Congenital (childhood) glaucoma – definition, causes, symptoms, treatment

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Childhood glaucoma is a congenital disease that runs frequently in families and hereditary. It is caused by a disturbed development of the intraocular fluid outflow tract. Immediately after birth, due to fluid blockage and an increase in intraocular pressure, one (or both) eye begins to enlarge, the cornea becomes cloudy, and the sclera becomes severely thinned. The eye can reach very large sizes.

Congenital (childhood) glaucoma – definition

Congenital glaucoma is an eye defect that often runs in families and in families. The ailment is about three percent. all cases of glaucoma. In addition, over 80% of primary congenital glaucoma is diagnosed. in children in the first year of life, and in 1% at birth. It is caused by irregularities in the routes of the outflow of intraocular fluid. Immediately after birth, due to fluid stagnation, the baby gets high intraocular pressure, which results in:

1. enlargement of one or both eyes
2. haze in the field of view,
3. thinning of the sclera.

The causes of congenital glaucoma

Congenital glaucoma results from a defective development of a child’s eye still in the fetal stage. The tissue is then overgrown, the task of which is to filter the intraocular fluid from the anterior chamber of the eye into the bloodstream. It is also referred to as corneal iridial angle dysgenesis. As a result of this defect, the intraocular pressure rises and aqueous humor begins to accumulate.

The development and degree of these disorders is not the same in every child and depends on the development of abnormalities in the structure of the angle of infiltration in children with congenital glaucoma (this affects the diagnosis of the disease at different times). The abnormalities are not accompanied by other additional abnormalities in the structure of the eyeball or systemic disorders.

Symptoms of congenital (childhood) glaucoma

Early symptoms of congenital glaucoma are:

1. excessive tearing,
2. sensitivity to light,
3. involuntary contraction of the child’s eyelids, which is often misdiagnosed as conjunctivitis.

Childhood glaucoma can be associated with various congenital abnormalities of the eye structure.

In addition, an increase in intraocular pressure causes:

1. woloocze – that is, enlargement of the eyeball;
2. staining of the sclera blue due to stretching of the walls of the eyeball;
3. iris enlargement,
4. a deepening and enlargement of the optic nerve disc that is pushed to the outside of the eye. There is also an asymmetrical arrangement of blood vessels,
5. clouding of the iris – appears as a result of iris tissue that cannot withstand the tensile force of the eye and bursts from the inside. Then the intraocular fluid enters the rupture, which causes the eye to become cloudy,
6. damage to the optic nerve due to the pressure of fluids on the nerves, as well as the blood vessels that nourish the nerve.

Congenital glaucoma can occur with many congenital eye defects. We also distinguish two types of congenital glaucoma:

1. primary congenital glaucoma – diagnosed in the first two years of life and also includes neonatal glaucoma,
2. primary childhood glaucoma – diagnosed between the ages of three and ten.

Treatment of congenital glaucoma

Treatment of congenital (childhood) glaucoma involves surgery, and surgery should be performed as early as possible, before the optic nerve atrophies and completely blinds. Usually, pharmacological treatment is undertaken first, only the insufficient effect of such therapy, i.e. progressive neuropathy, is an indication for surgery. The operation consists in cutting through the overgrown tissue and preventing it from growing back together. Sometimes doctors create a new way of outflow of intraocular fluid. Surgical procedures are effective in over 80% of cases, and if performed relatively early and supported by pharmacology, they can help maintain eyesight in most children.

Congenital glaucoma is also treated with other methods, which include:

1. filter setons,
2. goniotomy (intersecting the filtration angle in order to open it),
3. iridectomy – during which the peripheral part of the iris is removed, creating a new path between the anterior and posterior chambers,
4. trabeculotomy – a method that connects the anterior chamber with the venous sinus,
5. laser treatments.

Drug treatment is based on the use of eye drops to help treat congenital glaucoma. Commercially available eye drops help to reduce the production of intraocular fluid and at the same time facilitate the drainage of fluids into the main chamber of the eye. These types of measures are used in children who are currently unable to undergo surgery.

Each child undergoing surgery for congenital glaucoma should be under constant medical supervision for the rest of its life. The intraocular pressure measurement should be performed every few months.

Is It Possible To Cure Congenital Glaucoma?

There is no causal treatment for glaucoma, so it cannot be cured XNUMX% and needs to be constantly monitored. There is no such thing as stopping treatment for this condition, as it requires constant follow-up by an ophthalmologist and taking anti-glaucoma preparations (as indicated). Sometimes it is necessary to perform further procedures to restore normal pressure inside the eyeball and inhibit progressive glaucomatous neuropathy.

Can it be prevented?

There are no known preventive measures for congenital glaucoma. Only parents of children with congenital glaucoma should undergo genetic testing to assess the risk of developing glaucoma in subsequent children.

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