Recognizing Pediatric Glaucoma
A grandmother's concern and a physician's expertise help save a baby's visions
When people comented on her baby grandson's big blue eyes, Audrey Smith felt uneasy. From the time Jackson was born, she had worried that the eyes everyone noticed looked different than other children's eyes. In addition to being big, they were cloudy and had a film over them, she says. She finally suggested that her daughter-in-law ask Jackson's doctor about it.
"I kept watching his eyes, because I had never seen anything like that before," she says. "I wanted them to be checked."
Mrs. Smith, who has glaucoma, never dreamed Jackson might have a congenital form of the disease. The child's parents took him to see his pediatrician, who then referred him to the Kellogg Eye Center, where the condition was diagnosed.
In pediatric glaucoma, pressure builds up in the eye and can damage the eye and lead to vision loss. The key symptoms include pain, abnormal sensitivity to light, tearing, enlarged corneas, and redness of the eyes. Jackson's tests revealed high intraocular pressure, corneal swelling, and signs of optic nerve damage, says Maya Eibschitz, M.D., a pediatric glaucoma specialist in Kellogg's Skillman Children's Eye Care Clinic.
Primary congenital glaucoma is relatively rare, appearing in only one in 10,000 births. "But when that one patient walks into your office, prompt diagnosis and treatment are crucial to preserving vision," Dr. Eibschitz says. Jackson had surgery at the age of five months, the day after he was seen in the clinic.
While adults with glaucoma usually try medication to lower intraocular pressure first, the primary course of treatment for infants is typically surgery to improve drainage in the eyes. The success rates for such surgeries in infants are as high as 75 percent to 95 percent. But children have to be followed closely by their physicians after an operation, says Dr. Eibschitz, who is one of just a few dozen pediatric glaucoma specialists in the country.
Jackson was in that successful majority, Dr. Eibschitz reports. "He is doing very well. His vision is normal, his intraocular pressures are normal, his corneal edema has resolved, and his optic nerve cupping has returned to normal."
His parents, Sharen and Almount Smith, are grateful to Dr. Eibschitz and Jackson's grandmother. "We thought his eyes were beautiful," Sharen Smith says. "We just didn't know."
For more information, see the Pediatric Ophthalmology and Adult Strabismus Clinic at the U-M Kellogg Eye Center.
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