Keypoint:
- 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 neglected, overlooked, or treated late. This is because the child has large pupils or black eyes. Then the general public sees it as a good, cute trait and doesn’t realize that it is a dangerous condition.
- Early detection of glaucoma It is very important and affects the treatment results. If a child is found to have suspicious symptoms Parents or guardians should immediately take them to see an ophthalmologist.
A small child with small, wide eyes is considered cute by many people. But if the child has abnormally excessive tears Or can’t fight the light That’s not cute anymore. Because young children have narrow and large eyes, they may be at risk for glaucoma and cataracts.
Glaucoma in infants and young children It is considered another subgroup of diseases that are special in terms of disease occurrence, disease characteristics, disease progression, and even treatment methods. It may 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 girls, and 75% of cases have it in both eyes.
Most are caused by abnormal development of the drainage system within the eye. Causes high intraocular pressure. Resulting in damage to the optic nerve. and eventually vision loss occurs
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Parents should keep an eye out for symptoms of glaucoma in their children.
Even though this disease still cannot find a way to prevent it. Because sometimes it is not possible to make a diagnosis immediately from birth, so a history examination must be done. and observe abnormal symptoms as well To help plan treatment in a timely manner
This is an abnormal symptom. that parents must keep in mind
- The eyeball is abnormally large.
- There are abnormally many tears, or tears flow all the time when the eyes are exposed to light.
- The lens of the eye is cloudy. When viewed with a flashlight, the pupil appears white.
- Have an allergic reaction to light
- The light reflected from the eyeball is abnormal. You can see that when taking a photo, the reflected light from the flash will make the pupil area appear red. This is called the red reflex.
- have high eye pressure Because the eyes of young children are still very flexible. When eye pressure increases The eyeball will become larger.
All these symptoms They are symptoms that can indicate cataracts. and congenital glaucoma The mother must keep an eye on the symptoms. If your baby has one or two of the symptoms listed above, you should consult an ophthalmologist immediately before causing permanent vision loss to your baby.
In addition to being born from birth Juvenile glaucoma may also occur in children who have been taking steroids for a long time. or in children who have a history of eye injury or have had eye surgery before
If you notice that your child has these abnormal symptoms It is necessary to take the child to see an ophthalmologist. If the doctor suspects that your child may have glaucoma and the child still does not cooperate Anesthesia may be required so the doctor can examine your eyes in detail. This usually takes about 15-20 minutes.
As for 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 required. 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 determined that it refers to people younger than 18 years of age. As for the definition of disease ‘Glaucoma in children’ according to the Childhood Glaucoma Research Network (CGRN) refers to a disease that has at least 2 symptoms from a total of 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 fossa or hole in the middle. There is a groove or notch at the edge of the optic nerve. or the size of the two optic nerve fossa is different by more than 0.2
3. There are changes to the cornea, such as larger diameter. There is a horizontal curved tear in the corneal tissue layer (Haab’s striae). The cornea is swollen.
4.Increasingly nearsighted (progressive myopia)
5. There is an abnormality of the visual field that is compatible with an abnormality of the optic nerve that is characteristic of glaucoma, and no other causes of the visual field abnormality have been found.
Chances of developing glaucoma in children
Glaucoma causes blindness in approximately 5% of the pediatric population. and affects more than 300,000 children worldwide. It is found in children of all races. It is more common in boys than girls, and 70-75% of cases affect both eyes. The incidence of glaucoma varies among newborn populations in each region. According to statistics as follows:
- Western countries find approximately 1:10,000 to 1:20,000.
- Developed countries found approximately 1:17,000 to 1:43,000.
- Middle Eastern countries like Palestine found approximately 1:8,200.
- Saudi Arabia found approximately 1:2,500
- The highest reported prevalence is 1:1,250 among Slovakian 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 (glaucoma suspect)
2.Primary glaucomas: The cause of the disease is unknown. and is not related to other abnormalities of the body Can be divided into 2 subgroups according to the time of birth:
- Congenital glaucoma (primary congenital glaucoma) occurs before the age of 3 years.
- Glaucoma in older children (juvenile open-angle glaucoma) occurs between the ages of 3-35 years or 3-40 years, depending on the definition. It is a less common type than 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’s a swing. Eye pressure ranges widely over the long term. Makes the visual field deteriorate more quickly
3.Secondary glaucomas: The cause of the disease is known. It is the most common type, such as after cataract surgery. Is related to a group of physical or eye diseases There is 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 may be expressed in different ways. Or there may be environmental influences involved.
Marriage within the next of kin is another important factor. and may contribute to disease Using steroids to treat diseases such as allergies without knowing it. or not under medical supervision
However, there are tears without eye discharge, light sensitivity, and eyelid twitching. It may be caused by other diseases such as blocked tear ducts, iritis, and corneal degeneration. Injury during birth Therefore, differential diagnosis is important. Including taking a history of glaucoma in the family. and marriages within relatives as well
What should I do when I suspect I have glaucoma?
Early detection of glaucoma It is very important and affects the treatment results. If a child is found to have suspicious symptoms Parents or guardians should immediately take them to see an ophthalmologist. To receive a correct diagnosis You will be able to begin treatment in a timely manner. This will help reduce the severity of the disease, help delay the disease, and preserve vision for a longer time with continuous treatment. It is recommended that parents and siblings of children with glaucoma also get checked. This is to ensure that there is no hidden glaucoma in anyone else in the family.
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 from higher intraocular pressure. But people generally view children’s having large eyes as a good, cute characteristic and do not 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 water flow out more easily. But because the drug’s effect doesn’t last long. Patients therefore need to strictly take the medication at the recommended time. If you use the medicine irregularly Eye pressure will increase as the medicine wears off. and continues to destroy vision until blindness
In addition, you must go for medical examinations from an ophthalmologist periodically. To see eye pressure and visual field, as well as other examinations This is to ensure that the medicine given is sufficient to control the disease. An ophthalmologist will help tailor treatment methods according to 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 eye pressure enough. or allergic to side effects of medicines Must use laser radiation or surgery. By making a new channel for transferring nourishing water. To make it flow more easily Used in cases where it is found that the optic nerve continues to be damaged. Even though the eye pressure is not very high. or those who cannot use medicine or use it ineffectively and patients living far away cannot come for regular treatment.
However, how to choose treatment? Depends on type Severity and symptoms of the disease and at the discretion of the ophthalmologist
refer: Ratnin Eye Hospital ,Nawawet Hospital , Phyathai Hospital
2024-02-11 08:42:00
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