Congenital glaucoma is an elevated intraocular pressure in children that is the result of congenital anomalies in the development of the eye. Many defects interfere with the aqueous humor outflow, for example, developmental anomalies of the trabecular meshwork, abnormal blood vessels of the iris, stromal hypoplasia or hyperplasia, Axenfeld, Rieger, or Peters anomalies. The disease is usually not associated with heredity and develops sporadically. Congenital glaucoma can be successfully cured in Germany. Surgical intervention allows doctors to normalize the aqueous humor outflow and achieve long-term intraocular pressure reduction.
Content
- Should glaucoma be treated?
- Conservative therapy
- Surgical treatment
- Why is it worth undergoing treatment in Germany?
Congenital glaucoma can be treated only with surgery. Conservative therapy is used as an additional technique or helps to quickly reduce intraocular pressure, while waiting for a surgical procedure.
You can undergo your treatment in one of the following hospitals: University Hospital Rechts der Isar Munich, University Hospital Frankfurt am Main, or University Hospital Ulm.
Please, contact the Booking Health specialists, and we will arrange treatment for your child in Germany. Booking Health will recommend the best clinic and pediatric ophthalmologist, help you apply for a visa and get to the clinic, take care of your accommodation, monitor the implementation of the medical program, and provide interpreting services and medical insurance.
Should glaucoma be treated?
Glaucoma should be treated as soon as possible, even if it does not cause any symptoms right now. Over time, the disease leads to irreversible vision impairment, up to its complete loss. At this stage, anti-glaucoma operations allow the patients to maintain their visual acuity, but it will not be possible to achieve a significant improvement.
Congenital glaucoma is a rare condition that affects about 1 in 15,000 newborns. At the same time, it accounts for about 10% of all cases of blindness in the world. The main problem for patients is the late diagnosis and untimely treatment. In 40% of children, the disease is still not diagnosed 6 months after birth, while in 20%, it is detected at the age of over 1 year.
In 75% of cases, congenital glaucoma affects both eyes. If left untreated, the child's eyesight gets worse quickly, and optic nerve atrophy progresses. Nonetheless, the disease can be cured in Germany. German ophthalmologists perform anti-glaucoma surgery for children of any age group, and, after surgery, intraocular pressure is completely normal.
Conservative therapy
In some cases, treatment of congenital glaucoma in Germany begins with conservative therapy, but surgery will still be required in the future. The drugs are used to temporarily lower intraocular pressure and reduce corneal edema, for example, while waiting for surgical treatment. Medicines work by reducing the production of aqueous humor.
Surgical treatment
The surgical treatment is considered the main one for congenital glaucoma. The goal of the operation is to achieve permanent intraocular pressure reduction.
The two main goals of congenital glaucoma surgery are as follows:
- ensuring the outflow of aqueous humor;
- reducing the production of aqueous humor.
To normalize the aqueous humor circulation, doctors eliminate the obstacles in the way of its outflow, which are caused by structural anomalies of the drainage area or form new paths to bypass the blocked ones.
The following surgical interventions can be used to remove obstacles:
- Goniotomy is a dissection of adhesions in the area of the iridocorneal angle of the eye.
- Ab interno-trabeculotomy is a dissection of the trabeculae from the anterior chamber angle.
- Laser trabeculoplasty is the cauterization of the inner surface of the trabecular diaphragm. It allows more aqueous humor to pass through.
- Iridectomy – doctors in Germany use the method of complete or basal iridectomy. The operation can be performed with a surgical instrument or a laser.
Operations for the formation of a new channel for the aqueous humor outflow are called fistulizing. These include:
- Diathermogoniopuncture or microdiathermogoniopuncture is a perforation of tissues in the area of the iridocorneal angle using electrical energy.
- Ab externo-trabeculotomy is a dissection of the trabecula through the conjunctiva and sclera.
- Sinustrabeculectomy is one of the most effective operations providing stable results. Doctors perform a deep sclerectomy to expand the space inside the sclera and bring the fistula into it from the anterior eye chamber.
In some cases, doctors have to implant drainage systems or valves. They help better control intraocular pressure and prolong the effect of the operation.
The operations to reduce the production of aqueous humor are performed less commonly. Their essence lies in the temperature effect on the ciliary processes or the arteries that supply them. Doctors use a laser, a cyclodiathermy, and a cryocoagulation technique.
Why is it worth undergoing treatment in Germany?
You can undergo surgical treatment for glaucoma in Germany. There are a few reasons for you to undergo your treatment in this country:
- high-precision diagnostics, which allows the doctors to choose the best anti-glaucoma surgery option depending on the clinical case and plan it perfectly;
- sparing surgical interventions;
- laser procedures;
- successful treatment of even the most severe cases of glaucoma;
- safe eye surgeries in children during the first weeks of their life;
- a comprehensive rehabilitation without any damage to the child's vision with the timely intervention;
- a long-term result without revision surgical interventions.
You are kindly welcome to use the Booking Health service to see the prices and book your treatment in one of the German hospitals. The price for medical services in clinics in Germany will be lower for you due to the lack of additional coefficients for foreign patients. The Booking Health specialists will help you select a specialized center whose doctors have vast experience in the treatment of glaucoma in children and arrange your trip abroad.
Authors:
The article was edited by medical experts, board certified doctors Dr. Vadim Zhiliuk and Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
Sources:
Open Ophthalmology Journal
British Journal of Ophthalmology
MedlinePlus
