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Diagnosis of congenital glaucoma at the EMC Children's Clinic
Treatment of congenital glaucoma at the EMC Children's Clinic
Congenital glaucoma is based on abnormalities in the development of the eyeball. It creates an obstacle to the outflow of intraocular fluid or its significant obstruction, which increases intraocular pressure. Increased intraocular pressure causes the eyeball to enlarge due to stretching of the cornea and sclera.

Due to eye pain, photophobia, and lacrimation, the child becomes restless, moody, loses his appetite, and sleeps poorly.

Congenital glaucoma can be hereditary or it occurs during intrauterine development. The cause may be various factors: infection of the mother during pregnancy (measles rubella, influenza, mumps, toxoplasmosis, etc.), endocrine disorders, hypo- and vitamin deficiency, various intoxications, hypoxia, etc.

The main symptoms of congenital glaucoma are high intraocular pressure, an increase in the diameter of the cornea and eyeball, clouding of the cornea, deepening of the anterior chamber, dilation of the pupil and slowing reactions to light, decreased visual functions. The presence of certain symptoms and their severity depend on the form and stage of the disease.

symptoms of glaucoma in children

Pediatric congenital glaucoma is accompanied by progressive visual impairment. As the disease progresses, vision decreases significantly, including decreased light perception and blindness in the later stages.

There are three forms of congenital glaucoma. The most common is a simple (classic) one with changes in the angle of the front camera. The second form is congenital glaucoma with anomalies of the anterior segment or the eyeball as a whole (displacement of the lens, absence of the iris, reduction of the eyeball). The third form is congenital glaucoma with phacomatoses (neurofibromatosis, aniomatosis). There may also be forms of the disease with changes in the iris, which are classified as juvenile glaucoma (Frank-Kamenetsky and Rieger syndromes).

Most patients with congenital glaucoma have nearsightedness and myopic astigmatism.

treatment of glaucoma in children

Diagnosis of congenital glaucoma at the EMC Children's Clinic

The diagnosis of congenital glaucoma is established based on the results of an examination, including examination, keratometry, biomicroscopy, gonioscopy, gonioscopy with corneocompression, ophthalmoscopy, tonometry, tonography, and examination of visual functions. Ultrasound biometrics is important as a method of diagnosis and control of treatment effectiveness. Eye examination in children under 3 to 5 years of age is performed under medical sleep.

Early diagnosis is important when an examination is performed in maternity hospitals by an obstetrician and a neonatologist. If glaucoma is suspected, the newborn is referred to an ophthalmologist, and treatment is carried out in a timely manner upon confirmation of the diagnosis.

Treatment of congenital glaucoma at the EMC Children's Clinic

The only possible treatment for congenital glaucoma is surgery. Drug therapy is an adjunct to surgery.

Surgical intervention is performed immediately after diagnosis and preoperative preparation. There are no age-related contraindications to surgery. The earlier the treatment is performed, the better the result.

In cases where ophthalmotonus increases after surgical treatment, repeated surgery is required. Of particular importance is the timely re-operation in young children, in whom the process is progressing rapidly.

The EMC Children's Clinic performs operations for children with congenital glaucoma. Operations are performed using microsurgical instruments and an operating microscope. The success of surgical treatment is largely determined by the correct choice of technique, depending on the stage of the disease and the nature of the pathological changes.

After treatment, the children are monitored at the clinic, undergoing monthly examinations. For children under 3 years of age, as well as for all patients experiencing severe discomfort, the necessary studies are carried out in a hospital setting.

After the operation, medical treatment is performed, correction of refractive error is prescribed, and pleoptic treatment is indicated. An important task of dispensary monitoring is to identify possible pathologies in a timely manner and correct them in a timely manner.

 

The author of the material is Viktor Makarov, Ph.D., ophthalmologist and surgeon at the EMC Children's Clinic

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