Glaucoma

Glaucoma

It signifies increased intra-ocular pressure. Glaucoma in children may be primary or secondary.

Primary Glaucoma

Causes

• Malformation of fibres or a persistence of foetal tissu which obstructs the filtration angle.

• Intra-uterine uveitis which has resulted in peripheral anterior synechiae.
• Glaucoma may be associated with conditions such as neurofibromatosis or haemangiomatosis.

Clinical Features

The increased intraocular pressure causes the globe to enlarge. About two thirds of the cases occur in males.

The eye ball appears prominent, with a large and globular cornea.

Diagnostic Evaluation

Examination is done under general anaesthesia. Intraocular pressure is raised. Corneal diameter over 12 mm is pathological. Optic disc shows pathological cupping.

Treatment

Early surgery is essential.

Secondary Glaucoma

It usually develops due to an obstruction of the aqueous outflow channels.

Etiology

Haemorrhage into the eye; anterior synechiae, iritis exudations, lens dislocation, forward encroachment of intra-ocular tumors and metabolic upset following central venous thrombosis.

Treatment

A reduction of aqueous production by acetazolamide (Diamox) is helpful. In cases of uveitis, steroids can be used in full doses to diminish the exudation. If possible underlying cause should be removed.