CONGENITAL GLAUCOMA

NEONATAL GLUCOMA: Present before birth

INFANTILE: present upto 3 year

JUVENILE: present between 3 to 16 year

syndromes associated with congenital glaucoma

1. neurofibramatosis

2. sturge weber syndrome

CLINICAL FEATURES: 

1. The patient presents with watery eye. Parent may notice large or opaque cornea

2. The younger patient is examined under anesthesia. Ketamine anesthesia is preferred because it does not lower IOP as in case of halothane. 

3. Assessment of corneal diameter

4. Assessment of optic disc

5. IOP measurement

6. Retinoscopy

7. Anterior segment examination with microscope or hand held slit lamp

8. posterior segment examination with indirect ophthalmoscopy

TREATMENT

Treatment of congenital glaucoma is essentially surgical after medical control of IOP

Goniotomy is done if cornea is clear

method

A specially constructed knife is passed at the limbus.

A Barkan goniotomy knife is swept across the angle of the anterior chamber in the opposite segment under direct  gonioscopic observation.

It opens up the blockage of the corneoiridic angle by the persistent embryonic tissue

In opaque corneas 

trabeculotomy, 

trabeculectomy and 

glaucoma valves are options