visual field test to check for peripheral vision loss, pupil dilation to examine the eye’s retina and optic nerve, and a tonometry test to determine the level of fluid pressure in your child’s eyes. Other imaging techniques, such as optical coherence tomography (OCT) or ultrasound may also be used. Younger children may need to be examined under anesthesia in order to accurately assess the eye’s drainage system.
While there is no cure for this disease, ongoing advances in clinical research have led to increased hopes that glaucoma-related vision loss can someday be reversed or prevented.
In some cases, surgery is enough to correct glaucoma’s defects. Other times, a combination of surgical intervention and medication is needed. Treatments such as eye drops and oral medicines help lower eye pressure by increasing the drainage of eye fluid or by decreasing the production of fluid.
When surgery is indicated, there are a few different types of procedures that may help.
- Laser Surgery – uses a laser to make a small opening in the iris
- Filtering Surgery – creates a drainage canal in the eye using micro tools
- Glaucoma Implant Surgery – an artificial device with a tube is inserted to drain fluid
- Goniosurgery – also called angle surgery; opens the natural pathway in the eye
- Cycloablation – uses a laser to decrease the eye’s ability to make fluid
In addition to medical interventions, there are other aspects of living with glaucoma that you will need to help your child learn to manage. For example, special glasses can be worn to help with glare, and large print may be needed to assist your child’s low vision in school. Some children need a special educational plan at school in order to ensure they are able to properly learn despite their reduced vision. Regular eye pressure checks may also become a part of your child’s life. Parents and doctors must work together with the child to learn how to successfully manage this disorder.
Early detection and treatment are key to preventing irreversible vision loss. Regular vision screenings are also important for finding glaucoma and other eye conditions during childhood. If you suspect that your child may be exhibiting symptoms of juvenile glaucoma, schedule an appointment with a pediatrician right away.