Childhood Glaucoma

Published on 22/03/2015 by admin

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Last modified 22/03/2015

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Chapter 624 Childhood Glaucoma

Scott E. Olitsky, Denise Hug, Laura S. Plummer, Merrill Stass-Isern

Glaucoma is a general term used to indicate damage to the optic nerve with visual field loss that is caused by or related to elevated pressure within the eye. It is classified according to the age of the patient at presentation and the association of other ocular or systemic conditions. Glaucoma that begins within the first 3 yr of life is called infantile (congenital); glaucoma that begins between the ages of 3 and 30 yr is called juvenile.

Primary glaucoma indicates that the cause is an isolated anomaly of the drainage apparatus of the eye (trabecular meshwork). More than 50% of infantile glaucoma is primary. In secondary glaucoma, other ocular or systemic abnormalities are associated, even if a similar developmental defect of the trabecular meshwork is also present. Primary infantile glaucoma occurs with an incidence of 0.03% (see Table 624-1 on the Nelson Textbook of pediatrics website at www.expertconsult.com).

Table 624-1 PRIMARY AND SECONDARY CHILDHOOD GLAUCOMAS

I.PRIMARY GLAUCOMAS

A Congenital open-angle glaucoma

1 Congenital
2 Infantile
3 Late recognized

B Autosomal dominant juvenile glaucoma
C Primary angle-closure glaucoma
D Associated with systemic abnormalities

1 Sturge-Weber syndrome
2 Neurofibromatosis type 1 (NF-1)
3 Stickler syndrome
4 Oculocerebrorenal (Lowe) syndrome
5 Rieger syndrome
6 Hepatocerebrorenal syndrome
7 Marfan syndrome
8 Rubinstein-Taybi syndrome
9 Infantile glaucoma associated with mental retardation and paralysis
10 Oculodentodigital dysplasia
11 Open-angle glaucoma associated with microcornea and absence of frontal sinuses
12 Mucopolysaccharidosis
13 Trisomy 13
14 Cutis marmorata telangiectasia congenita
15 Warburg syndrome
16 Kniest syndrome (skeletal dysplasia)
17 Michel syndrome
18 Nonprogressive hemiatrophy

E Associated with ocular abnormalities

1 Congenital glaucoma with iris and pupillary abnormalities
2 Aniridia

a Congenital glaucoma
b Acquired glaucoma

3 Congenital ocular melanosis
4 Sclerocornea
5 Iridotrabecular dysgenesis
6 Peters syndrome
7 Iridotrabecular dyagenesis and ectropion uveae
8 Posterior polymorphous dystrophy
9 Idiopathic or familial elevated episcleral venous pressure
10 Anterior corneal staphyloma
11 Congenital microcornia with myopia
12 Congenital hereditary endothelial dystrophy
13 Congenital hereditary iris stromal hypoplasia

II.SECONDARY GLAUCOMAS

A Traumatic glaucoma

1 Acute glaucoma

a Angle concussion
b Hyphema
c Ghost cell glaucoma

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