Can children have glaucoma?

Written by Dong Xian Yan
Pediatrics
Updated on September 04, 2024
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Children can develop glaucoma. Congenital glaucoma typically presents within the first year of life and is more common in boys. The disease onset before the age of two to three years leads to increased eye pressure, which results in the enlargement of the eyeball. This manifests as photophobia, tearing, and eyelid spasms. Once diagnosed, early surgical treatment is recommended. For children under three years old, the preferred surgical procedures are trabeculectomy or goniotomy. As children are in a developmental stage and have poorer overall tolerance, anti-glaucoma medications are only suitable for short-term bridging treatment.

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What to do with high eye pressure glaucoma?

Glaucoma is a group of eye diseases characterized by typical optic nerve atrophy and visual field defects. Its main features are high intraocular pressure and visual field damage. The treatment of glaucoma primarily focuses on controlling intraocular pressure, delaying damage to the optic nerve, and preserving remaining vision. Lowering intraocular pressure is essential for treating glaucoma, so it can be treated locally with medications that reduce intraocular pressure. If medications cannot control the pressure, surgery may be necessary to manage it. (Specific medications should be used under the guidance of a physician.)

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Glaucoma open angle vs closed angle differences

Primary glaucoma is clinically divided into two major categories: angle-closure glaucoma and open-angle glaucoma. The difference between them is that angle-closure glaucoma is due to a pre-existing abnormal configuration of the iris, leading to a mechanical blockage of the anterior chamber angle by peripheral iris tissue, which obstructs the outflow of aqueous humor, thus causing an increase in intraocular pressure. In contrast, open-angle glaucoma has a normal appearance of the anterior chamber angle, which remains open, and its increase in intraocular pressure is due to a pathology in the trabecular meshwork’s aqueous humor outflow system, increasing the resistance to aqueous outflow. Currently, the ratio of primary angle-closure glaucoma to primary open-angle glaucoma is about 3:1, making it the most common type of glaucoma in China.

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The difference between open-angle and closed-angle glaucoma

Primary angle-closure glaucoma is a type of glaucoma caused by the peripheral iris blocking the trabecular meshwork, or permanently adhering to the trabecular meshwork, obstructing the outflow of aqueous humor, leading to increased intraocular pressure. It is characterized by a narrow angle and the anatomical feature of the peripheral iris being prone to contact with the trabecular meshwork. Gonioscopy confirming angle closure is an important diagnostic criterion. The characteristic of open-angle glaucoma, however, is that even though intraocular pressure is elevated, the angle remains open, with the obstruction of aqueous outflow occurring at the trabecular meshwork system.

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Early symptoms of glaucoma

There are many types of glaucoma, and the symptoms vary between different types. Some patients with glaucoma might not have noticeable symptoms in the early stages; others may only experience mild eye soreness and occasional blurred vision, which can improve with rest; some present with insidious vision decline and field defects. Glaucoma refers to a group of progressive optic nerve damage that eventually impairs vision, mainly associated with pathological elevation of intraocular pressure. Glaucoma is the second leading cause of blindness worldwide, and it is the top irreversible blinding eye disease. Common symptoms of glaucoma include blurry vision, vision decline, field defects, and acute attacks, often accompanied by eye pain, headache, nausea, vomiting, and more. If glaucoma symptoms occur, or there is a suspicion of glaucoma, it is advised to visit an ophthalmology clinic for comprehensive examinations like visual acuity, intraocular pressure, fundus examinations, etc., to determine the cause and provide targeted treatment, actively reduce intraocular pressure, and protect the optic nerve.

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What are the symptoms of a glaucoma attack?

Typical acute angle-closure glaucoma has several different clinical stages, divided into the preclinical stage, prodromal stage, acute attack stage, intermittent stage, chronic stage, and absolute stage. The acute attack stage is mainly characterized by severe headache, eye pain, photophobia, tearing, and significant deterioration of vision, often reduced to counting fingers or hand motion, and may be accompanied by systemic symptoms such as nausea and vomiting. Physical signs include eyelid edema, mixed congestion, corneal epithelial edema, and the appearance of small droplets under the slit lamp. Patients may complain of rainbow vision, which primarily occurs due to the large number of small vesicles in the swollen corneal epithelium and the spaces between epithelial cells.