Bilateral Congenital Glaucoma – A Rare Case Report

Pugazharasan M, Aluru Jayakrishna Reddy, Manikandan R S, Arul M

Careful diagnosis and timely intervention of the paediatric eye leads to the most promising outcome and gives these children a long morbidity-free life.

Abstract

Background: Glaucoma in childhood is a potentially blinding condition, yet, there is a lack of epidemiologic and clinical data regarding this pathology. Unlike glaucoma in adults, which is notoriously difficult to detect since there are no symptoms, glaucoma in children does present with signs and symptoms which can be detected by paediatricians and even parents, who are usually the first contacts of these children. Methodology: A detailed evaluation under general or local anaesthesia is advisable to establish the diagnosis and plan for management. Medical therapy has a limited role and surgery remains the primary therapeutic modality. While goniotomy or trabeculotomy ab externo is valuable in the management of congenital glaucoma, primary combined trabeculotomy–trabeculectomy offers the best hope of success in advanced cases. Result: The childhood glaucoma research network (CGRN) has provided a new classification system of paediatric glaucoma’s. Careful diagnosis and timely intervention leads to the most promising outcome and gives these children a long morbidity free life. Early diagnosis, prompt therapeutic intervention and proper refractive correction are keys to success. Conclusion: Management of residual vision and visual rehabilitation should be an integral part of the management of children with low vision and lifelong follow-up is a must.

Key Words: Congenital glaucoma, trabeculotomy, trabeculectomy and combined trabeculotomy– trabeculectomy

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