Glaucoma in Children- Congenital Glaucma

Congenital glaucoma and children glaucoma

Glaucoma in children or what we call congenital glaucoma is a rare disease caused by rise of the pressure inside the eye of the infant. The rise of eye pressure in infants/ children causes pressure on the optic nerve head, which is responsible for transmitting the visual implulses seen by the eye to the brain. This can seriosly damage the eyesight in the infant’s eye if left untreated.

treatment of congenital glaucoma children glaucoma at Dr Ahmad Khlalil Eye CLinic in Cairo, Egypt

Glaucoma in children can lead to eye enlargement and cloudiness

In children with congenital glaucoma, the eye yields to pressure rise and swells gradually resulting in larger eyes. This is due to the elastic nature of the eye in the infant. In more advanced cases of congenital glaucoma, fluid is pushed through the cornea (the transparent part infront of the eye). This leads to cloudiness and greyish discoloration. This alos leads the infant to become very intolerant to bright light and his eyes tearing.

What causes children glaucoma (congenital glaucoma)?

The eye is normally filled by a clear fluid which circulates in the eye to get out of the eye through tissues in the angle between the iris (the coloured tissue of the eye) and the cornea (the transparent clear part infront of the eye). If the circulation of this fluid out of the eye is impaired, the pressure inside the eye risees, and can cause damage to the optic nerve (responsible of image transmission to the brain). Glaucoma in children can be caused by heriditary reasons. or some other disorder in the eye.

Glaucoma in children is treated by surgery

Primary glaucoma in children

Congenital Glaucoma (Glaucoma in children) can be 'primary', meaning that it happens with no particular reason. Sometimes, glaucoma in children can be inherited, if both parents carry some particular gene. This can occur if parents are relatives. Glaucoma usually affects both eyes of the baby. Less commonly, the child can have glaucoma in only one eye.

large cloudy eyes of congenital glaucoma

Secondary glaucoma in children

Glaucoma in children can occur as a result of another eye problem. These types of children glaucoma are called 'Secondary Glaucomas'. In infants, glaucoma that can occur after surgery for congenital cataracts. Other entities include Sturge-Weber Syndrome, Uveitis (eye inflammation), aniridia (absence of the iris) and Axenfeld-Rieger syndrome (otherwise known as 'anterior segment dysgenesis').

What are the symptoms of glaucoma in children?

  • persistent tearfulness
  • intolerance to average normal light conditions (photophobia)
  • eye enlargement, which can be inequal in both eyes if the degreee of congenital glaucoma is different in both eyes
  • greyish discoloration

How do we diagnose children glauocma?

Examination of children can be carried out at Dr Khalil office while the baby is awake. This is usually possible in the early weeks of life.  As examination requires the infant to be fully relaxed, it is more often than not carried out under light anesthesia in the operating room.

Among several other tests, Dr Khalil measures the eye pressure, the size of  the eye and sees the back of the eye to assess the condition of the optic nerve and extent of pressure on it.

18 years after having successful child glaucoma surgery at the age of 1 month after birth at the congenital glaucoma clinic of RIO which Dr Khalil founded in 1998

Dr Khalil and congenital glauocma

Dr Khalil has been very actively fighting congenital glaucoma in children for more than 25 years. He has successfully operated on more than 1000 surgeries for children with glaucoma. This is one of the highest figures internationally for this rare disease. This is also due to many referrals from various primary and secondary care doctors and centers.

Are there certain areas in the world where children glaucoma is more prevalent than others?

Congenital glauocma has a high prevalence rate in the Middle East and Indian subcontinent. Genetic and environmental factors might play a role in this preddeliction. That is why some of the best centers in the world for the treatment of congenital glaucoma in children are in Egypt and India.

How glaucoma in children is treated?

Treatment of glaucoma in children is mainly surgical, by special surgeries designed for the eye of the infant. Due to their potential side effects  and weakness in infant eyes, medicines in the form of glaucoma eye drops is used only temporarily till surgery. 

Dr Ahmad Khalil is pioneering a technique of surgery, a modified trabeculotomy, since 1998. He has operated well over thousand eyes with some of the highest success rates in the world. Most of these children keep following up at the clinic. Some of the happiest moments of Dr Khalil are when a 20-years-old who had his congenital glaucoma operations done in infancy by Dr Khalil. Most of these children enjoy a normal eyesight and vision functions.

Thank you for taking care of our child with congenital glaucoma

Messages from the parents of children who had their congenital glaucoma operated by Dr Ahmad Khalil