Glaucoma is a very serious eye disease caused by increased intraocular pressure, which can lead to detachment of the cornea and retina, and, as a result, complete or partial blindness. It is expressed in the changed pupil color. Due to the greenish tint, the disease is also called "green cataract." Glaucoma can be congenital (intrauterine or hereditary), juvenile (juvenile) and secondary. Diagnosed as hydrophthalmus (dropsy of the eye). The symptoms and causes of glaucoma in children are closely related. The signs of the disease, which are listed below, will help parents independently diagnose the disease in the child.
Causes of Congenital Disease
Congenital glaucoma in children in 80% of cases is caused by a gene mutation, and in 20% of pregnancy pathology in the first 3 months, this is mainly:
- STIs (sexually transmitted infections);
- various poisonings, including intestinal;
- abuse of alcoholic drinks, smoking mixtures;
- altered radioactive background in places of residence;
- lack of vitamins, mainly retinol. Possibly due to poor nutrition;
- fetal hypoxia (lack of oxygen).
Causes of Acquired Disease
Causes of glaucoma in children of the acquired form:
- increased arterial and intraocular pressure;
- dysfunction of the main systems of the body (endocrine, cardiovascular and nervous);
- hereditary eye disease;
- eye injuries.
Symptoms
Glaucoma is an eye disease that has a progressive pattern of development, characterized by an increase in intraocular pressure and a decrease in visual acuity. In children, this pathology can have a congenital etiology. Also, the ailment can occur due to the anatomical features of the structure of the eye. Ophthalmologists distinguish the following symptoms of glaucoma in children:
- An increase in the size of the eyeball.
- The presence of signs of fear of light and brightly lit rooms by a child, tarnishing of the cornea and its edema.
- At the initial stages of the development of the disease, this phenomenon is not observed, however, with the progression of glaucoma, severe destructive changes can occur.
- The manifestation of clinical symptoms and their severity depends on the stage and form of the disease.
The danger of this disease lies in the rapid progression of the manifestations of the disease and the danger of blindness in the child. Therefore, parents need to be examined annually by a specialist to treat and control the visual functions of the child.
In children, ophthalmologists usually distinguish congenital, secondary infantile and juvenile forms of glaucoma. More details about them will be described later.
Congenital Glaucoma
The disease is usually detected in newborn babies. Ophthalmologists believe that the main cause of this form of glaucoma is a hereditary predisposition. But no less important are possible eye injuries during childbirth, as well as intrauterine damage to the embryo.
With congenital glaucoma in children, the photo of which is given in the article, the embryo can be affected as a result of an infectious disease of a pregnant woman, as well as due to the action of trigger factors on it: taking some dangerous drugs, poisoning, drug addiction, alcohol, smoking, especially at the beginning of pregnancy, when the child's organs of vision are laid.
Secondary glaucoma
The development of this form occurs against the background of infectious damage, trauma, eye myopia, as well as pathologies in other organs and systems. The fetus may have an injury during the gestation or an inflammatory process in the eyes. Damage to the front corner of the eye structure during childbirth often causes a decrease in fluid outflow, but nevertheless it continues to stand out, provoking the appearance of glaucoma.
Inflammatory
Inflammatory glaucoma develops as a result of the presence of inflammation in the choroid of the anterior eye. Adhesions that form between the lens capsule and the back of the lining of the eye can cause pupil circular fusion along the edge. This provokes an increase in pressure in the eyes.
Infantile glaucoma
Glaucoma of this type appears in children from birth to 3 years. The reasons for its appearance do not differ from the factors of the early development of the disease. Symptoms are an increase in the affected eyes, since collagen of the cornea and sclera of the eyes can stretch due to increased pressure in the eyes. The cornea can become cloudy and thinned, the child begins photophobia and lacrimation.
Juvenile glaucoma
This type of glaucoma usually develops in children older than 3 years. It arises mainly due to the pathological development of the angle of the cornea and iris, which can also be due to a hereditary factor. In most cases, such glaucoma occurs without obvious symptoms, so it is detected rather late. If juvenile glaucoma is not treated, corneal opacity will progress over time, the optic nerve is damaged, it can swell, and even blindness develops.
Treatment
The diagnosis of childhood glaucoma is performed by an ophthalmologist, having prescribed an examination to identify the stage of the disease, as well as the possible cause that provoked its appearance. Also, a specialist may ask for a pregnancy card - this will also help determine the prerequisites for this disease.
