To spread the word about the sight-stealing disease, Glaucoma is the leading cause of irreversible blindness where as much as 40% of vision can be lost without a person noticing. Glaucoma can affect children even before 3 years of age but the clinical signs and symptoms are different.
What is Glaucoma?
Glaucoma is a disease of progressive Optic Nerve damage caused by increase in intraocular pressure. Congenital/Infantile glaucoma starts before 3 years of age and juvenile glaucoma is seen in more than 3 years of age.
Glaucoma can lead to optic nerve damage and consequent visual loss. Dr Vineet Sehgal, Senior Consultant at Sharp Sight Eye Hospitals describes it as a heterogeneous group of eye diseases that are characterized by a progressive optic neuropathy, manifested by cupping of the optic disc and usually, but not always, associated with increased intraocular pressure (IOP).
Glaucoma damages the connection between the eye and the brain which in turn leads to slow shrinking of area of vision that one can see (visual field) and ultimately may progress to complete blindness.
Causes of Glaucoma:
The most common cause of childhood glaucoma is inadvertent use of steroidal eye drops for various allergic diseases of the eye. These eye drops can cause blinding glaucoma. So even for slightest ailment of the eye patient needs to consult an eye specialist as child’s eyes are very sensitive.
Glaucoma often follows cataract surgery in babies and young children. Cataract surgery replaces the lens in the eye if it has become cloudy. The IOP fluctuations post cataract surgery can lead to glaucoma. It can also occur if the eye becomes inflamed for any reason, such as in children who have a childhood form of arthritis, as the drainage channels may get blocked with inflammatory cells.
Symptoms or warning signs of Glaucoma:
The doctors list that children affected with glaucoma may have:
- Excessive watering (Epiphora),
- Photophobia – sensitivity to light or inability to see in light,
- Enlargement of eyes (buphthalamos),
- Pain and redness.
- A cloudy cornea is one of the common signs of congenital glaucoma. The healthy cornea is transparent. The loss of this transparency is caused by edema, or swelling of tissue from excess fluid accumulation due to high IOP. This occurs in the corneal epithelium (outermost layer of the cornea) and in the corneal stroma (middle layer of the corneal tissue). The careful inspection of the cornea may also reveal defects in its inner layer, which is further proof of a raised eye pressure (IOP).
Treatment of Glaucoma:
“Early diagnosis and management of intraocular pressure are mainstay of treatment in Glaucoma. Medical therapy and surgical procedures are both viable options and the doctor will choose it depending on the type of glaucoma and extent of optic nerve damage,” says Dr Aparna Darawal.
She suggested, “If there is a family history of childhood glaucoma, early check-ups by ophthalmologist should be for glaucoma screening. Even though congenital glaucoma is not completely reversible, early and effective treatment can prevent disease progression and vision loss.”
Revealing easier prevention methods, Dr Anita C Kamarthy offered, “As most say prevention is better than cure, it can be prevented to a certain degree by mother’s getting fully vaccinated especially rubella prior to pregnancy. Also avoiding teratogenic drugs and drug abuse during pregnancy. Most of these children have to be examined under general anaesthesia for intraocular pressure, corneal diameter, retinoscopy, ophthalmoscopy and gonioscopy. Depending upon the severity of involvement, the management varies which is mostly surgical. Initially medical treatment is used to lower intraocular pressure by using hyperosmotic agents , beta-blockers,carbonic anhydrase inhibitors. While miotics and alpha agonists are contraindicated in PCG.”