Key point:
- Glaucoma is a disease that can occur at any age and can be present from birth. It’s not just the elderly.
- Important things that cause glaucoma are often overlooked, overlooked, or treated late. This is because the child has large pupils or black eyes. So the general public sees it as a nice, good trait and doesn’t realize that it’s a dangerous condition.
- Early detection of glaucoma It is very important and influences the results of treatment. If a child is found to have suspicious symptoms Parents or guardians should take them to see an eye doctor immediately.
A small baby with small and large eyes is considered cute by many people. But if the baby has abnormally excessive tears Or you can’t fight the light It’s no longer cute. Because young children have small, large eyes, they may be at risk of developing glaucoma and cataracts.
Glaucoma in infants and young children It is considered another subgroup of peculiar diseases in terms of disease onset, disease characteristics, disease progression and even treatment methods. It can be found at birth or later. The incidence of the disease in newborns has been found to be approximately 1:10,000-1:20,000. It is found in children of all races. It is more common in boys than in girls and in 75% of cases it is present in both eyes.
Most are caused by an abnormal development of the drainage system within the eye. Causes high intraocular pressure. Resulting in damage to the optic nerve. and vision loss eventually occurs
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Parents should keep an eye out for glaucoma symptoms in their children.
Although this disease still can’t find a way to prevent it. Because sometimes it is not possible to make a diagnosis immediately from birth, this is why it is necessary to do an anamnestic examination. and also observe abnormal symptoms To help plan treatment in a timely manner
This is an abnormal symptom. that parents need to keep in mind
- The eyeball is abnormally large.
- There are many tears abnormally, or tears flow continuously when the eyes are exposed to light.
- The lens of the eye is opaque and when viewed with a flashlight the pupil appears white.
- Having an allergic reaction to light
- The light reflected from the eyeball is abnormal. You can see that when taking a photo, the light reflected from the flash will make the pupil area appear red. This is called the red reflex.
- have high eye pressure Because young children’s eyes are still very flexible. When eye pressure increases the eyeball will become larger.
All of these symptoms are symptoms that may indicate cataracts. and congenital glaucoma The mother should keep an eye on the symptoms. If your child exhibits one or two of the symptoms listed above, you should immediately consult an eye doctor before causing permanent vision loss to your child.
In addition to being born from birth Pediatric glaucoma can also occur in children who have been taking steroids for a long time. or in children who have a history of eye injuries or have already had eye surgery
If you notice that your child has these abnormal symptoms You need to take your child to see an eye doctor. If your doctor suspects that your child may have glaucoma and your child continues to be uncooperative, you may need anesthesia so your doctor can examine your eyes in detail. It usually takes about 15-20 minutes.
Regarding the treatment of glaucoma in children In most cases, the doctor will have to perform surgery to open the drainage channel in the eye. In some cases, multiple surgeries may be necessary. Combined with the use of eye drops to reduce intraocular pressure.
Medical diagnostic criteria “Glaucoma in children”
Definition of the word “child” by the National Institutes of Health (NIH), United States. and the United Nations Convention on the Rights of the Child (CRC, UNCRC) has established that it refers to persons under the age of 18. “Glaucoma in children” according to the Childhood Glaucoma Research Network (CGRN) means a disease that has at least 2 of the 5 diagnostic criteria as follows:
1. Eye pressure greater than 21 mmHg.
2. There is an abnormality of the optic nerve caused by glaucoma, such as an enlarged pit or a hole in the middle. There is a groove or notch on the edge of the optic nerve. or the size of the pit of the two optic nerves is different by more than 0.2
3. There are changes in the cornea, such as a larger diameter. There is a horizontal curved tear in the corneal tissue layer (Haab striae), and the cornea is swollen.
4. Increasingly shortsighted (progressive myopia)
5. There is a visual field abnormality consistent with an optic nerve abnormality characteristic of glaucoma, and no other causes of the visual field abnormality have been found.
Possibility of developing glaucoma in children
Glaucoma causes blindness in approximately 5% of the pediatric population. and affects more than 300,000 children worldwide and is found in children of all races. It is more common in boys than in girls and in 70-75% of cases it affects both eyes. The incidence of glaucoma varies among neonatal populations in each region. According to statistics as follows:
- Western countries find approximately 1:10,000 to 1:20,000.
