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Primary Congenital Glaucoma

What Are the Symptoms of Primary Congenital Glaucoma?

There are three main symptoms that a parent is likely to notice:

  • Involuntary protective closing of the eyelids
  • Painful oversensitivity to light
  • Excessive tearing

Depending how far the disease has progressed, other symptoms can include:

  • Cloudiness of the cornea, the normally clear front layer of the eye
  • Enlargement of one or both eyes
  • Red eye

How Is Primary Congenital Glaucoma Diagnosed?

A thorough eye exam is needed to accurately diagnose PCG and determine the proper treatment.

It can be difficult to examine the eyes of a baby or a small child in the same way a doctor examines the eyes of older children or adults. So the exam is almost always done in an operating room under general anesthesia.

During the exam, the doctor will:

  • Measure the pressure inside the eye
  • Thoroughly examine all parts of the eye

A formal diagnosis of primary congenital glaucoma will be made only after ruling out other possible conditions that could be responsible for the glaucoma or that could cause symptoms similar to glaucoma.

How Is Primary Congenital Glaucoma Treated?

The first choice for treating primary congenital glaucoma is almost always surgery. And because of the risk for young children associated with anesthesia, the surgery is often performed at the same time the diagnosis is confirmed. If the primary congenital glaucoma affects both eyes, the doctor will normally operate on both at the same time.

In some cases when surgery can't be performed immediately, the doctor will prescribe eye drops, oral medicine, or a combination of both to help control pressure before surgery.

One common approach is microsurgery. This uses small surgical instruments to create a drainage canal for the excess fluid.

Sometimes the doctor will implant a valve or small tube to allow the fluid to drain from the eye.

If the usual surgery or implanting a tube isn't effective, the doctor may perform laser surgery to destroy the area where the fluid is produced.

In some cases following surgery, the doctor will prescribe medicine to help control pressure in the eye.

What Are the Possible Complications From Surgery?

The most common complication is a reaction to the anesthesia. Other complications can include:

  • Insufficient reduction of eye pressure or excessive lowering of eye pressure
  • Developing a lazy eye, called amblyopia
  • Retinal detachment
  • Astigmatism
  • Dislocation of the eye's lens

Because increased pressure can reoccur at any time, regular eye checkups are needed throughout life.

WebMD Medical Reference

Reviewed by Alan Kozarsky, MD on May 26, 2014
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