Summary about Disease
Infantile glaucoma, also known as primary congenital glaucoma, is a rare eye condition that occurs in infants and young children. It is characterized by increased intraocular pressure (IOP) that damages the optic nerve. This increased pressure is typically due to a malformation in the eye's drainage system (the trabecular meshwork), preventing proper outflow of aqueous humor (the fluid inside the eye). If left untreated, infantile glaucoma can lead to vision loss and blindness.
Symptoms
Excessive tearing (epiphora)
Light sensitivity (photophobia)
Clouding of the cornea (the clear front part of the eye)
Enlarged eyes (buphthalmos or "ox eye") - happens over time
Frequent blinking or squeezing of the eyelids
Corneal edema (swelling of the cornea)
Causes
The primary cause of infantile glaucoma is typically a developmental abnormality of the eye's drainage system, specifically the trabecular meshwork, which is responsible for draining aqueous humor. This abnormality is usually present at birth (congenital) and can be caused by genetic factors or occur sporadically. In some cases, infantile glaucoma may be associated with other genetic syndromes, such as Sturge-Weber syndrome or neurofibromatosis type 1.
Medicine Used
Medications are usually a temporizing measure, used to lower eye pressure before or after surgery. Common medications used in infantile glaucoma include:
Topical beta-blockers (e.g., timolol)
Topical alpha-adrenergic agonists (e.g., brimonidine)
Topical carbonic anhydrase inhibitors (e.g., dorzolamide, brinzolamide) However, medication alone is rarely effective in the long term, and surgery is almost always required.
Is Communicable
No, infantile glaucoma is not a communicable disease. It is not caused by an infection and cannot be spread from person to person.
Precautions
Since it is a birth defect or genetically linked, the typical precautions are limited to preventative genetic testing and monitoring if there is a family history. Once the disease is present, the only precautions are adhering to the treatment plan prescribed by the ophthalmologist to prevent further vision loss.
How long does an outbreak last?
Infantile glaucoma is not an "outbreak"-related disease. It is a chronic condition that requires ongoing management. If untreated, the symptoms and damage to the optic nerve persist indefinitely, leading to progressive vision loss.
How is it diagnosed?
Diagnosis involves a comprehensive eye exam, which may require anesthesia in young children. The ophthalmologist will assess:
Intraocular Pressure (IOP): Measures the pressure inside the eye using tonometry.
Corneal Diameter: Measures the size of the cornea to check for enlargement.
Optic Nerve Examination: Examines the optic nerve for signs of damage (cupping).
Gonioscopy: Uses a special lens to examine the drainage angle of the eye.
Pachymetry: Measures the thickness of the cornea.
Refraction: To assess refractive error and rule out other causes of symptoms.
Axial Length: Measure the length of the eye.
Timeline of Symptoms
The onset and progression of symptoms can vary, but a typical timeline is:
Birth to a few months: Excessive tearing, light sensitivity, and clouding of the cornea may be noticeable.
Several months: Enlargement of the eyes (buphthalmos) may become apparent.
Without treatment: Progressive vision loss occurs over time.
Important Considerations
Early Diagnosis and Treatment are Critical: Prompt diagnosis and treatment are essential to minimize vision loss.
Surgery is Usually Required: Surgical intervention is almost always necessary to correct the drainage problem and lower intraocular pressure.
Lifelong Monitoring: Even after successful surgery, lifelong monitoring by an ophthalmologist is necessary to detect and manage any potential complications or recurrence of glaucoma.
Genetic Counseling: Genetic counseling may be recommended for families with a history of infantile glaucoma.
Amblyopia (Lazy Eye) Treatment: Amblyopia (lazy eye) may develop if one eye is more affected than the other. Treatment, such as patching or eye drops, may be necessary to improve vision in the weaker eye.