Monday, January 16, 2012

Childhood Glaucoma

Glaucoma is the abnormal elevation of eye pressure that results in optic nerve damage that leads to vision loss.  Childhood Glaucoma developes in 1 out of 10,000 children. Glaucoma occurs when the fluid in the eye's drainage is impeded by abnormal development or injury to the porous drainage tissues. Childhood glaucoma may be of primary genetic origin or occur secondary to other pediatric eye diseases. A wide variety of systemic diseases may cause childhood glaucoma and must be considered in children with glaucoma.Childhood glaucoma may be of primary genetic origin or occur secondary to other pediatric eye diseases. A wide variety of systemic diseases may cause childhood glaucoma and must be considered in children with glaucoma.

The significance of signs of elevated eye pressure may not be obvious. Parents should look for these symptoms:

  • Cloudy, enlarged corneas
  • One eye larger than the other
  • Light sensitivity
  • Excessive tearing without discharge

When these warning signs of glaucoma are present, a prompt examination for your child by your pediatrician, family physician or pediatric eye doctor is indicated.

Knowing the warning signs is so important as most pediatricians are not trained to detect this disease in infants and children.   Most young children show symptoms if you know the warning sign to look for.  An eye examination that measures the eye pressure is how the diagnosis is confirmed.  If there is a family history or a systemic disease known to be associated with childhood glaucoma early exams will be very important.

Treatments:  Treatment of the gluacoma is most sucessful with an early diagnosis.  Both surgery and drugs are used in the treatment of Childhood Glaucoma. 

Resources Children's Glaucoma Foundation Glaucoma Foundation

Christopher's Story

Christopher is our littlest miracle who was brought to us on Thanksgiving Day 2001. He was a good baby who hardly ever cried.  But on the morning of April 4th 2002, he was unusually fussy and hardly nursed. We left the house and went to a kick box class where he started screaming. I thought that it was because he was hungry (I later learned it was because of the bright lights in the studio) so I brought him home and tried to nurse him again. While nursing, I noticed that his right eye was cloudy.

I had just been in the pediatrician’s office 3 days prior, so I called the office to inquire as to whether this was of concern. While waiting for them to call me back I went to the computer and did a search on “cloudy eyes”. What I found as a reason for “cloudy eyes” scared me. When the nurse from the office called back I was told that it was probably mucus, that I should “just have him blink his eye”. I am also a mother of now 16 year old premature twins, one of whom has had many other medical problems, so my instincts told me that it wasn’t “just mucus”.

I called the pediatric ophthalmologist in town that cared for my twins when they were born 7 weeks early. The staff brought me into the office that same afternoon. After a few hours and many tests later, my fears were confirmed; my baby was diagnosed with Infantile Glaucoma. He was only 4 months old.

I had never heard of Glaucoma in a baby, only in adults. Our wonderful pediatric ophthalmologist, Dr. Walter
Merriam recommended that we travel to another state to see a world-renowned expert in Infantile Glaucoma. Two days later, Christopher and I were on the road traveling the 6 hours to see Dr. David Walton. Since that day, Christopher and I have made that journey to Boston many times. He has had two goniotomies (surgery) in his right eye and one in his left eye and many eye drops.  He was having his eyes checked an average of about every other week after the surgeries.

We had tried to take him off the eye drops several times but the pressures went back up each time. We have now been off all drops for about 7 years and Christopher has been able to maintain good eye pressures.  For now we keep praying and continued to see Dr. W. Merriam every 6 months to check his pressures. If the pressures go back up he will need to return to the drops and most likely have another surgery. He will only be able to have the same surgery done on the right eye one more time before Dr. Walton will need to try a different type of surgery, one that is has more risks and is not as successful for children Christopher’s age.

Infantile Glaucoma has put our family on a roller coaster journey. I never know when I will have to pack up Christopher and leave my husband and two other children to travel to Boston. This disease requires that families have patience, perseverance and faith. My husband and son’s, Alex and Ryan, have done just that! With the patience and faith of my family and the wonderful care from Dr. David Walton and Dr. Walter Merriam, Christopher still has his eyesight! We are working hard together to keep it this way.

Christopher is now a healthy, happy, very active 10 year old!  He is a great educator about Childhood Glaucoma and a strong advocate for himself when it comes to what he needs.  He has been doing  fundraising, selling childhood glaucoma wrist bands for about a year to raise money to go towards research to help find a cure. I'm so proud of him! 

I feel that this story is so important to share with other parents because it could mean the difference between a child being able to see or not. Glaucoma is a leading cause of childhood blindness that affects 1 in 10,000 children. Most pediatricians are not aware of the signs of childhood glaucoma (extreme fussiness, due to discomfort caused by elevated pressure; very large, prominent eyes; excessive tearing; tilting of the head in bright light; closing of eyes in bright light; cloudy corneas; and one eye larger than the other) and therefore it may be missed. Christopher had several of these early signs, which were discussed with the pediatrician a few days prior to diagnosis. Early detection is the best way to prevent damage to the optic nerve, which is what causes blindness. I truly believe that parents are their child’s best advocates and that if they have the knowledge we may help to save a child’s precious vision.

I am also advocating that newborn vision screening be done for Glaucoma and more pediatricians be educated about Infantile Glaucoma. Please share this information with your pediatrician.  This is vital to preventing vision loss in children. I have spoken to many parents across the states where their children were not diagnosed until much later than Christopher and have many problems due to optic nerve damage. 

January is Glaucoma Awareness Month.  Make this the month that you have your children's eye's checked!

Contributed by MOM Michelle Cuttler

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