why Childhood Glaucoma is called THE ‘SILENT THIeF OF sight’

Glaucoma is also called the “silent thief of sight” since there are no symptoms, and once vision is lost, it is permanent. It is one of the leading causes of irreversible blindness. Glaucoma is caused when fluid, known as aqueous humor, builds up in the eye, increasing eye pressure (called intraocular pressure, or IOP). High IOP causes damage to the optic nerve, leading to loss of vision. This glaucoma awareness month, let us delve deeper into the causes and prevention of glaucoma and enable healthy eyesight for all. , While more common in adults, glaucoma can also affect infants and children. Congenital glaucoma occurs at birth, while infantile glaucoma occurs in the first three years of life. Children can be affected by another type of glaucoma known as juvenile or venile glaucoma. Infants and children with glaucoma typically have different signs and symptoms than adults. Several cases of pediatric glaucoma have no specific, identifiable cause and are considered primary glaucoma. Inadvertent use of steroidal eye drops for various allergic and gastrointestinal eye diseases is the most common cause of childhood glaucoma. These eye drops can cause blinding glaucoma. Thus, it is vital to consult an eye specialist even for the slightest ailment of the eye, as a child’s eyes are very sensitive. When glaucoma is caused by or associated with a specific condition or disease, it is called secondary glaucoma. Examples of conditions that can be associated with childhood and glaucoma include Axenfeld-Rieger syndrome, aniridia, Sturge-Weber syndrome, neurofibromatosis, chronic steroid use, trauma, or previous eye surgery such as childhood cataract removal. Symptoms, The symptoms of glaucoma depend on the type and stage of the individual’s condition. Glaucoma can affect one eye or both. , , The most common symptoms of congenital or infantile glaucoma are excessive watering of the eyes, light sensitivity, and a large, cloudy cornea, which can cause the iris to appear dull. On the other hand, juvenile glaucoma tends to develop without any obvious symptoms, like adult glaucoma. Patients with juvenile glaucoma often tend to have a family history. On exam, the eye pressure will typically be elevated, and there may be signs of optic nerve cupping. If the eye pressure increases rapidly, there may be pain and discomfort. Some people may have non-specific symptoms like headaches, watering eyes, or seeing a colored halo that resemble other eye problems or medical conditions. Parents and caregivers should look for these symptoms and get an early consultation with an oph-, thalmologist., , Prevention, , There are ways to prevent vision loss and blindness from glaucoma. Here’s how:, Regular comprehensive eye examinations are the best way to protect one’s vision from glaucoma. Many forms of glaucoma have no warning signs. If a child is at risk for glaucoma, it is critical to go for regular eye exams every year that include measuring intraocular pressure. This will help with early detection. It is equally important to take your glaucoma medications as prescribed by your doctor. A healthy diet plays a role in staving off a host of chronic diseases, and glaucoma is no exception. Eye injuries can lead to glaucoma. It is recommended to wear protective eyewear while participating in sports or as and when required. Intense exercise that raises the heart rate can also raise the ocular pressure. But regular walking and exercising at a moderate pace can lower blood pressure and improve overall health. If you have glaucoma or are at high risk for the disease, don’t place your head below your heart for long periods of time. Head-down positions can significantly raise the ocular pressure. It is also important to sleep in the right position. Avoid sleeping with your eye against the pillow or on your arm. Treatment options for glaucoma include medication, surgery, or both. For infants and young children, surgery is often the first treatment to avoid long-term vision impairment. The goal of surgery is to repair the drainage issue so that fluid drains normally from the eye. There are different types of surgical options available. Based on several factors, including the underlying nature of the disease, the ophthalmologist determines the best surgery for the patient. Various surgical operations are available nowadays, including trabeculotomy and goniotomy, with the highest success rates. Other procedures are trabeculectomy, combined trabeculotomy, trabeculectomy, and glaucoma drainage devices, to name a few. The earlier the surgery, the better the outcome. Cyclophotocoagulation is the last resort for a blind, painful eye that is unresponsive to other treatments. This type of surgery is performed in severe cases of childhood glaucoma. , , Specific treatment for glaucoma will be determined by the ophthalmologist based on the child’s age, overall health, medical history, and other factors. Children diagnosed with pediatric glaucoma have a higher risk of developing other eye diseases as they get older. Foremost, early diagnosis and treatment, combined with careful monitoring, are crucial for long-term eye health. Dr. Suneeta Dubey and Dr. Vidya Chelerkar are the heads of glaucoma services at an eye hospital.

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