Pattern of Childhood Glaucoma

Abstract

Glaucoma is one of the important causes of blindness in children all over the world1 .
Childhood glaucoma encompasses a wide variety of conditions ranging from primary
congenital glaucoma to different acquired varieties. They may present with only ocular
involvement or as a part of a syndrome with multiple system involvement. The
visual prognosis of childhood glaucoma depends upon the structural involvement, stage
of presentation, time of intervention and their follow up2. Though all glaucomas are
known to produce blindness, childhood glaucoma unlike the glaucoma in adults have
different disease process which enables the optic nerve fibers to regain their functional
integrity once the IOP is brought down to normal.3 Thus, early diagnosis and
early treatment to achieve normal intraocular pressure can, to some extent, bring
back one’s vision. Childhood glaucoma certainly needs to be addressed with much
more emphasis than that of adult glaucoma, as it may threaten physical as well as
mental growth if not tackled at proper time to retain visual stimuli.
Most of the literatures on childhood glaucoma have emerged from western world 4,5,6.
There has been no literature in this regard from Nepal and profile of childhood glaucoma
is yet to be determined. This was a retrospective study carried out by Glaucoma
Unit B.P. Koirala Lions Center of Ophthalmic Studies with the main intention to see
the profile of glaucoma in Nepalese children.
Out of a total of 475 cases of glaucoma seen in a period of 5 years, 27 (5.68%) were
found to be the cases of congenital glaucomas.
Primary congenital glaucoma (PCG) was most frequently seen among children. Majority
of the cases of PCG presented late, after 3 years of age, with significant amount
of visual loss. Most of them were brought to hospital for the complaint of watering and
enlargement of eyeball.