Normally afflicting newborn babies or toddlers aged under three, primary congenital glaucoma is caused by faulty development of the eye's trabecular meshwork and is resulted with failure to properly slough away aqueous humor fluid from inside the eye. Secondary infantile glaucoma can be caused by inflammation, tumors, inborn error of metabolism and other congenital causes.
50%-70% of all congenital glaucoma sufferers are afflicted with either primary congenital or infantile glaucoma. While approximately one in every 10,000 babies is born with glaucoma, some 60% of infants affected are diagnosed within the first six months, and about 80% are identified by their first birthday. Roughly 65% of all sufferers are males and 70% have bilateral glaucoma.
Each condition is clinically diagnosed by examining the intraocular pressure and corneal diameter and optic axis for primary medical symptoms including epiphora, photophobia, buphthalmos. At the same time, a gonioscope is used to check the eyes' trabecular meshwork while an ophthalmoscope scans the retinas and optic nerves. Retinal nerve fiber imaging is very important during case follow-ups.
External ocular examination often shows abnormal enlargement of toddlers' corneas from the regular 9.5 to 10.5 mms diameter before age one. The lightness or severity of this distortion is dependent on the degree of intraocular pressure.
While medication cannot control intraocular pressure for long periods nearly as well as early surgery, it can ease surgeons' work by keeping the cornea clear and free of edema.
While it is always best to seek treatment as soon as possible, some sufferers' intraocular pressure can be controlled after surgery. That said, patients may still develop amblyopia because of cataracts and astigmatism and high intraocular pressure may recur in future.
- source by Professor Ray Jui-Fang Tsai, M.D., Chairman of ORBIS Taiwan and ORBIS Flying Eye Hospital Volunteer Faculty