Glaucoma is a very serious eye disease caused by increased intraocular pressure, which can lead to detachment of the cornea and retina of the eye, and, as a result, complete or partial blindness. It is expressed in the changed color of the pupil. Because of the greenish tint, the disease is also called "green cataract". Glaucoma can be congenital (intrauterine or hereditary), juvenile (juvenile) and secondary. Diagnosed as hydrophthalmos (dropsy of the eye). The symptoms and causes of glaucoma in children are closely related. The signs of the disease listed below will help parents self-diagnose the disease in their child.
Causes of congenital disease
Congenital glaucoma in children in 80% of cases is caused by a gene mutation, and in 20% by pathology of pregnancy in the first 3 months, mainly:
- STIs (sexually transmitted infections);
- various poisonings, including intestinal ones;
- alcohol abuse, smokingmixtures;
- changed radioactive background in places of residence;
- lack of vitamins, mainly retinol. Possibly due to poor nutrition;
- fetal hypoxia (lack of oxygen).
Causes of acquired disease
Causes of acquired glaucoma in children:
- increased blood pressure and intraocular pressure;
- violation of the function of the main body systems (endocrine, cardiovascular and nervous);
- hereditary eye disease;
- eye injury.
Symptoms
Glaucoma is a progressive eye disease characterized by increased intraocular pressure and reduced visual acuity. In children, this pathology may have a congenital etiology. Also, the disease can occur due to the anatomical features of the structure of the eye. Ophthalmologists distinguish the following symptoms of glaucoma in children:
- Increase in the size of the eyeball.
- The presence of signs of fear of light and brightly lit rooms by the child, tarnishing of the cornea and its swelling.
- This phenomenon is not observed at the initial stages of the development of the disease, however, with the progression of glaucoma, severe destructive changes may appear.
- The manifestation of clinical symptoms and their severity depends on the stage and form of the disease.
The danger of this disease lies in the rapid progression of the manifestations of the disease and the risk of developing blindness in a child. Therefore, parents need to be examined annually by a specialist for treatment andcontrol of the visual functions of the child.
In children, ophthalmologists usually distinguish congenital, secondary infantile and juvenile forms of glaucoma. More details about them will be discussed later.
Congenital glaucoma
The disease is usually detected in newborn babies. According to ophthalmologists, the main cause of this form of glaucoma is precisely hereditary predisposition. But no less important are possible eye injuries during childbirth, as well as intrauterine damage to the embryo.
With congenital glaucoma in children, the photo of which is given in the article, the embryo can be affected as a result of an infectious disease of a pregnant woman, as well as due to the action of trigger factors on it: taking certain dangerous drugs, poisoning, drug addiction, alcohol, smoking, especially at the beginning of pregnancy, when the child's organs of vision are laid.
Secondary glaucoma
The development of this form occurs against the background of an infectious lesion, trauma, eye myopia, as well as pathologies in other organs and systems. The fetus during pregnancy may experience injury or an inflammatory process in the eyes. Damage to the anterior angle of the eye structure during childbirth often causes a decrease in the outflow of fluid, but still it continues to stand out, provoking the appearance of glaucoma.
Inflammatory
Inflammatory glaucoma develops as a result of the presence of inflammation in the choroid of the anterior eye. Adhesions that form between the lens capsule and the back of the shell of the eye can cause a circular infection of the pupil around the edge. This provokes an increase in pressure in the eyes.
Infantile glaucoma
Glaucoma of this type occurs in children from birth to 3 years. The reasons for its appearance do not differ from the factors of the early development of the disease. The symptoms are enlargement of the affected eyes, as the collagen in the cornea and sclera of the eyes can be stretched due to increased pressure in the eyes. The cornea may become cloudy and thin, and the child may experience photophobia and watery eyes.
Juvenile glaucoma
This type of glaucoma usually develops in children older than 3 years. It occurs mainly due to the pathological development of the angle of the cornea and the iris, which can also be due to a hereditary factor. In most cases, such glaucoma occurs without obvious symptoms, so it is detected quite late. If juvenile glaucoma is left untreated, clouding of the cornea will progress over time, the optic nerve will become damaged, it may swell, and even blindness may develop.
Treatment
Children's glaucoma is diagnosed by an ophthalmologist, who prescribes an examination to identify the stage of the disease, as well as the possible cause that provoked its appearance. Also, a specialist may ask for a pregnancy card - this will also help determine the prerequisites for this disease.
