Glaucoma

Glaucoma is a condition in which the normal fluid pressure inside the eyes slowly rises. This occurs when the fluid inside the eyes does not drain properly. The fluid collects and causes damage to the optic nerve, eventually causing loss of vision. Glaucoma can affect one or both eyes.

Although common in adults, glaucoma is rare in children. More than 60 percent of children with glaucoma are diagnosed before they are 6 months old.

Because glaucoma is rare in children, the symptoms might not be as obvious as those in adults. The most common symptoms of childhood glaucoma are:

• Excessive tearing
• Sensitivity to light
• Closure of one or both eyes in the light
• Cloudy, enlarged cornea
• One eye appearing larger than the other
• Vision loss

Your child may also have pain, seem fussy or have a poor appetite.

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.

To diagnose glaucoma, your child’s doctor will take a complete medical history and perform an eye examination. Specific eye tests 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 test to determine the fluid pressure inside the eye

Because 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.

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.
• Surgery: The purpose of 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 trabeculotomy, iridotomy, and cyclophotocoagulation. These procedures use lasers to either drain the fluid or reduce the production of fluid in the eye.

The Ophthalmology Department at Boston Children’s Hospital offers specialized care for children with glaucoma. Our team of experts, including comprehensive pediatric ophthalmologists and glaucoma specialists, are dedicated to providing the latest testing and treatment options for your child.