What is it
Congenital glaucoma
Congenital glaucoma is a form of glaucoma unique to childhood. This birth disease causes progressive damage to the optic nerve, which is responsible for transmitting information from the eye to the brain. As a result of this damage, a milder or more severe loss of vision occurs, depending on its degree of degeneration.
The main risk factor for developing glaucoma is elevated intraocular pressure. This increase in intraocular pressure (IOP) is caused by an imbalance between the production and elimination of aqueous humour (a colourless fluid that oxygenates and nourishes the ocular structures), which affects the proper functioning of the eye.
Congenital glaucoma usually manifests itself in the first three years of life, although it is rare as it affects 1 in 30,000 newborns. The typical symptoms that parents should observe in the child are that they are bothered by light (photophobia), their eyes water and that they usually have them closed.
Read more
As the disease progresses, the normal appearance of the eyes changes when there is a loss of transparency of the cornea and a disproportionate increase in the size of the eye due to distension in the tissues.
To confirm the diagnosis, the ophthalmologist will need to give the affected child an in-depth examination.
Treatment of congenital glaucoma
If the treatment of congenital glaucoma is approached at an early stage of the disease, it is possible to slow its progression. On the contrary, its prognosis worsens when several months pass with high intraocular pressure and without treatment or when the diagnosis is made at the time of birth. In the latter case, it is recommended that the surgical intervention be immediate.
Surgery is the indicated option to treat this type of glaucoma, although the choice of surgical technique will depend on the degree of opacity of the cornea and whether or not the angle formed by the cornea with the iris is altered.
Other procedures, such as placement of a drainage valve, may be indicated if previous procedures do not achieve the expected results.
If the cornea is still transparent, a gonotiomy should be performed, which is a specific technique for children with congenital glaucoma. It consists of releasing the abnormal tissue that obstructs the exit of the aqueous humor from the eye, with the aim of reducing intraocular pressure.
Otherwise, when the cornea is already opaque, the chosen technique will be trabeculectomy. This drainage surgery consists of creating a direct communication pathway between the anterior chamber of the eye and the subconjunctival space to promote the passage of aqueous humor in sufficient quantity and thus reduce intraocular pressure. To ensure the normal functioning of the eye, it is essential to reestablish the balance between the production and elimination of aqueous humor.
The surgery is carried out in only one eye and then in the other, if both are affected by the disease. In some cases, prior drug treatment is established to keep intraocular pressure under control until surgery is performed.
Surgical treatment of congenital glaucoma has good results in 60-80% of cases, as long as it is performed in time, reaching adulthood with an acceptable visual capacity. The success of surgical treatment is not the same when it is late or when intraocular tension cannot be controlled. In these cases, total loss of vision in the eye can occur.
Other pathologies
SUBSCRIBE
to our newsletter
Be the first to hear all the latest news from the Oftalmedic Salvà group and receive exclusive promotions that may interest you.