It is noteworthy thatsymptoms are often confused with conjunctivitis in a child. It is necessary to check the eye pressure and the size of the cornea. Eye pressure is measured to the child after the introduction of anesthesia to the child. The diameter of the cornea between the limbs is also measured. They conduct an examination of the optic nerve, the integrity of the cornea membrane, its transparency, refraction.
Medicated and conservative therapy
In some forms of this eye disease, conservative treatment of glaucoma in children alone may not be enough. Usually combine the use of "Acetazolamide" intravenously and oral use of drugs. Also, a pediatric ophthalmologist may prescribe Pilocarpine and Betaxolol. The dose of the drug is prescribed taking into account the age and weight of the baby.
Conservative therapy is exclusively an additional concomitant method used to prepare for the operation, as well as some time after it. To normalize disturbed intraocular pressure, Halothane or similar medications are used. However, they are not effective enough to completely eliminate the symptoms of the disease. Therefore, doctors recommend the fastest possible surgical intervention, which has no age-related contraindications.
Miotics are designed to reduce ophthalmotonus, but they practically do not reduce the symptoms of the disease in children. With hydrophthalmos, for at least a slight decrease in ophthalmotonus, the use of 1% is indicated.pilocarpine. Fluid production inside the eye is reduced by "Diakarb", and "Glycerol" is an effective osmotic hypotensive agent.
Surgery
As noted above, the examination of the baby is carried out after the introduction of anesthesia (ketalar or ferrous-halothane). But it is not recommended to use intubation, suxamethonium and ketamine, since these substances can increase the pressure inside the eyes. Children with glaucoma are operated on using high-precision microsurgical instruments and an operating microscope. Basically, a goniotomy is performed if a transparent cornea is noted. But if there is a corneal tear, trabeculotomy is indicated.
- Yttrium-aluminum-garnet goniotomy restores eye pressure longer than surgical goniotomy. But there are other facts that refute this information. Basically, this operation is performed at the initial stage of the disease. In this case, air is used - an air bubble is blown into the eye chamber, which allows you to view the area for surgical intervention. The result of a goniotomy should be the normalization of intraocular development, the suspension of the progression of complications that provoke problems with normal vision.
- Trabeculotomy is performed in the treatment of congenital glaucoma, especially if a normal view of the anterior chamber of the corner of the eyes is not provided.
- Endolaser, cyclocryotherapy and implantation of drains are effective. Basically install tubulardrainage, if surgery did not bring the desired result. Through the use of a drainage system, the ophthalmologist removes formations that prevent the outflow of excess fluid. This technique can cause blood to pool in the eye, sometimes leading to infection and reduced eye pressure. But if the operation is carried out with high quality, the child's complications will disappear rather quickly.
- Sinustrabeculectomy is used in more complex cases of glaucoma, if the goniotomy did not bring a positive result and excessive changes in the camera angle of the eyes.
- Laser cyclophotocoagulation is the treatment of damaged areas of the eye by exposure to high or low temperatures. Bad formations are cauterized for several seconds, and if the growths decrease, the operation can be omitted.
Otherwise, cyclophotocoagulation is repeated after 3 months. The effectiveness of the operation is affected by the timeliness of the parents' visit to the ophthalmologist, the duration of clinical symptoms, the correct choice of treatment methods, the age of the child and the severity of the disease.
After surgery
The duration of rehabilitation after surgery in a child is usually 2-3 weeks. During the restoration of visual functions, the child may experience slight discomfort at the site of the operation, lacrimation and photophobia. After the operation, parents must make sure that the children have clean hands and eyes, if possible, do not visit dusty places with a lot of people, do not allow them to liftheavy things, as well as giving him vitamins and medicines prescribed by his doctor.
Prevention
First of all, for prevention, you need to know why and under what conditions a child can develop glaucoma. If the disease is detected at the initial stage, then the risk of acquiring disability disappears. Therefore, it is recommended to visit an ophthalmologist with your child at least once a year. The undoubted benefit in maintaining eye he alth will bring a balanced diet and maintaining a he althy active lifestyle. In this case, it is necessary to eliminate factors that can negatively affect the disease detected in the child. It will help to improve the state of affairs and the rejection of any bad habits, reducing stressful situations.
The doctor may prescribe eye drops for a child or teenager for preventive purposes. The action of the drops in such cases is aimed at reducing the pressure in the eyes and reducing the volume of fluid produced. Also, many experts strongly recommend 8-hour sleep per day, and it is strictly forbidden to lift any weights in case of problems with the eyes. Work with small details, such as embroidery or plasticine modeling, reading and watching TV should be carried out only with good lighting so that eye strain is minimal.
