Pediatric Glaucoma | National Glaucoma Awareness Month

If you think of glaucoma, you might believe it only occurs in older adults. Although the risk of glaucoma does increase after age 60, it can affect people much younger. Even babies and children can develop glaucoma.
 
Glaucoma occurs due to increased interocular pressure in the eyes. We all have interocular fluid in our eyes that nourishes the eyes and keeps them healthy. 

The right balance of fluid is needed to keep the eye pressure at an appropriate level. If fluid increases too much, it can increase eye pressure.

Increased eye pressure can squeeze the optic nerve, leading to damage and vision loss. Increased fluid develops because either there is a problem with the fluid draining from the eye or too much fluid is being produced.
 
When glaucoma occurs in babies, children, and teens, the condition may be referred to as pediatric glaucoma. There are further classifications of pediatric glaucoma, including congenital, infantile, and juvenile glaucoma, and each type typically has a different age of onset:

• Congenital glaucoma: This type of glaucoma is present from the time a baby is born.
• Infantile glaucoma: Symptoms of infantile glaucoma usually develop in babies between one month and 24 months of age.
• Juvenile glaucoma: Juvenile glaucoma is open-angle glaucoma that develops in children and young adults. It typically develops after age 3, but can occur even in young adulthood.

Symptoms of Pediatric Glaucoma

Fortunately, congenital, infantile, and juvenile glaucoma are considered uncommon. According to the Glaucoma Foundation, congenital and infantile glaucoma occur in about 1 out of every 10,000 births. According to the U.S. Department of Health and Human Services, juvenile glaucoma occurs in about 1 in every 50,000 people.
 
Symptoms of juvenile glaucoma may not be noticeable at first and may only be detected through an eye exam. Symptoms of congenital and infantile glaucoma may include:

• Cloudy eyes
• Dull appearing iris (colored part of the eye)

• Sensitivity to light
• Excessive tearing​

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Causes & Risk Factors Of Pediatric Glaucoma

Pediatric glaucoma is considered either primary or secondary. Primary means glaucoma is not associated with any other condition. Secondary means glaucoma developed due to a specific condition. For instance, certain conditions are associated with juvenile glaucoma, including neurofibromatosis, Sturge-Weber Syndrome, and chronic steroid use.
 
Children who sustain an eye injury that damages the draining system of the eye are also at a higher risk of developing juvenile glaucoma. In instances of childhood injury to the eye, it’s also possible that glaucoma will develop later in adulthood.
 
Although the exact cause of primary pediatric glaucoma is not always known, recent research has been able to identify certain gene abnormalities that are inherited and associated with the condition.
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Diagnosis Of Pediatric Glaucoma

​Diagnosis of pediatric glaucoma is made through an eye exam. The eye pressure needs to be measured to confirm a diagnosis. During an exam, the eye doctor will perform certain tests to measure eye pressure, along with corneal diameter and clarity. Depending on the age of the child being examined, sedation may be needed.
 
In cases of juvenile glaucoma, especially if the individual is a young adult, additional tests may be needed to rule out other conditions that could cause similar symptoms. A quick and accurate diagnosis is essential for treatment that could save eyesight.
 

Treatment of Pediatric Glaucoma

The goals of treatment for all forms of pediatric glaucoma are to lower intraocular pressure and preserve vision, by either reducing the amount of fluid produced by the eye or improving the outflow of the fluid to decrease pressure.
 
Usually, treatment involves surgery. Different surgical procedures may be used. Goniotomy and trabeculotomy are two common procedures used to open the drainage canals and promote the outflow of fluid.
 
In some cases, oral medications or eye drops may also be used to treat juvenile glaucoma. Medication or eye drops may help decrease the interocular pressure. The medications may be used in addition to surgery or after surgery.
 
According to the Glaucoma Foundation, about 80 to 90 percent of babies that have congenital or infantile glaucoma who receive quick treatment preserve all or most of their vision. When pediatric glaucoma is not promptly diagnosed and treated, the outcome is worse. The foundation reports that about two to 15 percent of children with primary congenital glaucoma have vision loss.
 
If you have any questions about glaucoma and your child or you would like to schedule an appointment with one of our eye doctors, please call our office at 508-746-8600.
 
Please check back with us soon for more eye health tips and info. Thanks for reading!
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