Pediatric Glaucoma

About Pediatric Glaucoma

Glaucoma is a disease that affects the optic nerve caused by increased pressure inside the eye. Glaucoma can lead to vision loss and even blindness. Like cataracts, glaucoma can also occur in childhood or infancy.

In fact, childhood cataract is often associated with the subsequent development of glaucoma. Although the detection of glaucoma in children can be challenging as there are often no symptoms, Columbia’s experts have the resources and experience to diagnose and treat the disease.

Symptoms

Although there are often no symptoms of pediatric glaucoma, some might include:

• Poor focusing
• Trouble seeing
• Nystagmus (rhythmic shaking of the eyes)
• White pupils
• Strabismus (eyes not aligned)
• Glare in bright lights
• A cloudy cornea
• Persistent light sensitivity
• Excessive tearing
• An obvious enlargement in the size of the eye

Congenital glaucoma is when a child has a problem with the angle of the eye that then slows the normal drainage of fluid.

Diagnosis

Glaucoma in infants is often symptomatic but in older children and adolescents often has no symptoms at first. However, as the disease progresses, a person with glaucoma might notice their side or peripheral vision gradually failing. Objects in front might still be clear, but objects to the side might be missed. Glaucoma can be diagnosed using the following tests:

• Comprehensive eye exam that includes a visual acuity test, Tonometry (checking the pressure of the eye), pachymetry (checking the thickness of the front of the eye), and dilated eye exam.
• Visual field test that measures peripheral vision.
• Optical coherence tomography, which measures optic nerve thickness.

Pictures of the optic nerve serves as a baseline to monitor changes over time. The eye doctor might take a picture of the optic nerve. This picture can serve as a baseline to see if changes happen over time.

Treatments We Offer

While glaucoma cannot always be cured, prompt treatment can often control it. Studies have shown that early detection and treatment of glaucoma is the best way to control the disease.

Congenital glaucoma treatment usually requires surgery and glaucoma in older children and adolescents may also require surgery.

Surgery options may include:

• Trabeculotomy - a new opening is made through the meshwork of the eye for the fluid to leave the eye.
• Glaucoma drainage implant - we place an implant inside the eye to help fluid drain.
• Goniotomy - opening the meshwork inside the eye from inside the eye to help fluid drain.
• Peripheral iredectomy – this surgery is used for closed angle glaucoma. We surgically create a hole in the iris to help relieve blockage of the angle. In older children, a laser iridotomy may be able to take the place of this conventional surgery.

Why Choose Columbia?

Columbia ophthalmologists are experts in diagnosing, treating, and monitoring pediatric glaucoma and our researchers will never stop looking for a cure.