It is noteworthy that the symptoms are often confused with conjunctivitis in a child. It is imperative to check the eye pressure and size of the cornea. Eye pressure is measured in a child after anesthesia is administered to the child. The diameter of the cornea between the limbs is also measured. An examination of the optic nerve, the integrity of the corneal membrane, its transparency, refraction.
Drug and conservative therapy
In some forms of this eye disease, a single conservative treatment of glaucoma in children may not be enough. Usually, the use of Acetazolamide intravenously and oral use of drugs is combined. Also, a pediatric ophthalmologist may prescribe "Pilocarpine" and "Betaxolol." The dose is prescribed taking into account the age and weight of the baby.
Conservative therapy is an exclusively additional concomitant method used to prepare for the operation, as well as some time after it. To normalize the disturbed intraocular pressure, use "Halotan" or similar medical devices. However, they are not effective enough to completely eliminate the symptoms of the disease. Therefore, doctors recommend the fastest possible surgical intervention, which has no age-related contraindications.
Miotics are designed to reduce ophthalmotonus, but they practically do not reduce the symptoms of the disease in children. With hydrophthalmus, for the at least a slight decrease in ophthalmotonus, the use of 1% pilocarpine is indicated. The production of fluid inside the eye is reduced by Diacarb, and Glycerol is an effective osmotic antihypertensive.
Surgical intervention
As noted above, the examination of the baby is carried out after the introduction of anesthesia (ketalar or nitrous-fluorotane). But it is not recommended to use intubation, suxamethonium and ketamine, since these substances can increase pressure inside the eyes. For children with glaucoma, surgery is performed using high-precision microsurgical instruments and an operating microscope. Basically, goniotomy is performed if a transparent cornea is noted. But if there is a rupture of the cornea, a trabeculotomy is indicated.
- Yttrium-aluminum-garnet goniotomy longer restores ocular pressure when compared with surgical goniotomy. But other facts are known that refute this information. Basically, this operation is carried out at the initial stage of the disease. In this case, air is used - an air bubble is blown into the eye chamber, which allows you to view the area for surgery. The result of goniotomy should be the normalization of intraocular development, the suspension of the progression of complications that provoke problems with normal vision.
- Trabeculotomy is performed in the treatment of congenital glaucoma, especially if a normal view of the anterior chamber of the eye angle is not provided.
- Endolaser, cyclocryotherapy and drainage implantation are effective. Basically, tubular drains are installed if the surgical intervention did not bring the proper result. Through the use of a drainage system, the ophthalmologist removes the formation that prevents the outflow of excess fluid. This technique can cause blood to accumulate in the eye, which sometimes leads to infection and a decrease in eye pressure. But if the operation is carried out qualitatively, the child’s complications will disappear quite quickly.
- Sinustrabekulectomy is used in more complex cases of glaucoma, if goniotomy has not yielded a positive result and excessive changes in the angle of the eye chamber.
- Laser cyclophotocoagulation consists in treating damaged areas of the eye through exposure to high or low temperature. Bad formations are cauterized for several seconds, and if the growths decrease, the operation can be omitted.
Otherwise, cyclophotocoagulation is repeated after 3 months. The effectiveness of the operation is influenced by the timeliness of the parents' visit to the ophthalmologist, the duration of the clinical symptoms, the correctness of the selection of treatment methods, the age of the child and the severity of the disease.
After operation
The duration of rehabilitation after surgery in a child is usually 2-3 weeks. During the restoration of the visual functions, the child may experience slight discomfort at the site of the operation, lacrimation and photophobia. After the operation, parents must make sure that their children have clean hands and eyes, if possible, do not visit dusty places with a large number of people, do not allow lifting heavy things, and also give him vitamins and medicines prescribed by your doctor.
Prevention
First of all, for prevention, you need to know why and under what conditions a child may develop glaucoma. If the disease is detected at the initial stage, then the risk of acquiring disability disappears. Therefore, it is recommended that you visit an ophthalmologist with your child at least once a year. The undoubted benefit in maintaining eye health will bring a balanced diet and maintaining a healthy active lifestyle. In this case, it is necessary to eliminate factors that can adversely affect the disease detected in the child. Helps to improve the state of affairs and the rejection of any bad habits, reducing stressful situations.
A doctor may prescribe eye drops for a child or teenager for preventive purposes. The action of drops in such cases is aimed at reducing pressure in the eyes and reducing the volume of fluid produced. Also, many experts strongly recommend an 8-hour sleep per day, and categorically prohibit any weight problems with eye problems. Work with small details, like embroidery or sculpting from plasticine, reading and watching TV should be done only with good lighting, so that the eye strain is minimal.