A rewarding profession, helping kids keep their sight
by Dr. Arbuckle, RE: Pediatric Glaucoma
Glaucoma is a thief of sight. Each day it steals from you precious memories – not of what was, but of what’s to come. ~ Jeremiah Lim, OD, PhD Candidate, University of Melbourne, Australia
My patient first came to Children’s Eye Physicians as a bouncy kindergartner, following a recommendation by her school. Her teachers noticed her holding her papers close to her face and using lots of squinting, trying to see what was on the page.
When working through the steps of a routine eye exam, our skilled Technician noticed tearing, photophobia and cloudy corneas present with this patient. An alarming eye pressure reading was found in both eyes. Intraocular pressure (IOP) was between 53 and 60. Normal IOP is between 12 and 22. This young patient was on the verge of permanently and irreversibly losing her eye sight due to her status of advancing glaucoma disease. At the time, she was the most potentially severe glaucoma patient I had cared for during my career.
Immediate action was required, as surgery was necessary for both eyes. We performed a Trabeculotomy on one of her eyes two days after her first visit. Surgery for her other eye was scheduled two weeks following the first.
A Trabeculectomy is a surgical procedure used in the treatment of congenital glaucoma in children, to relieve intraocular pressure by removing part of the eye’s trabecular meshwork and adjacent structures. It is the most common glaucoma surgery performed and allows drainage of aqueous humor from within the eye to underneath the conjunctiva where it is absorbed.
In a very short period of time with aggressive treatment, the progression of my patient’s glaucoma was stopped in its tracks, and her pressures are normal and stable. She continues to enjoy school, and is quickly becoming a talented musician, studying the violin and playing the piano.
Every day at Children’s Eye Physicians, I am reminded I am part of a unique family, one which impacts others over long periods of time, and in profound ways.
Congenital Glaucoma, Infantile Glaucoma, Juvenile Glaucoma.
Glaucoma is a multi-factorial, complex eye disease with specific characteristics such as optic nerve damage and visual field loss. Increased pressure inside the eye (called intraocular pressure or IOP) is usually present, though patients with normal range IOP can develop glaucoma.
In Pediatric Glaucoma, age of onset will give classification of the disease. Congenital glaucoma is present at birth. Infantile glaucoma develops between ages 1-2 years. Juvenile Glaucoma usually has an onset after 3 years of age. Infants and children with glaucoma have different signs and symptoms than adults.
Symptoms of congenital/infantile glaucoma include excessive tearing, light sensitivity and a large, cloudy cornea, which can cause the iris to appear dull. Symptoms of juvenile glaucoma are similar to adult glaucoma, elevated eye pressure and signs of optic nerve cupping. Patients with juvenile glaucoma often have a family history of the disease.