TREATMENTS



Oral medication and eye drops can be administered to help sooth symptoms and combat the worst effects of glaucoma, yet for children born with the condition, or those that develop it early on, surgery is usually the only effective course of action. Surgery (and medication) is designed to alleviate the pressure on the eye and avoid further damage to sight.

Eye drops have two primary functions: to slow down the rate at which the eye produces fluid, or to increase the rate at which fluid is drained from the eye. Which one is used depends upon each particular case. Oral medication and other types of eye drops can also be prescribed to help lower inflammations pre- or post-surgery.

SURGICAL PROCEDURES



There are several types of surgical procedure that can be performed on children with glaucoma, each dependent on the child's particular condition. Procedures include:

• Drainage device: One surgical option is the application of a drainage tube that connects the fluid in the front of the eye to pocket under the conjunctiva that is held open by the tube. These tubes have various names for various purposes, including Ahmed, Molteno and Baerveldt.

• Goniotomy: a small incision made in the drainage channel of the eye to help relieve the blockage. This treatment, while effective at surgery, can cause scarring, which leads to follow-on problems for the patient.

• Laser surgery: Lasers can sometimes be used to treat damaged tissue around the eye, helping to reduce the amount of fluid being produced. A similar procedure is cryotherapy, which uses a freezing probe instead of a laser to repair the damage.

• Trabeculotomy: This treatment requires the insertion of a fine probe passed through the Schlemm canal (drainage system) of the eye, forming a connection between the front of the eye and the drainage system.

• Trabeculectomy: This procedure involves the creation of a bypass drain in the eye to allow fluid to drain from the front of the eye under the conjunctiva. The new pathway forms a pocket in which the fluid is absorbed. To protect against the pocket scar closing, mitomycin (a special medication) is sometimes used to prevent scarring.

SURGICAL RISKS



Most of the surgeries listed above have a high success rate, sometimes in excess of 90%. Doctors will attempt to control the IOP via one or two angle surgeries. If the first angle is unsuccessful, the second angle will be attempted before another strategy is considered.

There are, however, risks inherent with these surgeries. Although some mild discomfort is to be expected after surgery, prolonged pain could be a sign of complications. The most common post-trabeculectomy surgery is scarring of the opening, which can prevent fluid draining normally. Additional complications can include:

• Low pressure in the eye (causing blurred vision and fluid build up)
• High pressure in the eye, causing the anterior chamber to collapse
• Bleeding in the eye
• Severe blurring of vision
• Sudden and permanent loss of central vision
• Infections
• Droopy eyelids
• Cataracts that are worse than before surgery

However, the majority of glaucoma operations are usually successful in reducing the pressure on the eye, although it can often be the case that more than one operation will be required. Some children will continue to have poor vision afterwards, and may require a continuous course of eye drops to aid their comfort and vision.




LINKS



SUNRISE K FOUNDATION 2013

Raising awareness about childhood glaucoma. Sunrise K' Foundation – a non-profit organisation dedicated to raising awareness about childhood glaucoma, one of the leading causes of childhood blindness. Working with Moorfields Eye Charity – the charity that supports London’s acclaimed Moorfields Eye Hospital - and world-renowned glaucoma expert Professor Sir Peng Tee Khaw, the Sunrise K' Foundation's mission is to support research dedicated to finding a cure for this debilitating disease.

COPYRIGHT SUNRISE K FOUNDATION 2013


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