Childhood Glaucoma: Symptoms, Preventions, Treatment and Important facts

Childhood Glaucoma: Due to the lack of symptoms and the fact that once eyesight is lost, it cannot be recovered, glaucoma is often known as the "silent thief of sight." It can affect newborns and children, despite being more frequent in adults. Infantile glaucoma develops during the first three years of life, whereas congenital glaucoma manifests at birth. The signs and symptoms of glaucoma in infants and children are often different from those in adults. And because pediatric glaucoma is uncommon and harder to detect, it is important to seek specialised care. 

What is Glaucoma?

Glaucoma is a condition that damages the nerve of the eye. The increased pressure in the eye, which is known as intraocular pressure, can damage the optic nerve which is responsible for sending images to the brain. If the damage worsens, glaucoma can cause permanent vision loss or even total blindness within a few years. The buildup of fluid in the eye, known as aqueous humour, which raises intraocular pressure, is what causes glaucoma (IOP). 

Childhood Glaucoma: Symptoms

The symptoms of glaucoma depend on the type and stage of the individual's condition. Glaucoma can affect one eye or both.

The most common symptoms of congenital/infantile glaucoma are excessive watering of eyes, light sensitivity, and a large cloudy cornea which can cause the iris to appear dull. On the other hand, juvenile glaucoma tends to develop without any obvious symptoms, like adult glaucoma. Patients with juvenile glaucoma often tend to have a family history. On exam, the eye pressure will typically be elevated and there may be signs of optic nerve cupping. If the eye pressure increases rapidly, there may be pain and discomfort.

Some people may have non-specific symptoms like headache, watering eyes, or seeing a colored halo, which resemble other eye problems or medical conditions. Parents and caregivers should look for these symptoms and get an early consultation with an ophthalmologist.

Childhood Glaucoma: Preventions

The best way to protect one's sight from glaucoma is to get regular comprehensive eye examinations. Many forms of glaucoma have no warning signs. If a child is at risk for glaucoma, it is critical to go for regular eye exams every year that 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 staving off a host of chronic diseases, and glaucoma is no exception.

Eye injuries can lead to glaucoma. It is recommended to wear protective eyewear while participating in sports or as and when required.

Intense exercise that raises the heart rate can also raise the ocular pressure. But regular walking and exercising at a moderate pace can lower eye pressure and improve overall health.

If you have glaucoma or are at high risk of the disease, don't place your head below your heart for long periods of time. Head-down positions can significantly raise the ocular pressure. It is also important to sleep in the right position. Avoid sleeping with your eye against the pillow or on your arm.

Childhood Glaucoma: Treatments 

Glaucoma treatment options include medication, surgery, or both. For infants and young children, surgery is often the first treatment to avoid long-term vision issues. The goal of surgery is to repair the drainage issue so fluid drains normally from the eye. 

Cyclophotocoagulation is the last resort for a blind, painful eye that is unresponsive to other treatments. This type of surgery is performed 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, the extent of the disease, tolerance for specific medications, procedures, or therapies, and other factors.

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(Inputs contributed by Dr. Suneeta Dubey, Head of Glaucoma Services, Dr. Shroff’s Charity Eye Hospital, and Dr. Vidya Chelerkar, Head of Glaucoma Department, PBMA’s HV Desai Eye Hospital Orbis Partner Hospitals)