Glaucoma can affect newborns and children, although it occurs more frequently in adults. Infantile glaucoma develops during the first three years of life, while congenital glaucoma appears at birth. Children can be affected by juvenile glaucoma, a different type of glaucoma. The signs and symptoms of glaucoma in infants and children are often different from those of adults.
Many cases of pediatric glaucoma have no specific identifiable cause and are considered primary glaucoma. The most common cause of childhood cataracts is inadvertent use of steroidal eye drops for various allergic diseases of the eye. These eye drops can cause glaucoma of blindness. Thus, it is important to consult an eye specialist even for the slightest eye ailment as a child’s eyes are very sensitive.
When glaucoma is caused by or associated with a specific condition or disease, it is called secondary glaucoma. Examples of conditions associated with childhood glaucoma include Exenfeld–Rieger syndrome, aniridia, Sturge–Weber syndrome, neurofibromatosis, chronic steroid use, trauma, or previous eye surgery such as childhood cataract removal. Not all patients with these conditions will develop glaucoma, but the incidence of glaucoma is much higher than average, and they should be monitored regularly.
Symptoms of Glaucoma in Children
The symptoms of glaucoma depend on the type and stage of the condition in a person. Glaucoma can affect one eye or both.
The most common symptoms of congenital/infantile glaucoma are excessive watering of the eye, sensitivity to light, and extensive clouding of the cornea, which can cause the iris to appear dull. On the other hand, juvenile glaucoma develops without any obvious symptoms like adult glaucoma. Patients with juvenile glaucoma often have a family history. On examination, eye pressure will usually be elevated and there may be signs of optic nerve cupping. If eye pressure rises rapidly, pain and discomfort can occur.
Some people may have non-specific symptoms such as headache, watery eyes, or seeing colored halos, which may resemble other eye problems or medical conditions. Parents and caregivers should watch for these symptoms and seek prompt consultation with an ophthalmologist.
Risk Factors and Prevention
There are ways to prevent vision loss and blindness from glaucoma. Here’s how:
The best way to protect one’s vision from glaucoma is to have regular comprehensive eye exams. Many forms of glaucoma have no warning signs. If a child is at risk for glaucoma, it is important to have regular eye exams every year, which include measuring intraocular pressure. This will help in early detection. It is equally important to take your glaucoma medications as prescribed by your doctor.
A healthy diet plays a role in warding off many chronic diseases, and glaucoma is no exception.
Glaucoma can result from an eye injury. It is recommended to wear protective eyewear when participating in sports or when required.
– Intense exercise that increases the heart rate can also increase intraocular pressure. But regular walking and moderate-intensity exercise can lower eye pressure and improve overall health.
– If you have glaucoma or are at high risk of this disease, do not keep your head below your heart for a long time. The head-down position can increase ocular pressure significantly. It is also important to sleep in the right position. Avoid sleeping with your eye close to a pillow or on your arm.
treatment for glaucoma
Treatment options for glaucoma include medication, surgery, or both. For infants and young children, surgery is often the first treatment to avoid long-term vision problems. The goal of surgery is to correct the drainage problem so that fluid can drain normally from the eye. A variety of surgical options are available. Ophthalmologists decide the best surgery appropriate for the patient based on a number of factors including the underlying nature of the disease. Various surgical options are available nowadays including trabeculotomy and goniotomy with the highest success rates. Other procedures include trabeculectomy, combined trabeculotomy, and trabeculectomy and glaucoma drainage device. The earlier surgery is performed, the better the outcome.
Cyclophotocoagulation is the last resort for a blind, painful eye that is unresponsive to other treatments. This type of surgery is done in severe cases of childhood glaucoma.
Specific treatment for glaucoma will be determined by the ophthalmologist based on the child’s age, overall health and medical history, extent of disease, tolerance to specific drugs, procedures, or treatments, and other factors. Children with pediatric glaucoma are at higher risk of developing other eye problems as they get older. Therefore, early diagnosis and treatment, coupled with careful monitoring, are important for long-term eye health. The good news is that early detection can prevent serious damage and save eyesight. New advances in glaucoma care bring researchers closer to curtailing the disease.
(Inputs provided by Dr. Sunita Dubey, Head of Glaucoma Services, Dr. Shroff’s Charity Eye Hospital, and Dr. Vidya Chelerkar, Head of Department of Glaucoma, HV Desai Eye Hospital, Orbis Partner Hospitals of PBMA)