bro(ght to a hospital and was diagnosed with hyphema and gla(coma
)e was then lost to *ollow-(p and
was bro(ght to +,) Eye Examination
-is(al .c(ity
,ross Eye E/amination
"0 "S 1+ at $%*t 1+ at $%*t +(pils $mm 234 +(pils $mm 234 5-6 2.+0 Eye Examination
3onometry
E"MS 7 *(ll and e8(al
1(ndoscopy "0 "S 9rm 9rm "0 "S 5:6 2"2, ha!y media 5:6 2"2, ha!y media Assessment
Congenital ,la(coma, "#
Discussion
,la(coma
,ro(p o* disorders that are mainly b(t
not always characteri!ed by an increased intraoc(lar press(re
3hose that occ(r early in li*e are mainly
secondary to abnormalities o* the anterior segment o* the eye and are considered deelopmental or congenital gla(coma Congenital Glaucoma
.;ected in*ants may be born with a high
intraoc(lar press(re or may deelop an increased <"+ within the =9rst wee>s o* li*e?@
Aoth eyes are (s(ally inoled, b(t to arying
seerity
&:&%,%%% births, B5C boys
Most sporadic - &%C a(tosomal recessie
.bsence o* angle recess with iris inserted
directly into trabec(l(m
3he <"+ eleation is ca(sed by the *ail(re
o* the anterior chamber angle and the trabec(lar meshwor> to deelop appropriately d(ring intra(terine deelopment@ Consequences of an Increased IOP during Infancy
0epending on the <"+ leel,
gla(comato(s damage is ineitable a*ter wee>s, months or een years@
occ(rs ia the same mechanisms as
in the ad(lt
<n addition to optic nere damage,
the globe 5eyeball6 enlarges beca(se the sclera is distensible
Enlargement o* the globe 5b(phthalmos6 is a
res(lt o* eleated intraoc(lar press(re@
3he anatomic landmar>s are displaced@
3he anterior chamber is deep
.ll segments o* the o(ter eye, b(t especially the
cornea and sclera, e/pand@
+rincipally at the corneoscleral D(nction
CLINICAL APPEARANCE
)oweer, certain layers o* the cornea are
not ery elastic, and stretching may res(lt in small tears 5)aabs striae6 that ca(se a certain degree o* corneal opaci9cation@ )aabs striae )aabs striae
Corneal epithelial edema ca(sed by
eleated intraoc(lar press(re and *ail(re o* the corneal endothelial p(mp mechanism@
Epiphora, photophobia and
blepharospasm
<* the <"+ is lowered, this
opacity is partially reersible@
.s a res(lt o* the optic nere
damage and/or corneal opacity, children with congenital gla(coma may be permanently is(ally impaired DIAGNOI O! CONGENI"AL GLA#CO$A