Childhood glaucoma is a group of eye diseases in which pressure inside the eye (intraocular) is elevated, causing damage to the optic nerve with associated loss of vision. Treating childhood glaucoma requires a specialist in pediatric ophthalmology like Dr. Ann Ranelle, a board-certified pediatric ophthalmologist with Fort Worth Eye Associates.
Childhood Glaucoma (Congenital Glaucoma or Pediatric Glaucoma)
Glaucoma is an eye disease that causes damage to the optic nerve of the eye due to high pressure and gradually gets worse over time. Most pediatric glaucoma patients inherit the condition and usually will experience its effects in their middle age. However, infants who experience this condition are generally born with it.
Glaucoma creates what is known as increased intraocular pressure, which can cause long-term damage to the optic nerve, the nerve that transmits images to the brain. When left untreated, this condition can cause permanent blindness.
Glaucoma is predominately caused by increased pressure to the eye in cases of poor fluid circulation. When the eye is healthy, the fluid (called aqueous humor) flows through a mesh-like channel out of the eye. When this channel becomes blocked, the fluids build-up, causing glaucoma. Glaucoma usually occurs in both eyes at once, but sometimes with differing extents of severity.
One treatment for glaucoma is eye drops, the purpose of which is to either decrease the formation of fluid in the eye or to increase its outflow.
Depending on the level of severity and how far glaucoma has developed, the doctor may suggest either laser treatment or microsurgery on the eye. In most cases of infant glaucoma, a doctor will primarily choose surgery as the treatment option, due to the complex nature of an infant’s ocular drainage system.
Treatment
Pediatric glaucoma is treated for the most part with surgery. It is necessary to lower the intraocular pressure (IOP) and this is the purpose of the surgery. The patient will always be under general anesthesia for glaucoma surgery, and it may be necessary to do multiple procedures and examinations to control glaucoma. There are two main types of surgery, trabeculectomy, and goniotomy, designed to open the drainage canals for the fluid to escape the eye. Other types of surgery involve creating a bypass route for the aqueous (fluid created by the eye) to drain out.
The trabeculotomy is completed to create a guarded opening between the front of the eye to a space just under the conjunctiva (the membrane covering the white of the eye). A tube shunt is then inserted into the front of the eye or through the back of the eye. Then fluid from the eye can efficiently drain to a reservoir located underneath the conjunctiva.
Following the glaucoma procedure, a doctor will prescribe eye drops and oral medications for the patient to take in the recovery process. Additional medication may be given in order to control the intraocular pressure (IOP).
Glaucoma is not simply fixed with the lowering of the intraocular pressure because the condition can often cause myopia (nearsightedness) which requires a patient to have glasses. The risk is also increased for a patient who suffers from amblyopia (decreased vision) and strabismus (crossed eyes), and these issues may also require treatment of a surgical nature. Even with the speedy intervention of pediatric glaucoma, the possibility still exists for significant and permanent loss of vision, so the earlier a child is seen and treated by a doctor, the more likely a positive long-term outcome.
If you would like to learn more about childhood glaucoma by our pediatric ophthalmologists, please call our Fort Worth office at 817-732-5593.