Glaucoma in children
Glaucoma in children is on the list of the most severe ophthalmic pathologies. If glaucoma is not treated, sooner or later, increased intraocular pressure can lead to malnutrition of the optic nerve, and then to blindness and loss of vision. How to diagnose glaucoma in time, what methods of treatment are available – we deal with an ophthalmologist

What is glaucoma

Glaucoma is a progressive disease leading to irreversible blindness. Due to increased intraocular pressure in glaucoma, retinal cells are destroyed, the optic nerve atrophies, and visual signals cease to flow to the brain. The patient begins to lose sight, his peripheral vision is disturbed, subsequently the visibility zone is limited. In children, glaucoma can be congenital. There is still no consensus on what causes the development of these ailments, but if left untreated, their outcome is the same – optic nerve atrophy and blindness.

Causes of glaucoma in children

Congenital glaucoma in children develops as a result of intrauterine influence of adverse factors. If during pregnancy the expectant mother suffered rubella, influenza, toxoplasmosis or other infectious diseases, as well as endocrine disorders, hypo- or hypervitaminosis, various intoxications, including severe toxicosis, hypoxia, the influence of radioactive waves, then such glaucoma is considered to be secondary congenital .

There are also genetic reasons when a mutation occurs in the gene responsible for the development of eye structures in utero. Such glaucoma is called primary.

There is also juvenile glaucoma, otherwise it is called youthful. It appears in children older than three years. The progress of the disease is quite slow. Most often, it is caused by congenital defects in the structure of the eye, and secondary juvenile glaucoma, which is the result of another disease, also occurs. So, with juvenile glaucoma, similar to senile glaucoma, changes occur in the iris, the iris root area gradually atrophies, which leads to the development of symptoms very similar to the manifestations of senile glaucoma. The patient’s intraocular pressure increases, changes occur in the optic nerve and the field of view narrows.

Signs of glaucoma in children

There are several symptoms by which you can understand that a child is developing glaucoma:

  • enlargement of the eyeball (“expressive eyes”);
  • photophobia – increased sensitivity of the eyes to light. Children with glaucoma usually complain of pain, pain in the eyes, a desire to squint or close their eyes, and other unpleasant symptoms that occur when they go out into bright light;
  • lacrimation – a condition in which tear fluid flows onto the face through the edge of the eyelid. Normally, tear fluid drains completely from the eyes into the nasal cavity through the tear ducts;
  • an increase in the diameter of the cornea;
  • clouding, swelling of the cornea;
  • deepening of the anterior chamber of the eye;
  • decrease in visual functions.

The manifestation of signs of glaucoma depends on the form and stage of the disease. That is, at first, the child has single floating opacities, when the disease progresses – the child has diffuse opacities, destructive changes, hemorrhages.

Treatment of glaucoma in children

Treatment of glaucoma in children begins with a visit to an ophthalmologist – it is impossible to eliminate this disease with drug treatment, it is ineffective in this case. Therefore, in this case, only surgery that does not have age-related contraindications will help. After the examination, the doctor will suggest a traditional surgical or laser solution.

Laser surgery gives a good result in the resumption of the outflow of fluid by natural channels. The operation is done in the region of the iris, the liquid drainage is restored with a laser beam. The use of a laser provides such advantages as: efficiency, high accuracy, non-invasiveness.

Traditional operation glaucoma is done under general anesthesia. The purpose of the procedure is to create an outflow bypassing the disturbed one. Operations are adjusted according to the specific diagnosis.

The effectiveness of the operation may decrease due to the rapid overgrowth of the channels, and after a while it leads to a relapse. Accordingly, it is necessary to resort again to surgical intervention.

After the operation, medical therapy is prescribed for a speedy recovery. The operated child in the first decade needs supervision and implementation of recommendations. A minor should not wash his eyes, rub his eyeball, he must eat properly, exclude solid, salty, very hot food. During sleep, the problematic eye should be at the top, you can not lie on your stomach, side, where the operated eye is.

Diagnostics

Only a specialist can determine if a child has glaucoma, and in what form the disease proceeds. Diagnosis of glaucoma requires several basic studies:

  • the child will have intraocular pressure measured (tonometry);
  • a study of the visual field (perimetry) will be carried out;
  • determine the state of the optic nerve during the examination of the fundus (ophthalmoscopy);
  • computed tomography of the retina and optic nerve (ophthalmoscopy) will be performed.

The results of these studies will allow the doctor to recommend treatment. If necessary, they may also prescribe an additional examination.

Modern treatments

Pediatric glaucoma is a rare eye disease that is one of the main causes of irreversible blindness at an early age. Only timely treatment will help save vision, the best methods of which can be selected by a highly qualified specialist after a thorough examination of the child’s visual system.

The most effective method of treatment is antiglaucoma surgery – as described above, it is worth resorting to either traditional surgery or laser surgery.

Medications will be prescribed after the operation. Drug therapy plays an important role in the complex treatment of the disease and includes taking measures to stabilize intraocular pressure, prevent severe postoperative scarring, and use drugs to preserve and improve visual functions. After surgery and treatment, every child with glaucoma will undergo a mandatory examination once a month, during which intraocular pressure, corneal diameter, limbus width and visual functions are measured.

Prevention of glaucoma in children at home

There are several ways to prevent glaucoma in children at home:

  • You can’t overstress. Both physical and psycho-emotional stress should be limited;
  • Don’t keep your head down. It is harmful for patients with glaucoma to engage in activities that require a long forward tilt of the head. This applies to drawing, drawing, knitting, embroidery and similar activities;
  • It is necessary to maintain an even position of the head when playing or working at a computer, watching TV;
  • Set up the right lighting. It is dangerous for people with glaucoma to work in poor lighting conditions. It is important to make it optimally bright so as not to overstrain the eyes;
  • Do not wear clothing that interferes with blood circulation in the neck and head.

Popular questions and answers

Comments Candidate of Medical Sciences, ophthalmologist Natalia Voroshilova:

How to detect the primary symptoms of the disease?

Glaucoma in children can be congenital, and then the parents themselves can notice the signs of the disease in the form of an enlarged cornea, which is not as shiny as in a normal eye. Also, the transparency of the cornea decreases, it becomes cloudy. An eye with glaucoma increases in size – this is also one of the symptoms. To detect congenital diseases, there is a first appointment with an ophthalmologist in one month. The reception was created precisely so that the doctor could diagnose glaucoma and other diseases early. Also, glaucoma can be juvenile in children, which develops in childhood and adolescence. It is due to the fact that the structures in the eye, which are responsible for the removal of intraocular fluid, are inadequately developed. Signs that indicate the presence of juvenile glaucoma are the same as those of congenital glaucoma: the cornea becomes less shiny, it becomes cloudy, the eye is enlarged. If there is any suspicion, parents should consult a doctor. The envisaged system of medical examination by an ophthalmologist at one month, then at six months, at three years, at seven years before school, is aimed at detecting eye diseases in children. Even if the child does not have eye problems, be sure to undergo a medical examination. This will contribute to the early diagnosis of the disease.

For what reason can a child be denied an ophthalmic operation?

Usually these are general somatic reasons – that is, for the state of general health. Also, this includes inflammation of the eyes in the acute stage, obstruction of the lacrimal ducts.

What are the recommendations for shortening the recovery period after treatment (surgery)?

It is important to follow all the recommendations of your doctor, they are individual for each. It is usually recommended not to touch the operated eye for two weeks, to use the drops prescribed by the doctor, not to go to the baths for 30 days, not to overexert. Children with congenital glaucoma are followed up by an ophthalmologist after surgery and are examined once a month.

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