We generally associate glaucoma with older adults. But babies and children can also develop glaucoma. It is called paediatric glaucoma. As per the American Academy of Ophthalmology, paediatric glaucoma affects more than 3,00,000 children globally. Early diagnosis and the right treatment can protect your child’s vision and ensure a healthy future for them.
In this blog, we are going to shed light on paediatric glaucoma, what causes it, how it is diagnosed, and the treatments that help children have healthy eyes and live an active life.
What is Paediatric Glaucoma?
Paediatric glaucoma is a serious eye condition in babies and children. The pressure inside their eye (intraocular pressure or IOP) becomes too high. This pressure damages the optic nerve – the nerve which carries signals from the eye to the brain. If not treated, the condition can lead to permanent vision loss.
Types of Paediatric Glaucoma
There are two main types of paediatric glaucoma:
1. Primary Congenital Glaucoma (PCG)
Primary congenital glaucoma or infantile or newborn glaucoma affects infants and children till the age of 3 years. Increased IOP can damage the optic nerve, leading to visual impairment and even blindness if left untreated.
The exact cause of PCG is not properly known. However, it is believed that some children are born with it, due to genetic factors, especially if there’s a family history.
2. Secondary Glaucoma
This type of paediatric glaucoma happens because of other eye problems, injuries, or diseases. Some causes include:
- Eye injuries
- Eye infections or inflammation
- Previous eye surgery
- Certain medical conditions, like Sturge-Weber syndrome or Axenfeld-Rieger syndrome
Sometimes, glaucoma can also develop in children who were born with cataracts or who have had cataract surgery. According to AAPOS, up to 30% of children who underwent cataract surgery are susceptible to glaucoma in the first five years after surgery.
Signs and Symptoms to Watch Out For
Most children cannot explain if something is wrong with their vision, and if there is any problem, what it is. So, parents must stay alert. Here are some common signs of paediatric glaucoma:
- Excessive tearing (not due to crying)
- Light sensitivity (child squints or turns away from bright light)
- Cloudy-looking eyes
- Enlarged eyes
- Frequent blinking or rubbing eyes
- Red eyes
- Poor vision or eyes that do not seem to focus properly
In babies, the white part of the eye (cornea) may appear hazy or dull instead of clear. If you notice any of these signs in your child, it is important to consult an eye specialist as soon as possible.
How is Paediatric Glaucoma Diagnosed?
Diagnosing glaucoma in children can be challenging. Your child’s eye specialist performs a comprehensive dilated eye exam and other required tests in their office or an operating room using general anaesthesia. It ensures a safe and accurate diagnosis. Some frequently used tools and techniques for diagnosis include:
1. Eye Pressure Measurement (Tonometry)
A quick test to check if the pressure inside the child’s eye is too high.
2. Examination of the Eye’s Drainage System
The paediatric ophthalmologist checks if the eye fluid is draining properly. They do this by using special lenses and microscopes.
3. Checking the Optic Nerve
The doctor looks at the back of the child’s eye to see whether the optic nerve looks healthy or damaged.
4. Checking Corneal Size and Clarity
In glaucoma, the cornea may become enlarged or cloudy.
Treatment Options
Treatment is chosen according to the type and severity of the condition. Treatment also considers the child’s age and the underlying cause. The goal is to lower the eye pressure and protect the optic nerve from damage.
1. Medicines
Eye drops and oral medicines can be used to lower IOP. They either decrease the production of the eye fluid or increase its outflow. Common examples of these medications include beta-blockers, prostaglandin analogs, carbonic anhydrase inhibitors, and alpha-agonists.
Parents must follow the doctor’s instructions properly and give medicines to the child on time. Regular follow-up visits are also very important.
2. Surgery
Surgery is often the initial treatment for paediatric glaucoma. Surgery may also be required when medicines alone are not enough to control eye pressure. Surgical interventions include:
- Trabeculectomy – The procedure makes an opening in the sclera to allow the eye fluid to exit the eye.
- Glaucoma Drainage Devices (GDDs) – Also known as tube shunts, glaucoma drainage devices are implanted in the child’s eye to create a new route to help drain the eye fluid and lower intraocular pressure.
In most cases of congenital glaucoma, surgery is the main treatment. Both surgeries aim to reduce the eye pressure and prevent eye damage.
Life After Diagnosis: Living with Paediatric Glaucoma
Knowing that your child has glaucoma can be emotionally draining. But early detection and treatment can make a big difference. Many children with glaucoma retain good vision and lead normal, active lives.
How Parents Can Help
- Stay consistent with your child’s treatment and do not miss any follow-ups.
- Watch out for any changes in your child’s vision or behaviour.
- Talk regularly to your child’s eye doctor and discuss your concerns.
- Support your child emotionally – they may need extra care, especially before and after surgery or while adjusting to the treatment.
- See if your child can benefit from vision therapy and glasses.
- Talk to their school authorities to seek special support if needed.
Final Thoughts
Glaucoma is a serious eye condition that can result in vision loss – if not treated in time. Paediatric glaucoma is rare but seems to be even more serious. However, with early diagnosis and the right treatment, your child’s vision can be protected for life. That is the reason regular eye check-ups of children, including their first eye examination at birth and complete visual assessment between 6-12 months of age, are crucial.
Apart from staying alert and keeping a watch on your child’s eyes, religiously follow their eye-check-up calendar. If you ever notice anything unusual about your child’s eyes or vision, don’t wait – schedule a checkup with a paediatric eye specialist.
At Sohana Hospital, the most trusted hospital in North India, we have dedicated child eye specialists who are experts in treating child glaucoma cases, with highly successful outcomes. So, if a paediatric eye specialist in Chandigarh is what you are looking for, you must visit Sohana Hospital.
Your awareness, love, and timely action can make all the difference in your child’s life.
