Symptoms for developmental (congenital) glaucoma
The outer coat (sclera) of a child’s eye is much softer and more flexible than that of an adult. As a result, if the pressure rises in the eye, the eye expands rather like a balloon being blown up. This enlarged eye size is one of the important indicators of raised eye pressure in a baby or young child. Reducing the pressure does not usually bring the eye back to its normal size but may reduce the size of the eye very slightly. Some parents of children with glaucoma report how people have tended to remark on what lovely large eyes their child has.
Sensitivity to light
Children with raised eye pressure (IOP) often become very sensitive to light. There may be several causes for this. The clear window of the eye (cornea) may be slightly waterlogged and cloudy, which can be uncomfortable. When the cornea is not absolutely clear, light bounces off the cornea irregularly and causes glare. It will not harm the child’s vision in the short term to wear dark glasses, particularly in bright lighting conditions. Even after the pressure is lowered, some degree of sensitivity to light may persist in the long term.
The cornea has a sheet of little cells on the inside which pump the watery fluid (aqueous humour) out of the cornea, keeping it clear. If the pressure rises sufficiently, the fluid is pushed into the cornea, making it waterlogged and cloudy. If the cornea expands, small cracks may occur on the inside of the cornea and this may also cause partial clouding. The clouding clears when the pressure is reduced but this may sometimes take several months.
Watering is a natural response to any form of irritation of the eyes. If the eye pressure is high, and if there is glare from lights and also some swelling of the cornea, then the natural reflex will be watering of the eyes. This should improve when the pressure in the eye is controlled.
Poor vision and jerky eyes (nystagmus)
Occasionally, if raised pressure in the eye has caused clouding of the cornea or pressure on the optic nerve head (the area where all the nerves leave at the back of the eye), vision may be poorer than usual and there may also be movements of the eye. After treatment, most of these symptoms improve.