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[CHILDHOOD GLAUCOMA].

Harefuah 2019 Februrary
INTRODUCTION: "Childhood glaucoma" is a heterogenic group of diseases, characterized by elevated intraocular pressure (IOP) associated with optic-disc damage and other ocular comorbidities. Diagnosis requires two or more of the following: elevated IOP, optic nerve damage, enlarged cornea or Descemet's membrane ruptures, enlarged eye, high myopia and visual field defects. Childhood glaucoma is classified as primary if it occurs as an isolated ocular disease, and secondary, when the disease occurs along with other ocular anomalies or systemic diseases such as Neurofibromatosis and Sturge-Weber, or with acquired conditions such as uveitis complications, ocular trauma, cataract surgery, as well as from systemic and ocular steroid use. The clinical manifestations of childhood glaucoma depend on the age of presentation. In newborns, an enlarged eye with an enlarged cloudy cornea can be found, while infants present with an enlarged eye and signs of tearing, blinking and glare. Older children are usually asymptomatic and the disease is discovered incidentally on eye examination for other ocular problems. Treatment of childhood glaucoma is complicated and demanding. Most types of pediatric glaucoma require surgery in order control IOP, while medical treatment has a supportive role. Different types of glaucoma surgery are indicated for different types of pediatric glaucoma. Regular lifelong monitoring, including IOP control and treatment for the prevention of amblyopia is necessary to obtain and maintain good vision.

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