Pediatric Glaucoma

What is Pediatric Glaucoma?

Glaucoma is a group of eye disorders characterized by increased intraocular pressure and resultant damage to the optic nerve, leading to visual loss. Glaucoma in children (pediatric glaucoma) can also affect additional ocular structures if the child is under 3 years old – this includes affecting the cornea and the eye length.

Pediatric glaucoma can be divided according to the age of onset:

• Congenital glaucoma: Also known as newborn glaucoma, the condition is noticed and diagnosed immediately after birth (or within one month of life).
• Infantile glaucoma: This type of glaucoma develops within the first 3 years of life and includes congenital glaucoma.
• Juvenile glaucoma: This type of glaucoma develops after 3 years of age but before adulthood. Unlike infantile glaucoma, juvenile glaucoma does not affect the cornea or the length of the eye.

What Causes Pediatric Glaucoma?

Pediatric glaucoma is typically due to an abnormality of the drainage system in the front of the eye. It can be from

• Gene mutation
• Systemic disease
• Ocular disease
• Medication side-effect
• Trauma
• Developmental defect of unknown cause.

What are the Signs and Symptoms of Pediatric Glaucoma?

• Closure of the eye(s) in light (photophobia)
• Cloudy and enlarged cornea
• Excessive tearing
• Eye discomfort
• Fussy behavior
• Loss of appetite
• Loss of vision

How is Pediatric Glaucoma Diagnosed?

In infantile glaucoma, structural eye changes from increased intraocular pressure support the diagnosis. These include corneal haze, corneal breaks, increased optic nerve head cupping, high myopic refractive error, and eye enlargement. The intraocular pressure measurement is typically elevated. In juvenile glaucoma, optic nerve head cupping and increased intraocular pressure suggest the diagnosis. Older children can have visual field testing, and abnormalities in visual field also support the diagnosis.

How is Pediatric Glaucoma Treated?

Pediatric glaucoma typically requires surgery. Medications can be used to reduce intraocular pressure, but this is usually a temporary option until surgery can be performed.

The aim of surgery typically is to create an opening through which fluid can drain from the eye. This is done using microsurgical techniques. Rarely, a laser is used to decreased fluid production.

Follow-up and care after surgery are essential in protecting the ongoing health of the child’s eyes. Even when intraocular pressure is controlled after surgery, failure to have post-operative amblyopia (lazy eye) management in early childhood leads to later irreversible blindness. Pediatric ophthalmologists, orthoptists and optometrists work together to provide optimal management.

The Pediatric Eye Service within Cleveland Clinic Abu Dhabi’s Eye Institute offers a range of treatment options for the full spectrum of eye disorders in children. Talk to one of our pediatric ophthalmologists to find out more.

Pediatric Eye Service

Eye diseases in children are different to those in adults and require a specialized approach. The experienced team within our Pediatric Eye Service work together to provide the best possible care for children.

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