Causes

There are many different types of glaucoma to be found in babies and children:

Primary congenital glaucoma

This is the most common type of glaucoma in babies and children. The normal filter system in the eye does not develop as it should, and as a result the watery fluid (aqueous fluid) does not flow out of the eye properly and the pressure in the eye (intraocular pressure) rises. Many cases of this type of glaucoma may run in families and specific advice on the chance of inheritance should be sought from an expert (genetic counsellor).

Axenfeld’s or Reiger’s Anomaly

These conditions are named after the doctors who first described them. In this type of glaucoma, there is a problem with the filter system and are usually abnormalities in the development of the iris, and sometimes in parts of the cornea. In addition there can be changes in the shape of the teeth, face, ears and other parts of the body, although these changes may not be present. There is a significant chance of developing glaucoma, and patients with Axenfeld’s or Reiger’s Anomalies need to have regular check-ups for life.

Peter’s Anomaly

In this condition there are abnormalities in the lens and cornea of the eye. Sometimes the lens of the eye may be attached to the cornea. Glaucoma may develop and further treatment, such as surgery, may be required.

Other types of glaucoma

Glaucoma often follows cataract surgery in babies and children. If the lens of the eye becomes cloudy, this is called a cataract and may require surgery. This type of glaucoma most often occurs when cataract surgery has taken place very early in life. The reason for the development of glaucoma after cataract surgery is still not entirely clear. Glaucoma can also occur if the eye becomes inflamed for any reason, such as in children who have the childhood form of arthritis, as the filter system may get blocked with inflammatory cells.

Glaucoma can sometimes occur in children with other conditions such as aniridia, in which there is no, or very little, development of the iris. Glaucoma can also occur in Sturge Weber syndrome; these patients also have a blood vessel birth mark on the face, particularly the forehead, known as a port wine stain. Children with these physical signs need to be monitored for the development of glaucoma and treated if necessary.