CHILDHOOD BLINDNESS

CONGENITAL GLAUCOMA

by
Professor A. Rasheed

Dow International Medical College

ALSO CALLED AS BUPHTHALMOS, MEANING OX

EYE

1. CONGENITAL GLAUCOMAS IS A GROUP OF RARE

BUT POTENTIALLY BLINDING DISORDERS

CONGENITAL GLAUCOMAS ARE EITHER

PRESENT
AT BIRTH OR APPEAR DURING THE FIRST
3 TO 4 YEARS OF LIFE.

ABOUT 80% OF CONGENITAL GLAUCOMAS IS

EVIDENT BY
 3 MONTHS OF AGE.

CONGENITAL GLAUCOMA OCCURS IN ABOUT

1:10,000 BIIRTHS

THE CAUSE IS USUALLY AN ABNORMAL

DRAINAGE AT THE TRABECULAR MESHWORK

IF THE GLAUCOMA IS PRESENT AT BIRTH, THE

IOP IS RAISED.

IF THE GLAUCOMA DEVELOPS A YEAR OR TWO

AFTER BIRTH, THE PROBLEM IS LESS SEVERE.

THE YOUNGER THE AGE WHEN GLAUCOMA

APPEARS, THE MORE DIFFICULT IS TO
TREAT IT SUCCESSFULLY.

ABOUT HALF OF CONGENITAL GLAUCOMA IS

PRIMARY IN NATURE.

THE YOUNGER THE EYE THE SOFTER AND

ELASTIC IT IS.
SO THAT, IT ENLARGES WHEN THE IOP
RISES IN GLAUCOMA.

THIS DOES NOT HAPPEN SO MUCH

AFTER THE AGE OF THREE OR FOUR.
 MALE BABIES ARE
MORE COMMONLY AFFECTED - (65%).THE
CONDITION IS BILATERAL 70% OF THE TIME.

ALTHOUGH BOTH EYES

ARE USUALLY AFFECTED, ONE EYE IS
MORE SEVERELY AFFECTED
THAN THE OTHER.
SO THAT ONE EYE
MIGHT APPEAR LARGER THAN ITS FELLOW.

HEREDITY IS OCCASIONALLY A FACTOR.

ALTHOUGH AUTOSOMAL RECESSIVE

TRAIT IS BLAMED BUT THE EXACT
NATURE OF THE INFLUENCE IS NOT
KNOWN.

HEREDITY IS OCCASIONALLY A FACTOR.

ALTHOUGH AUTOSOMAL RECESSIVE TRAIT IS

BLAMED BUT THE EXACT
NATURE OF THE INFLUENCE IS NOT
KNOWN.
AS THE EYE ENLARGES, TEARS APPEAR
IN THE DESCEMETS MEMBRANE (HABBS
STRIA )LEADING TO CORNEAL CLOUDING
AN EYE WITH CLOUDY CORNEA BECOMES PAINFUL
AND THIS
LEADS TO WATERING.

THERE IS SENSITIVITY
 TO LIGHT (PHOTOPHOBIA) and
BLEPHROSPASM.
THUS,
CONGENITAL GLAUCOMA GIVES A LARGE,
WATERY EYE WITH CLOUDY CORNEA WHICH
DOES NOT SEE WELL AND IS SENSITIVE TO LIGHT.
THE VISUAL SYSTEM IS NOT FULLY DEVELOPED
AT BIRTH.

BINOCULAR VISION DEVELOPS ONLY WHEN

BOTH EYES SEE PROPERLY.
IF ONE EYE
DOES NOT SEE
PROPERLY,
THE VISUAL
SYSTEM DOES
NOT MATURE
ON THAT SIDE.

THIS MAY CAUSE AMBLYOPIA.

IF ONE EYE DOES NOT SEE PROPERLY,
HE VISUAL
SYSTEM DOES
NOT MATURE
ON THAT SIDE.

THIS MAY CAUSE AMBLYOPIA.

EARLY DETECTION AND TREATMENT IS
ESSENTIAL TO PRESERVE THE VISUAL
FUNCTION.
EARLY DETECTION AND TREATMENT IS ESSENTIAL
TO PRESERVE THE VISUAL FUNCTION.
ABOUT 50% OF CONGENITAL GLAUCOMA HAVE
ASSOCIATED OCULAR OR SYSTEMIC
ABNORMALITIES.
SECONDARY GLAUCOMA
ABOUT 50% OF CONGENITAL GLAUCOMA HAVE
ASSOCIATED OCULAR OR SYSTEMIC
ABNORMALITIES.

SECONDARY GLAUCOMA
CONGENITAL GLAUCOMA
CAN OCCUR SECONDARY TO
SUCH SYSTEMIC CONDITIONS
AS:

-NEUROFIBROMATOSIS
-CONGENITAL RUBELLA
-LOWEs SYNDROME
-STURGE WEBER SYNDROME
-HOMOCYSTINURIA
-MARFANs SYNDROME
-WEILL MARCHESANI SYNDROME

CONGENITAL GLAUCOMA CAN OCCUR SECONDARY

TO SUCH OCULAR CONDITIONS AS:

-AXENFELD ANOMALY
-REIGERs ANOMALY
-PETERs ANAMOLY
-ANIRIDIA
-PHPV
-NANOPHTHALMOS
-MICROPHTHALMIA

AN EUA IS USUALLY REQUIRED TO EXAMINE THESE

BABIES FOR THE PURPOSE OF DIAGNOSIS.
DIAGNOSIS IS MADE FROM:
-INDEX OF SUSPICION
-CLINICAL FEATURES
-EUA
PROGNOSIS OF
CONGENITAL GLAUCOMA
HAS IMPROVED IN THE RECENT YEARS.
THE TREATMENT IS ESSENTIALLY SURGICAL.

MEDICAL TREATMENT IS
GIVEN ONLY UNTIL
SURGERY CAN BE
PLANNED.
TREATMENT MUST BE
STARTED AS EARLY AS
POSSIBLE.
FOLLOWING
SUCCESSFUL TREATMENT,
A CHILD WITH
CONGENITAL GLAUCOMA NEEDS LONG TERM
FOLLOWUP, WHICH
MAY LAST FOR LIFE.
SUCCESSFUL
TREATMENTOFCONGENITALGLAUCOMA
CAN RESULT IN
REVERSAL OF SOME OF
THE EFFECTS OF GLAUCOMA
PROGNOSIS OF
CONGENITAL GLAUCOMA
HAS IMPROVED IN THE RECENT YEARS.

THANK YOU