Dr Anil K Mandal, Head – Children’s Eye Care Centre & Consultant – Centre for Glaucoma Care, L V Prasad Eye Institute
Glaucoma refers to a group of eye diseases that have common features, including elevated eye pressure, damage to the optic nerve, and vision loss. There are many types of glaucoma. Childhood glaucoma refers to the presence of glaucoma in a child. Congenital glaucoma is the common term used for glaucoma diagnosed in infancy or early childhood, and is also called pediatric or infantile glaucoma.
Childhood glaucoma is associated with physical changes in the eye which are caused by the high pressure. The increased fluid pressure can push on the optic nerve and cause cupping (an abnormal enlargement in the optic disc area). If the pressure remains too high for too long, the optic nerve fibres are damaged. Enlargement of the eye, cloudiness of the cornea and injury to the optic nerve are examples of changes that can occur as a result of glaucoma.
Childhood Glaucoma: Facts and Figures
- Childhood glaucoma occurs in one out of every 10,000 births in the Unites States. In other parts of the world, even higher rates have been reported. For example in Saudi Arabia, the incidence of childhood glaucoma has been noted to be as high as one out of 2500 births. According to the Andhra Pradesh Eye Disease Study (APEDS), it occurs as one in 3300 live births.
- Isolated or primary congenital glaucoma accounts for approximately 50 to 70% of all cases of congenital glaucoma. Most cases of pediatric glaucoma are diagnosed by the age of six months, with 80% diagnosed by the first year of life.
- In diagnosed cases, about 2/3rd of the patients are male. In about 3/4th of all cases, the glaucoma affects both eyes, which is termed bilateral.
- It has been estimated that approximately 300,000 children are afflicted with developmental glaucoma worldwide and 2/3rd are already blind (WHO bulletin, 1994)
Pediatric glaucoma is treated differently than adult glaucoma. Most patients require surgery and this is typically performed early. The aim of pediatric glaucoma surgery is to reduce IOP or intraocular pressure. Most babies who receive prompt surgical treatment, long-term care, and monitoring of their visual development will do well, and may have normal or nearly normal vision for their lifetime. Sadly, when childhood glaucoma is not recognized and treated promptly, more permanent visual loss will result.