What is glaucoma?

Glaucoma is a condition in which there is damage to the drainage angle in the eye. As fluid can't flow out properly, this leads to an increase in intraocular (inside the eye) pressure on the optic nerve (the nerve that sends messages from the eye to the brain).

What is congenital glaucoma?

Congenital glaucoma is a rare eye condition that affects roughly 1 in 10,000 children. Like glaucoma, It is caused by a structural abnormality however, the impact of the intraocular pressure looks a little different.

Just like growing bones, children's eyes are more flexible or floppy than adults' and consequently, too much intraocular pressure will stretch the eye and cause it to inflate like a balloon. As the eye enlarges, so does the cornea resulting in its membrane splitting. This can have a long term impact on the child's vision and lead to other eye conditions. 

What causes congenital glaucoma?

The most common cause of congenital glaucoma is the lack of development or malformation of the trabecular meshwork, which is the structure that allows for the normal drainage of fluid within the eye. There are several factors that can contribute to the development of congenital glaucoma, including:

1. Genetics: Congenital glaucoma can be inherited, and certain genetic mutations can increase the risk of developing the condition.

2. Environmental factors: Certain environmental factors, such as infections or exposure to certain chemicals during pregnancy, can increase the risk of congenital glaucoma.

3. Syndromic: Congenital glaucoma can be associated with certain inherited genetic disorders such as Axenfeld-Rieger syndrome, Peters anomaly, and others

4. Congenital glaucoma can be isolated or as a part of a more complex syndrome, such as congenital ocular malformations.

What are the symptoms of congenital glaucoma?

The symptoms of congenital glaucoma can vary depending on the severity of the condition, but may include:

1. Excessive tearing: Infants and children with congenital glaucoma may have excessive tearing, which can be one of the first signs of the condition.

2. Cloudy eyes: The eyes may appear cloudy or hazy, especially in infants.

3. Sensitivity to light: Infants and children with congenital glaucoma may be sensitive to light and may squint or close their eyes in bright light.

4. Larger-than-normal eye size: The increased pressure within the eye can cause the eye to bulge outwards, leading to a larger-than-normal eye size.

5. Blurred vision: The increased pressure within the eye can cause the cornea to become cloudy, leading to blurred vision.

6. Irregular shape of the eye: The increased pressure within the eye can cause the eye to bulge outwards, leading to an irregular shape.

7. Strabismus: Congenital glaucoma can also cause crossed eyes or other alignment problems.

8. Nystagmus: The eye movement disorder can be caused by congenital glaucoma.

How is congenital glaucoma diagnosed?

Diagnosis is typically made through a comprehensive eye exam, including measurement of the intraocular pressure, examination of the optic nerve, and measurement of the corneal thickness.

How is congenital glaucoma treated?

Treatment for congenital glaucoma typically involves medication to lower the pressure within the eye and surgery to improve the outflow of fluid from the eye. In some cases, a combination of both medication and surgery may be necessary to control the pressure and prevent further vision loss.

What should I do if I think my child has congenital glaucoma?

The symptoms of congenital glaucoma may not be immediately noticeable, and may develop gradually over time. Therefore, it is important to be aware of the signs and symptoms and to have your child's eyes examined as soon as you suspect a problem. We are big believers in the "it's better safe than sorry" mentality so, if you suspect a problem with your child's vision, seek a second opinion from a professional.

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