Congenital glaucoma describes a rare group of diseases that affect the eyes from birth. When a newborn has glaucoma, the fluid in the eye does not drain properly, placing pressure on the optic nerve.
Early treatment is crucial to
Read on to learn more about the symptoms and treatment of congenital glaucoma.
Congenital glaucoma typically affects newborns or infants a few months old. The three different types of congenital glaucoma
- Infantile glaucoma: Symptoms of infantile glaucoma are more obvious from 1 to 36 months of life. This is the most common type of congenital glaucoma and accounts for around 65% of cases.
- True congenital glaucoma: A parent, caregiver, or doctor may notice a visible enlargement of the eyes within the first month of life. This type of congenital glaucoma accounts for around 25% of cases.
- Juvenile glaucoma: This is when children who are 3 years and older show signs of glaucoma. This is the least common type of congenital glaucoma and accounts for around 10% of cases.
When the eye does not develop properly in the womb, the aqueous humor, the fluid that fills the front portion of the eye, cannot drain adequately. The purpose of the aqueous humor is to keep the eyeball in shape and deliver nutrients. The eye constantly replaces old fluid with new to keep itself healthy.
However, when the eye’s drainage system does not work due to developmental problems, the old liquid cannot drain and builds up in the eye. This accumulation of fluid applies pressure and stress on the optic nerve. When a developmental problem with the eye causes glaucoma, a baby has
Both congenital and secondary glaucoma have the potential to cause a permanent loss of vision. For this reason, they both require urgent treatment.
Congenital glaucoma does not necessarily run in families and often develops sporadically on its own, but there is a genetic link in some cases. Researchers have found that changes in the CYP1B1 and LTBP2 genes are more prevalent in babies or children with congenital glaucoma.
Moreover, in places where marriages between close relatives are more common, the number of babies or children with congenital glaucoma increases. Additionally, they tend to develop symptoms at a younger age compared with children whose biological parents are not close relatives.
The three main symptoms of congenital glaucoma
- excessive eye watering
- light sensitivity or avoidance, which doctors call photophobia
- involuntary tight closing of the eyes, especially in bright light
Other symptoms to consider are enlarged eyes, a whiteish-blueish cornea, and high pressure in the eyes.
- Examining the eye: The doctor will investigate the appearance of the cornea, iris, pupil, and lens.
- Checking the baby’s sight: The baby may not respond well to visual sight tests.
- Measuring intraocular pressure: If the pressure within the eye is higher than usual, fluid may not be draining.
In some cases, if a doctor cannot get all the measurements due to the child’s age and inability to cooperate, they may have to perform the exam under anesthesia in the operating room. A doctor will also want to know more about the baby’s family medical history and additional information, such as if the parents are closely related.
The goal of glaucoma treatment is to reduce pressure in the eye. Typically, this may involve surgery to help drain fluid to lower pressure in the eye, but medicines can also help.
- Angle surgery: This repairs the eye to prevent congenital glaucoma from returning. It also helps drain fluid.
- Filtering surgery: This creates a drain in the eye so fluid can escape, reducing pressure on the optic nerve.
- Cycloablation: This procedure uses a laser to destroy fluid-producing tissue within the eye. However, doctors will only recommend this type of surgery when other options are ineffective.
Before surgery, a doctor may suggest a course of topical or oral antiglaucoma medicines. For example, this may include eye drops or tablets. These medications can help reduce pressure in the eyes and corneal swelling.
While treatment cannot restore any loss of vision, it can stop symptoms from worsening and causing further vision loss. Many children who receive treatment live typical lives with their remaining sight.
Congenital glaucoma is a serious eye condition that could cause vision loss. For this reason, it is important doctors spot the signs and symptoms quickly so treatment can begin as soon as possible. Generally, babies receive surgery to repair the eye and drain fluid.
These treatments can immediately reduce pressure and stress on the optic nerve. However, they do not cure glaucoma, and a person will need to monitor the condition their whole life.