Glaucoma living in infants

Overview

Glaucoma in infants is a rare eye condition where the pressure inside the eye is too high. This high pressure can damage the optic nerve, which sends images to the brain, and can lead to vision loss. It usually happens because the fluid in the eye does not drain properly. This condition is often present at birth or develops within the first year of life.

No, it is rare. About 1 in 10,000 to 20,000 babies are born with it.

It affects infants, usually diagnosed in the first year of life. It can occur in one or both eyes.

Symptoms

Common symptoms

• Cloudy or whitish cornea (the clear front part of the eye)
• Excessive tearing
• Sensitivity to light (photophobia) – the baby may keep eyes closed or cry in bright light
• Enlarged eye (buphthalmos – meaning 'ox eye')
• Frequent blinking or eye rubbing

Causes

Main causes

• A problem with how the eye's drainage system (trabecular meshwork) develops before birth
• Genetic mutations inherited from parents

Risk factors

• Family history of congenital glaucoma
• Certain genetic syndromes (such as Axenfeld-Rieger syndrome or aniridia)
• Other eye abnormalities present at birth

When to see a doctor

See a doctor urgently if:

• If you notice a cloudy or enlarged eye in your baby
• If your baby seems very sensitive to light and cries or keeps eyes closed

Book a routine appointment if:

• At well-baby checkups, your doctor will examine your baby's eyes
• If you have any concerns about your baby's vision or eye appearance, schedule an appointment

Diagnosis

Your baby will see an eye specialist (ophthalmologist) who will perform a complete eye exam while the baby is asleep (under anesthesia) or very calm. This allows the doctor to measure eye pressure, look at the optic nerve, and check the drainage system.

Tests that may be done

• Tonometry – a test to measure eye pressure
• Ophthalmoscopy – examining the optic nerve at the back of the eye
• Gonioscopy – using a special lens to look at the drainage angle
• Measuring the size of the cornea (the clear front part of the eye)

What to expect at your appointment

The exam is painless because the baby is asleep. The doctor will explain the findings and discuss treatment options. Early diagnosis is key to protecting your baby's vision.

Treatment

The main goal of treatment is to lower eye pressure to prevent damage to the optic nerve. In infants, this is often done with surgery. Sometimes medications are used first or as a complement. Your baby's doctor will create a plan based on the specific situation.

Self-care at home

• Follow all instructions for giving any prescribed eye drops or medications
• Keep all follow-up appointments to monitor eye pressure and vision development
• Protect your baby's eyes from bright light if they are sensitive

Medical treatments

Doctors may prescribe eye drops or oral medicines to help lower eye pressure. These are often used before surgery or if surgery is not possible. The exact type and dose will be chosen by your doctor based on your baby's needs. Never change or stop medication without consulting your doctor.

When is surgery considered?

Surgery is the most common treatment for infant glaucoma. The two main types are goniotomy or trabeculotomy, which open the drainage system to allow fluid to flow out. In some cases, a tiny drainage implant is placed. Surgery is usually successful, and many children have good vision afterward.

Living with this condition

Your baby will need regular checkups with an eye specialist, sometimes every few months. You may need to give eye drops daily. If your baby is sensitive to light, use a brimmed hat or sunglasses when outside. As your child grows, they may need glasses if their eyes have refractive errors.

Lifestyle tips

• Avoid letting your baby rub their eyes
• Encourage normal play and activities
• Use sun protection for the eyes if photophobia (light sensitivity) is present

Diet and exercise

No special diet or exercise is needed. Follow normal infant feeding and activity recommendations. Good overall health supports eye health.

Mental health and emotional wellbeing

A diagnosis of glaucoma in your baby can be very stressful. It's normal to feel worried or overwhelmed. Talk to your healthcare provider about your feelings. Many parents find comfort in connecting with others who have similar experiences.

Prevention

Congenital glaucoma cannot usually be prevented because it is present at birth. However, early diagnosis and treatment can prevent severe vision loss. If there is a family history, you may want to have your baby's eyes checked soon after birth.

Screening programmes

Newborn eye exams are part of routine well-baby care. If you have a family history of infant glaucoma, ask your doctor about an early screening by an eye specialist.

Complications

If left untreated

• Permanent vision loss or blindness
• Amblyopia (lazy eye)
• Optic nerve damage
• Globe enlargement (buphthalmos) that can distort the eye's shape

Long-term outlook

With early diagnosis and proper treatment, the outlook is often good. Many children achieve normal or near-normal vision and can lead active lives. However, lifelong monitoring is needed to maintain eye pressure control and vision health.

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