Congenital Glaucoma

Congenital Glaucoma in Kids

You all must be wondering what this condition is. Well let me first explain to you how a normal healthy eye works.  

In a healthy eye, the eye fluid circulates under a normal pressure and brings in nutrients that are essential for the eye. And it drains out through a network of cells and tissues. There is a constant circulation of this fluid in the eye. But what happens in glaucoma is this entire process goes out of track. In most cases the fluid does not drain and slowly start accumulating and increasing the pressure in the eye. The optic nerve which is at the back of the eye and is responsible for sending signals to your brain slowly starts getting compressed and damaged as a result of this increased pressure.  

Congenital glaucoma is a very serious condition. It affects every 1 in 10,000 infants. Scary isn’t it? If you leave it untreated it can even lead to blindness. Usually we doctors try and diagnose it as early as possible between 3 to 6 months of age but sometimes it is diagnosed even at the age of 3 years. The advantage is if it is diagnosed early, nearly 80 % of children respond well to treatment and will not have any vision complications.  

How can you predict Congenital Glaucoma? 

Well it is a very tricky question. It is really hard to predict which babies will be born with congenital glaucoma.  

  • Babies whose parents or relatives have such a condition are certainly more prone to it.  
  •  If your first and second child has it, there are higher chances that your subsequent kids will have it too.  
  • In fact studies have shown that boys are twice more susceptible than girls.  

Generally it affects only one eye but at times it can affect both eyes too.  

Even till today the exact cause as to why it happens is not understood. It is believed that the baby’s cells and tissues don’t grow like it should before birth and hence there is a difficulty in the drainage of the fluid after they are born.  

 What are symptoms of Congenital Glaucoma?  

 The most common symptoms that you will notice are 

  • The baby tries to close their eye lids  most of the time  
  • Extremely sensitive to light 
  • Excessive watering from the eye 

 In severe cases you will notice that 

  • A cloudy cornea-  the black part of the eye appears cloudy 
  • Either one or both the eyes appear large  
  • Increase redness of the eyes 

 What to do next? 

Your baby will require a complete eye examination. It is not an easy task to evaluate a toddlers’ eye.  So it is examined in an operating room where the child is sedated. 

 The doctor will evaluate the child’s eye pressure and have  a detailed examination of various parts of the eye including the retina, the angles of the eye.  

Treatment for Congenital Glaucoma

Once the diagnosis is confirmed, they usually start the baby on medical therapy. 

Medical therapy is started and is a temporary measure to bring the IOP under control so as to get a clear cornea prior to the surgery.  

Surgery– surgery is the main stay of treatment .The options are goniotomy and trabeculotomy.  The main aim is to create a drainage channel for the excess fluid.  

 Complications 

  • The eye pressure can be  lowered too much 
  • Lazy eye- amblyopia 
  • Detached retina 
  • Astigmatism 
  • Dislocated lens 

 Take home message 

Let me tell you it is very important to diagnose congenital glaucoma at the earliest. Early intervention be it medical and surgical is essential to restore the baby’s vision.  

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