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Pediatric Glaucoma

The Samuel & Ethel Balkan International Pediatric Glaucoma Center

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Although it most commonly affects the elderly, childhood glaucoma (from birth to 18 years of age) affects 1 in 5,000 children.  In these children, the fluid inside their eyes (which controls the intraocular pressure or IOP) does not drain properly. Normally, fluid flows in and out of the eye. When it builds up to high levels, however, it creates too much pressure inside the eye. This condition damages the optic nerve, the structure that delivers visual information from the eyes to the brain. Left untreated, glaucoma leads to irreversible blindness.

Because pediatric glaucoma is uncommon and harder to detect, it is important to seek specialized care. If you have concerns or questions about your child’s development or eye health, the experts at The Samuel & Ethel Balkan International Pediatric Glaucoma Center at Bascom Palmer Eye Institute, are here to help.

The Samuel and Ethel Balkan International Pediatric Glaucoma Center

The Samuel and Ethel Balkan International Pediatric Glaucoma Center at Bascom Palmer Eye Institute was made possible by a generous contribution by the Balkan/Litowitz family. Under the directorship of Alana L. Grajewski, M.D., this center offers a first of its kind multi-disciplinary approach to diagnosing and treating pediatric glaucoma. 

The different treatment specialties include:

How Do I Know If My Child has Glaucoma?

The signs and symptoms of childhood glaucoma include:

  • Enlarged eyes – one or both (often subtle and mistaken for normal)
  • Excessive tearing
  • Cloudy corneas and a dull iris
  • Sensitivity to light in one or both eyes
  • Myopia (nearsightedness) in one or both eyes

Childhood glaucoma can sometimes be missed – the signs are not always obvious, the disorder mimics other conditions and children cannot always explain their symptoms. For this reason, your pediatrician should examine your baby’s eyes during the first year of life. If vision appears to be developing normally, your child needs a comprehensive eye exam by their fourth birthday, and every two years after that. If you or your pediatrician suspect an eye problem or if your child has signs of childhood glaucoma, schedule an appointment with a Bascom Palmer ophthalmologist right away.

What Causes Glaucoma in Children?

As a parent, you naturally wonder what caused your child’s glaucoma. While some glaucoma can run in families, most primary childhood glaucoma have no identifiable causes. Secondary pediatric glaucoma occurs more often in children who have any of the following conditions:

  • Axenfeld-Rieger Syndrome
  • Aniridia
  • Sturge-Weber Syndrome
  • Neurofibromatosis
  • Chronic steroid use
  • History of retinopathy of prematurity and laser treatment
  • Trauma or previous eye surgery such as childhood cataract removal

Tests

Comprehensive Eye Examinations - Our pediatric ophthalmologists use child-appropriate exam techniques to diagnose childhood glaucoma.

Imaging Tests - Optical coherence tomography (OCT) gives your child’s physician a 3-D view of the retina, optic nerve and other structures inside the eye. Other imaging tests may include photography and ultrasounds.

Treatments

Surgery - Most children, especially babies with primary congenital glaucoma, have better vision results from surgery than medication. Options may include goniotomy, trabeculotomy, or a glaucoma drainage device. Some children need surgery more than once to control the eye pressure. In infants younger than 2 months of age or who were premature, sometimes an overnight stay is required after surgery. Otherwise, most children go home the same day after glaucoma surgery. 

Approximately 80-90% of babies who receive prompt surgical treatment will do well, and may have normal or nearly normal vision for their lifetime. Most babies who have glaucoma and do not obtain appropriate care quickly will lose their vision. Early detection and treatment can mean the difference between sight and blindness.

Eye Drops and Oral Medications - When glaucoma develops during childhood, in addition to surgery, your child’s physician may prescribe eye drops or oral medications to control intraocular pressure (IOP)

Glasses and Patching Therapy - Many children with pediatric glaucoma develop myopia (nearsightedness) and amblyopia (lazy eye), and will need glasses and patching therapy.

Why Choose Bascom Palmer Eye Institute?

Specialized, Child-centered Care. At Bascom Palmer, we believe each child is unique, with vision care needs very different from those of adults. That’s why we created The Samuel & Ethel Balkan International Pediatric Glaucoma Center. The center is the first of its kind offering a multi-disciplinary approach to diagnosing and treating pediatric glaucoma.

University-based Vision Care. Powered by the University of Miami Health System, our physicians have the resources to pioneer promising treatments. Choosing Bascom Palmer for your child’s eye care gives your child access to clinical research trials and innovative technologies. We believe that every child deserves a promising future and that preserving eyesight is the first step toward that future.

Family-friendly Eye Care. It takes a special person to work with infants and children, but the rewards are great. Each member of our pediatric eye care team understands that working with children demands creativity, patience and passion. From child-specific eye exams to specialized pediatric treatment plans to taking the time to comfort a concerned parent, they are here to support you and your child.

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