Glaucoma Surgery in Children: What Parents Need to Know

Glaucoma, a condition that damages the optic nerve due to high pressure in the eye. Paediatric glaucoma represents one of the subtle diseases with numerous causative factors, from genetic and developmental anomalies to underlying diseases. It may be present at birth, or infantile or juvenile glaucoma occurs during infancy or childhood. While uncommon, it can have severe consequences for vision if left untreated. Early diagnosis and intervention are crucial to protect your child’s sight.

Symptoms of Paediatric Glaucoma

• Enlarged eyes: Often one of the first noticed symptoms, particularly in babies.
• Light sensitivity: Children tend to squint or avoid bright light.
• Intense tearing: Teary eyes are known to be one of the symptoms, or rather be known to manifest.
• Cloudy cornea: The cornea turns cloudy, which is normally clear.
• Bulging eyes: In advanced cases, the eyes may bulge out.

Diagnosis of Paediatric Glaucoma

A paediatric glaucoma diagnosis always requires an exhaustive eye examination by an ophthalmologist specializing in pediatric eye care. The doctor will measure the eye pressure, inspect the optic nerve for any defects, and examine the overall health of the eye. Some supplemental tests, like tonometry, gonioscopy, and visual field testing, may also be applied to validate the diagnosis.

Unlike adults, medications for glaucoma are often less effective and may cause serious side effects in children. Therefore, surgery is often the primary treatment for paediatric glaucoma.

Types of Glaucoma Surgery for Children

Several surgical procedures are available to treat glaucoma in children. The choice of surgery depends on factors such as the child’s age, the type of glaucoma, and the condition of the eye:

• Goniotomy: This procedure involves making a small incision in the eye’s drainage system to improve fluid outflow. Goniotomy is effective for primary congenital glaucoma and requires a clear cornea for visualization. It has a high success rate, particularly for infants between 3 months and 1 year old.
• Trabeculotomy: Similar to goniotomy, trabeculotomy opens the eye’s drainage system. It can be performed even if the cornea is cloudy, making it suitable for cases where goniotomy isn’t possible. Several modifications exist, including 360° trabeculotomy using sutures or a specialized catheter.
• Trabeculectomy: This surgery creates a new drainage pathway for fluid to leave the eye. Trabeculectomy is often used for older children, those with aphakic glaucoma (glaucoma after cataract surgery), or cases where angle surgery has failed.
• Glaucoma Drainage Devices (GDDs): These implants help drain fluid from the eye when other surgeries are unsuccessful. GDDs can be considered for various types of pediatric glaucoma.
• Cyclodestructive Procedures: These procedures reduce fluid production in the eye by treating the ciliary body. While less common, they may be used for refractory glaucoma.

What to Expect After Surgery

Recovery from surgery varies depending on the procedure. Your child will need close monitoring and may require eye drops to control inflammation and pressure. Regular follow-up appointments are essential to ensure the surgery is working effectively and to manage any potential complications.

Important Consideration

• Long-term monitoring is vital, as glaucoma is a progressive condition that may require ongoing management.
• Discuss with your child’s doctor about the benefits and risks of each surgery.
• Adherence to medication regimens and regular follow-up visits are crucial for successful treatment.

Our team of experienced pediatric ophthalmologists & glaucoma surgeons at Madurai Eye Center (MEC) is dedicated to provide the highest quality care for children with glaucoma. We utilize the latest technology and techniques to ensure the best possible outcome for your child. If you have any concerns about your child’s eye health, don’t hesitate to contact us +91 9626613737.

Schedule an appointment at Madurai Eye Center (RS Puram & Kuniyamuthur), or call us at +91 9626613737 to know more