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Congenital glaucoma
What is congenital glaucoma?
Glaucoma is an ocular disease generally resulting from an increase in intraocular pressure due to alterations in the drainage system of the aqueous humour, a colourless fluid that nourishes the cornea and the crystalline lens. This fluid is constantly produced and, when it is not drained correctly from the eye, it accumulates in the eyeball and can cause irreversible damage to the optic nerve if not remedied in time.
Although glaucoma is a particularly common disease in people over the age of 60, congenital glaucoma occurs in newborn babies or childhood glaucoma in children under the age of 3. This condition affects 1 of every 10,000 newborns in developed countries and can be present in one or both eyes, although it is more often bilateral.
Glaucoma is an ocular disease for which early diagnosis in adults is rather difficult, as it progresses silently and only becomes apparent when there are secondary effects and there has been a significant loss of peripheral vision. Something similar occurs in the case of congenital glaucoma, although some symptoms might warn of the problem, such as excessive tearing or photosensitivity. Defects on the child’s eyelid are also commonplace, as well as enlarged eyes (buphthalmos) or differently sized eyes (megalocornea and myopia).
The symptoms are often vague, however, and might go unnoticed. A correct inspection of the eyesight of newborn babies is therefore important, and a specialist must be seen if anything untoward or defect is noticed, as early detection is essential in avoiding damage to the optic nerve, which could lead to irreversible vision loss.
Congenital glaucoma is due to a birth injury at the angle at which the cornea and the iris merge, which is the drainage channel through which the aqueous humour is expelled from the eye.
Although there is a genetic component to it, in most cases it appears sporadically. It may also be related to other eye diseases, such as congenital cataracts, aniridia (defect in iris development) and Peters’ anomaly (malformation of the cornea and the anterior chamber of the eye), or may be associated to syndromes involving malformations of other organs. In some cases, congenital glaucoma might be secondary to injuries or infection during pregnancy.
Treatment for congenital glaucoma must begin as soon as possible to reduce eyesight loss to a minimum and ensure the child has a good quality of vision.
As in adults, congenital glaucoma is often first treated with drugs in droplet form or eye drops in an attempt to control the intraocular pressure. In the case of younger patients, we often use this option until the most suitable age for surgery is reached. Surgery might involve several techniques that the experts at Miranza will indicate in each case for the best results.
