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Pediatric Glaucoma Treatment


Pediatric glaucoma is treated by lowering the intraocular pressure (IOP) via medical and/or surgical means. Most cases of primary pediatric glaucoma are treated with surgery. Trabeculotomy and goniotomy, which open the drainage canals, are the most common surgical interventions. Other procedures create a bypass route for the aqueous (fluid made by the eye) to drain out of the eye.
A trabeculectomy creates a guarded opening from the front of the eye to a space underneath the conjunctiva- which is the clear membrane that covers the sclera (the white part of the eye). A tube shunt is a device which is inserted into the front of the eye or into the vitreous cavity (back part of the eye). Fluid from the eye then drains to a reservoir that is located underneath the conjunctiva. Laser procedures can also be beneficial in some cases.
Control of the glaucoma often requires multiple procedures and examinations under anesthesia. Eye drops and oral medications are the primary treatments for secondary and juvenile glaucoma and are often used as adjuvant therapy after surgery in primary pediatric glaucoma. One or more  medications may be necessary to control the intraocular pressure (IOP), even after surgery.
The treatment of pediatric glaucoma is not simply a matter of lowering IOP. Many children with pediatric glaucoma develop myopia (nearsightedness) and require glasses. Also, amblyopia (decreased vision) and strabismus (crossing or wandering eye) occur more frequently and may require treatment with patching or surgery. Despite timely and aggressive treatment, pediatric glaucoma can still cause significant and permanent vision loss. Early diagnosis and treatment aid in a successful outcome.

Authored by Dr.S Tony Fernandez

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