Glaucoma isn’t just a disease impacting adults – it also can affect infants and children. Overall, glaucoma, or a group of conditions categorized by optic nerve damage, is the second leading cause of blindness and the leading cause of irreversible blindness worldwide.1
What is it exactly?
Glaucoma is a progressive eye disease that results in damage to the optic nerve.2 The optic nerve is a grouping of nerve fibers that transmits visual information from the eye to the brain. When it is damaged or doesn’t function, the precise transmission of visual information between the retina and brain is lost.3
A bit different from adult glaucoma, childhood glaucoma can be classified into three separate categories based on age: primary congenital glaucoma, juvenile open angle glaucoma and secondary glaucoma.4
In primary congenital glaucoma, 10 percent of these cases are present at birth, and 80 percent diagnosed within the first year of life, resulting from the abnormal development of the ocular drainage system.5
In juvenile cases, the glaucoma develops after three years, and doesn’t have the same symptoms as primary congenital glaucoma such as corneal clouding.6
Secondary childhood glaucoma is associated with a secondary cause or disease that can happen at any point in childhood. Some diseases that can be associated with glaucoma are Axenfeld-Reiger syndrome, Sturge-Weber syndrome, aniridia, and neurofibromatosis.7
What to look for
Common symptoms of primary congenital glaucoma are:
A large, cloudy, cornea that causes the iris to appear dull
Signs change as children get a bit older. Here are the signs for children under 18:
Eyes sensitive to sunlight or a camera flash
Significant vision loss
Difficulty adjusting in the dark
Complains of headaches and/or eye pain
Blinks or/and squeezes his/her eyes often
How is it treated?
If primary congenital glaucoma is suspected, an examination and surgery are usually done together. The disease requires early surgery unlike adult glaucoma where non-surgical methods such as eye drops, or laser treatments are tried first.
High eye pressure, or intraocular pressure (IOP) is often present and the only modifiable risk factor for glaucoma.9 A trabeculotomy and goniotomy are common surgery methods. They both open the drainage canals to help the fluid drain out of the eyes.
Even after surgery, the child needs to have routine checkups to make sure eye pressure does not increase once again. Early diagnosis is crucial especially in childhood glaucoma because it can lead to serious vision impairment.10
The International Agency for the Prevention of Blindness Glaucoma [Accessed February 12, 2018]