Congenital glaucoma, also known as childhood or pediatric glaucoma, occurs in babies and young children.* Pediatric glaucoma is a rare condition that may be inherited and is caused by incorrect development of the eye’s drainage system before birth. This can lead to increased intraocular pressure, which in turn damages the optic nerve located in the back of the eye. 

The disease is more common in boys in the United States, and it’s often diagnosed within the child’s first year of life. If glaucoma presents after three or four years of age, it is referred to as primary juvenile open-angle glaucoma (JOAG), according to the American Academy of Ophthalmology (AAO).

What are the symptoms?

Early detection, through regular and complete eye exams, is key for preventing damage to and total loss of vision that can be caused by glaucoma. Symptoms to watch out for in pediatric patients with symptoms of childhood glaucoma include:

• Enlarged eyes
• Excessive tearing
• Cloudiness of the cornea
• Photosensitivity (sensitivity to light)

What treatments are available?

If congenital glaucoma is suspected, an examination under anesthesia and surgery are usually done together. There are two main types of surgical treatments: filtering surgery (i.e., trabeculectomy) and laser surgery.

• Filtering surgery (also known as microsurgery) involves the use of small surgical tools to create a drainage canal in the eye and is performed while the child is under anesthesia, either localized or general. According to the AAO, filtering surgery has a high success rate, up to 90% or greater in some patients.
• Laser surgery uses a small, but powerful, beam of light to make a small opening in the eye tissue.

Medical treatments may also be incorporated. Medication may include topical eye drops and oral medications, which can help to either increase the exit of fluid from the eye or decrease the production of fluid inside the eye. Each results in lower eye pressure. It is important to note that medical treatment can be challenging since most glaucoma medications are not approved for use in children.

The main goal of managing childhood glaucoma is early diagnosis and, therefore, early surgical treatment to prevent damage and potential vision loss from increased eye pressure. In addition, long-term follow-up appointments are important to ensure children with glaucoma continue to live vibrant and quality lives.

Additional information on congenital glaucoma can be found on the American Academy of Ophthalmology website titled “Diagnosis and Treatment of Primary Congenital Glaucoma.”

*Glaucoma Research Foundation. (2019, Oct. 3). Childhood Glaucoma. https://www.glaucoma.org/glaucoma/childhood-glaucoma-1.php 

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