How is glaucoma discovered in infants? What are the systoms

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Katherine - posted on 04/17/2012

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Over 3 million Americans have glaucoma. And this is a cause of blindness that does not just affect older age groups. Glaucoma can strike even newborn infants.



Childhood glaucoma occurs in 1 out of every 8,000 children in the United States. Primary congenital glaucoma (PCG) accounts for approximately 50% to 70% of all cases of childhood glaucoma.

Diagnosing Glaucoma in Children



In most cases, primary congenital glaucoma is diagnosed within the child’s first year. Although uncommon, newborn primary congenital glaucoma is an important subtype of primary congenital glaucoma, notable because it is often the most severe and clinically challenging expression of this disease.



Babies born with newborn glaucoma typically manifest specific signs that help doctors to diagnose it at birth — signs which also become important in the assessment and determination of appropriate treatment.



Primary congenital glaucoma is the most common hereditary childhood glaucoma and an important cause of childhood blindness. For babies born with glaucoma, as well as infants who develop glaucoma, there are many significant challenges facing the child, the parents, the siblings, and health professionals caring for the child.

Treatment Methods



Both medical and surgical methods are used in treating childhood glaucoma. Medical treatments can come in the form of eye drops, pills, or suspension of medication for administration by mouth.



These treatments help to either increase the exit of fluid from the eye or decrease the internal ocular production of fluid. Both approaches result in a lowering the eye pressure. Surgical procedures that are used to help control eye pressure include goniosurgery, filtration surgery, glaucoma implant surgery, and laser surgery.



It is sometimes necessary to repeat glaucoma surgery in order to successfully control eye pressure. This can be difficult for the child and discouraging for parents. It is important that the child’s physical and emotional needs are considered by both the parents and the health care team.

What is Childhood Glaucoma?



Glaucoma refers to a group of eye diseases with common features that may include elevated eye pressure, damage to the optic nerve, and potential vision loss. There are many causes of adult and childhood glaucoma.



Quite simply, childhood glaucoma refers to the presence of glaucoma in a child. Congenital glaucoma is the common term used for glaucoma when diagnosed in infancy or early childhood.



Childhood glaucoma is associated with physical changes in the eye that are caused by the high pressure. Enlargement of the eye, cloudiness of the cornea, and injury to the optic nerve are examples of changes that can occur as a result of glaucoma.



There are many possible mechanisms for the drainage problem that results in childhood glaucoma. In each case, abnormal fluid drainage from the eye is the result of a blocked or defective trabecular meshwork drainage system.



The increased fluid pressure can push on the optic nerve and cause cupping (an abnormal enlargement in the optic disc area, which is the junction between the eye and the optic nerve). If the pressure remains too high for too long, the optic nerve fibers are permanently damaged.



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Article by David S. Walton, MD, Clinical Professor of Ophthalmology at Harvard Medical School. Dr. Walton is in private practice specializing in pediatric ophthalmology in Massachusetts. He is internationally recognized for his expertise in treating childhood glaucoma. Dr. Walton is pictured with his patient, Andrea Williams, age 5.





Symptoms of Glaucoma



cloudy cornea (usually transparent part of the eye in front of the pupil)

one eye becoming larger than the other

excessive tearing (epiphora)

light sensitivity (photophobia)

excessive blinking (blepharospasm)

strabismus (crossed or out-turned eyes)

decreased vision (amblyopia)



Many infants have excessive tearing caused by a blocked tear duct, but they should not have any of these other symptoms. If your infant has been diagnosed with a blocked tear duct and is very fussy, you might see a Pediatric Ophthalmologist for a second opinion to make sure that he doesn't have glaucoma.

Glaucoma Risk Factors



Aniridia

Marfan's syndrome

Sturge-Weber syndrome

Neurofibromatosis

Down's syndrome

Steroid therapy, including inhaled steroids for asthma and nasal steroids for allergies



See this outline of Primary and Secondary Childhood Glaucomas for a more complete list of diseases and conditions associated with glaucoma in children.

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