Childhood Glaucoma

Glaucoma is a potentially blinding disease that affects children and adults. Glaucoma, especially in children, is associated with increased eye pressure. The eye is a plumbing system in that fluid is made within the eye and then the fluid has to exit through drainage pathways. In children, increased eye pressure can be due to abnormal drain formation during pregnancy or trauma/damage to the drain. Increased eye pressure causes permanent damage to the optic nerve (the nerve that runs from the eye to brain). Early on, vision loss may not be detected as glaucoma first affects the periphery of the vision. However, if glaucoma is left untreated, all vision can be lost.

How is Glaucoma Diagnosed?

Glaucoma in children is much more rare (1:10,000) than in adults. In children under the age of 3-4 years, glaucoma often causes tearing and light sensitivity due to damage to the cornea (the clear front surface of the eye). Further, increased eye pressure in this young age group may lead the eye or eyes to grow disproportionately large. In older children, glaucoma may go undetected until there has been significant vision loss. Older children typically do not have light sensitivity and tearing, nor do they complain of pain. Thus, glaucoma may not be diagnosed until a child fails a vision screening or complains of decreased vision.

What are the Symptoms of Glaucoma?

In children under the age of 3-4 years, the classic findings of glaucoma in this young age range are:

• tearing
• light sensitivity
• difficulty opening eyes, especially in bright lights

In addition, these young children may have “large eyes” due to disproportionate growth from increased eye pressure. In older children, glaucoma may not have any symptoms and go undetected until there is significant vision loss.

How is Glaucoma Treated?

There are many different types of glaucoma. Treatment depends on the type of glaucoma and the severity of vision loss. Medications, namely eye drops, may be tried to lower eye pressure. However, many children with glaucoma need surgery to better control eye pressure.

Surgery for Glaucoma

There are three different categories of surgery for glaucoma:

1. Improving fluid outflow through the natural plumbing system
2. Creating a new way for the fluid to exit the eye
3. Decreasing the amount of fluid the eye makes

The choice of surgery depends on many factors such as the type of glaucoma, the age of the patient and whether the patient has undergone other glaucoma surgeries.

Recovery After Surgery

As with most eye surgeries, there is usually minimal pain or discomfort after the first 1-2 days. The eye is typically red for a few weeks and it may take up to a month for the vision to return to baseline. There are usually eye drops for the first month after surgery in order to prevent infection and promote healing.

The best possible outcome in childhood glaucoma is to obtain long-term eye pressure control in order to preserve vision. 

Why Choose Lurie Children's for Glaucoma Treatment?

Brenda Bohnsack, MD, PhD, the Division Head of Ophthalmology, is one of only a handful of experts in childhood glaucoma in the country. She has devoted her career to caring for children with glaucoma and has published numerous papers that have improved outcomes for these patients.