10.20 - Congenital Glaucoma

Abstract

This chapter discusses the epidemiology, pathophysiology, ocular manifestations, diagnosis, and treatment of glaucoma in infants and young children. Glaucoma in children less than 2 years of age can be subdivided into (1) primary congenital glaucoma (PCG), which is the result of isolated, abnormal development of the anterior chamber angle structures, and (2) secondary congenital glaucomas, either following infantile cataract surgery or those associated with ocular or systemic syndromes. Significant advances include the use of rebound tonometry to reduce the need for frequent exams under general anesthesia to assess intraocular pressure, as well as a growing arsenal of conjunctival-sparing surgical options. Although an earlier onset of glaucoma portends a more difficult clinical course and worse prognosis, early detection and prompt surgical treatment can lead to favorable long-term visual outcomes, particularly in patients with PCG.