Treatment of Congenital Glaucoma

About the disease

Congenital glaucoma is a severe eye condition, which develops when high pressure affects the optic nerve. High eye pressure can occur if its fluids don’t drain properly. This condition can be present at birth or it can develop when a child is 3-4 years old.

According to WebMD, 1 in 10,000 babies will develop congenital glaucoma. Most of the time, doctors detect it during the first few months of a child's life. The good news is that if congenital glaucoma is found early, chances for successful treatment reach 90%. If congenital glaucoma runs in the family it is important to have the child examined by a doctor on a regular basis, to detect the condition as early as possible.

Sometimes babies are born with congenital glaucoma even if this condition does not run in the family and the child has no genetic predisposition for it. In such a case, it is unclear what causes it, although it is likely that something abnormal occurred during the fetal development period. Congenital glaucoma is more common in boys than in girls. Although it mostly affects two eyes, in some cases only one eye develops abnormal pressure on the optic nerve.

10% of all cases of congenital glaucoma result in permanent blindness. This can occur if the diagnosis was made too late. Even if treated, congenital glaucoma can sometimes result in partial loss of vision, but this also happens rarely.

Symptoms

• Excessively watery eyes
• Increased sensitivity to light
• The child closes their eyes more frequently than normal
• Appearance of the cornea may change
• Pain in the eye
• Redness
• Swelling
• Eyes may be bigger than normal in size

Diagnosis

• During a general examination, the ophthalmologist will examine the patient’s eyes. Changes in the cornea and the eye’s overall size will be checked.
• The doctor will direct light into the eye to check for abnormal sensitivity: excessive tearing and blinking.
• The doctor will ask the child’s parents if any blood relatives had ever been diagnosed with congenital glaucoma in their infancy.
• The child will be given anesthesia so that the doctor can examine the eye more closely and use a tonometer to measure the eye pressure.
• Before diagnosing the child with congenital glaucoma, the doctor will rule out all other eye conditions that could be causing high eye pressure.

Treatment

• Congenital glaucoma can only be treated with surgery.
• Laser trabeculoplasty (ltp) is a surgical procedure that uses a beam of light to alter the drainage angle of the eye so that fluid can flow out as tears. It is very effective in stabilizing eye pressure and reduces the risk of vision loss to a minimum.
• An iridectomy is a surgical procedure whereby part of the iris is removed. This reduces the intraocular pressure substantially.
• Cryocoagulation is a procedure that uses extremely cold temperature to coagulate the eye.

Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko