This entity has been variously called as Congenital glaucoma, infantile glaucoma, Juvenile glaucoma depending upon the age of onset of the disease. The underlying pathology is the structural abnormality of the angle structures- the structures involved in the drainage of aqueous. Aqueous is the fluid inside the eye that help in maintaining the balance of the production and drainage of aqueous thereby maintaining the eye pressure. In many cases, the pathology is hereditary or inborn while in others, it may be caused by other eye diseases such as trauma to the eye, inflammatory diseases such as Arthritis in children, cataract surgery and other eye surgeries, uveitis in children, prolonged steroid intake etc.
The child can have symptoms such as excessive watering, difficulty in looking at bright light, subnormal vision, hazy cornea- the front portion of the eye. In very small children, the eyes may be enlarged as the eyeball tries to adjust the rise in eye pressure by stretching. However, raised pressure for a prolonged time can damage the optic nerve- the nerve responsible for vision.
As children are apprehensive for detailed evaluation of the eye, fundus, eye pressure recording, an assessment under anaesthesia is often required. Although the primary treatment aims at reducing the eye pressure by medications, the definitive control of the disease is achieved by surgery as the underlying abnormality in the angles is overcome by surgery. The surgery aims at correcting the structural abnormality and provide a way for drainage of aqueous. Post-surgery, the patient requires constant monitoring of the eye pressure as well as spectacles for fine vision.
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