KidsMD Health Topics

Glaucoma

  • Glaucoma is a condition in which the normal fluid pressure inside the eyes slowly rises. This occurs as a result of the fluid aqueous humor — which normally flows in and out of the eye — not being able to drain properly. With glaucoma, the fluid collects and causes pressure damage to the optic nerve (a bundle of more than 1 million nerve fibers that connects the retina with the brain) and, eventually, loss of vision.

    • Although common in adults, glaucoma is rare in children. If your child’s eye pressure increases rapidly, she may have pain and discomfort. You may also notice that your child becomes irritable, fussy and develops a poor appetite.

    • Glaucoma can affect one or both eyes, and more than 60 percent of children with glaucoma are diagnosed before they are 6 months old.

    • Glaucoma can be hereditary or it can be associated with other eye disorders. In approximately one-third of cases, congenital glaucoma is inherited by an autosomal recessive gene, meaning that both males and females are equally affected and that two genes are required to have the condition — one inherited from each parent.

    • Both medications and surgery have been successfully used to treat childhood glaucoma.

    Normal Vision     Glaucoma Vision

     

    Boston Children's Hospital
    300 Longwood Avenue
    Fegan 4
    Boston MA 02115

     

    617-355-6401



  • What is childhood glaucoma?

    Glaucoma is a condition in which the normal fluid pressure inside the eyes (known as intraocular pressure, or IOP) slowly rises. This occurs as a result of the fluid aqueous humor — which normally flows in and out of the eye — not being able to drain properly.

    In cases of glaucoma, the fluid collects and causes pressure damage to the optic nerve (a bundle of more than 1 million nerve fibers that connects the retina with the brain) and, eventually, loss of vision.

    Glaucoma is classified according to the age of onset. If it begins before the child is 3 years old, it is called infantile or congenital (present at birth) glaucoma. If it occurs in a child older than 3 years old, it is called childhood glaucoma.

    What causes childhood glaucoma?

    Glaucoma occurs when the fluid drainage from the eye is blocked by abnormal development or injury to the drainage tissues, thus resulting in an increase in the intraocular pressure, damage to the optic nerve and loss of vision.

    There are many causes of childhood glaucoma. It can be hereditary or it can be associated with other eye disorders. If glaucoma cannot be attributed to any other cause, it’s classified as primary. If glaucoma is a result of another eye disorder, eye injury or other disease, it is classified as secondary.

    In about one-third of cases, congenital glaucoma is inherited by an autosomal recessive gene, meaning that both males and females are equally affected and that two genes are required to have the condition — one inherited from each parent, who act as carriers.

    • Carrier parents have a one in four, or 25 percent, chance with each pregnancy to have a child with congenital glaucoma. The remaining two-thirds of congenital glaucoma cases occur sporadically, or by chance.
  • How is childhood glaucoma diagnosed?

    In addition to a complete medical history and eye examination of your child, diagnostic procedures for childhood glaucoma may include:

    • visual acuity test: a common eye chart test (with letters and images) that measures vision ability at various distances
    • pupil dilation: widening the pupil with eye drops to allow a close-up examination of the eye's retina
    • visual field: a test to measure a child's side (peripheral) vision
    • tonometry: a standard test to determine the fluid pressure inside the eye

    Younger children may be examined with hand-held instruments, while older children can often be examined with standard equipment used for adults. At times, children — particularly young children — may have to be examined under anesthesia to examine the eye and the fluid drainage system, and to determine the appropriate treatment.

    An eye examination can be difficult for a child, so it’s important that parents encourage cooperation.

    What are the symptoms of childhood glaucoma?

    Although common in adults, glaucoma is rare in children — and when it does occur, the symptoms might not be as obvious. Glaucoma can affect one or both eyes, and more than 60 percent of children are diagnosed before they are 6 months old.

    Since symptoms of glaucoma may resemble other eye problems or medical conditions, you should always consult your child's physician for a diagnosis. Early detection and diagnosis are critical in preventing vision loss.

    Although each child may experience symptoms differently, the most common symptoms of childhood glaucoma are:

    • excessive tearing
    • light sensitivity (photophobia)
    • closure of one or both eyes in the light
    • cloudy, enlarged cornea
    • one eye appearing larger than the other
    • vision loss

    If your child’s eye pressure increases rapidly, there may be pain and discomfort. You may also notice that your child becomes irritable, fussy and has a poor appetite.

  • It's important for treatment of childhood glaucoma to start as early as possible. Treatment may include:

    • Medications - Some medications cause the eye to produce less fluid, while others lower pressure by helping fluid drain from the eye.

    • Conventional surgery - The purpose of conventional surgery is to create a new opening for fluid to leave the eye.

    • Laser surgery - There are several types of laser surgery used to treat glaucoma, including the following:

      • Trabeculotomy: During this procedure, the most common type of laser surgery to treat open-angle glaucoma, a laser is used to place “spot welds” in the drainage area of the eye (known as the trabecular meshwork) that allow fluid to drain more freely.

      • Iidotomy: For this procedure, the surgeon uses the laser to make a small hole in the iris (the colored part of the eye) to allow fluid to flow more freely in the eye.

      • Cyclophotocoagulation: This procedure uses a laser beam to freeze selected areas of the ciliary body (the part of the eye that produces aqueous humor) to reduce the production of fluid. This type of surgery may be performed with severe cases of childhood glaucoma.

    Both medications and surgery have been successfully used to treat childhood glaucoma.

Request an Appointment

If this is a medical emergency, please dial 9-1-1. This form should not be used in an emergency.

Patient Information
Date of Birth:
Contact Information
Appointment Details
Send RequestIf you do not see the specialty you are looking for, please call us at: 617-355-6000.International visitors should call International Health Services at +1-617-355-5209.
Please complete all required fields

This department is currently not accepting appointment requests online. Please call us at: 617-355-6000. International +1-617-355-6000.

This department is currently not accepting appointment requests online. Please call us at: 617-355-6000. International +1-617-355-6000.

Thank you.

Your request has been successfully submitted

You will be contacted within 1 business day.

If you have questions or would like more information, please call:

617-355-6000 +1-617-355-6000
close
Find a Doctor
Search by Clinician's Last Name or Specialty:
Select by Location:
Search by First Letter of Clinician's Last Name: *ABCDEFGHIJKLMNOPQRSTUVWXYZ
BrowseSearch
Condition & Treatments
Search for a Condition or Treatment:
Show Items Starting With: *ABCDEFGHIJKLMNOPQRSTUVWXYZ
View allSearch
Locations
The future of pediatrics will be forged by thinking differently, breaking paradigms and joining together in a shared vision of tackling the toughest challenges before us.”
- Sandra L. Fenwick, President and CEO
Close