- Developed countries have detected approximately 1:17,000 to 1:43,000.
- Middle Eastern countries like Palestine have found about 1:8,200.
- Saudi Arabia found about 1:2,500
- The highest reported prevalence is 1:1,250 among Slovak gypsies.
Types of Glaucoma in Children You Should Know
Glaucoma in children is divided into 3 types according to the criteria of the Pediatric Glaucoma Research Network:
1. Similar to glaucoma (suspected glaucoma)
2.Primary glaucoma: the cause of the disease is unknown. and is not related to other abnormalities of the body. They can be divided into 2 subgroups based on the time of birth:
- Congenital glaucoma (primary congenital glaucoma) occurs before 3 years of age.
- Glaucoma in older children (juvenile open-angle glaucoma) occurs between the ages of 3 and 35 or between the ages of 3 and 40, depending on the definition. It is a less common type of congenital glaucoma, and unlike glaucoma in adults, glaucoma in older children is related to genetic abnormalities. It started at a young age. very high eye pressure Rarely have symptoms and discovered by accident There is a swing. Eye pressure varies widely over the long term. It causes the visual field to deteriorate more quickly
3. Secondary glaucoma: the cause of the disease is known. It is the most common type, such as after cataract surgery. It is related to a group of physical or ocular diseases. There is a genetic inheritance.
Causes of glaucoma in children
It can occur for many reasons. Studies have shown that 90% of glaucoma patients do not necessarily have a family history of glaucoma. Although it can be inherited genetically, it is found in a small percentage. And genetic characteristics can be expressed in different ways. Or there may be environmental influences involved.
Marriage between close relatives is another important factor. and may contribute to disease Using steroids to treat diseases such as allergies without knowing it. or less under the supervision of a doctor
However, there are tears without eye discharge, sensitivity to light and eyelid twitching. It can be caused by other diseases such as blocked tear ducts, iritis and corneal degeneration. Injuries during childbirth Therefore, differential diagnosis is important. Including family history of glaucoma. and also marriages between relatives
What should I do when I suspect I have glaucoma?
Early detection of glaucoma It is very important and influences the results of treatment. If a child is found to have suspicious symptoms Parents or guardians should take them to see an eye doctor immediately. To receive a correct diagnosis You will be able to start treatment in a timely manner. This will help reduce the severity of the disease, delay the disease and preserve vision for a longer period with continuous treatment. It is recommended that parents and siblings of children with glaucoma are also checked. This is to ensure that there is no hidden glaucoma in any other family member.
The important symptoms that cause glaucoma are often overlooked, overlooked, or treated late. It is when the child has large pupils or black eyes. Because it is enlarged by increased intraocular pressure. But people generally consider children’s big eyes as a good and cute feature and don’t realize that it is a dangerous condition.
Treatment of glaucoma in children
There are several ways to treat glaucoma:
1. Use of medicine
There are eye drops, oral medications, and intravenous medications to reduce the production of lubricant within the eye. Or expand the transfer channel to make the water flow out more easily. But because the effect of the drug does not last long. Therefore patients must take the drug strictly at the recommended time. If you use the medicine irregularly Your eye pressure will increase as the effect of the medicine wears off. and continues to destroy sight to the point of blindness
In addition, it is necessary to periodically undergo medical examinations by an ophthalmologist. To see your eye pressure and visual field, as well as other tests. This is to ensure that the medicine given is sufficient to control the disease. An ophthalmologist will help tailor treatment methods based on the severity of the disease.
2. Use of laser light and surgery
In cases where the medicine cannot be used or is ineffective This may be because the medicine does not lower the pressure in the eye sufficiently. or allergic to side effects of medicines It is necessary to use laser radiation or surgery. Creating a new channel for the transfer of nutrient water. To make it slide more easily Used in cases where it is found that the optic nerve continues to be damaged. Even if the eye pressure is not very high. or those who cannot use the medicine or use it ineffectively, and patients who live far away cannot come for regular treatment.
However, how to choose treatment? It depends on the type Severity and symptoms of the disease and at the discretion of the ophthalmologist
References: Rattanin Eye Hospital, Nawawet Hospital, Phyathai Hospital
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