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Juvenile glaucoma is an eye disease, the symptoms of which are not characteristic, therefore it is often not diagnosed early enough to be able to start effective treatment. And the number of cases is increasing, which is probably related to the rapid development of myopia, which is a significant risk factor for the development of glaucoma, especially in young people. What are the causes and other risk factors for developing juvenile glaucoma? What are the symptoms and what is the treatment like?

Juvenile glaucomabelongs to the group of primary open-angle glaucoma (POAG). all cases of glaucoma (however, these data seem to be greatly underestimated). According to the classification of the European Glaucoma Society, glaucoma in children up to 3 years of age is congenital glaucoma, between 3 and 10 years of age is childhood glaucoma, and between 10 and 35 years of age - it is juvenile glaucoma. In turn, glaucoma diagnosed after the age of 35 is primary glaucoma.

Juvenile glaucoma - causes and risk factors

The reasons for the development of adolescent glaucoma are unknown. It is only known that in its course there is a reduced outflow of aqueous humor due to anomalies of the anterior segment of the eyeball. This causes an increase in intraocular pressure, resulting in damage and atrophy of the optic nerves, and then blindness.

An important risk factor for the development of juvenile glaucoma is its family history. In about 20 percent. cases of juvenile glaucoma are genetically determined. The gene responsible for this type of glaucoma, GLC1A, is found on chromosome 1 and is inherited in an autosomal dominant fashion. This means that you only need to inherit one copy of the gene that determines the onset of the disease for the symptoms to appear.

In addition, myopia, which is strongly associated with juvenile glaucoma, is an important risk factor. It is worth knowing that the coexisting glaucoma and myopia may aggravate the lesions.

How to recognize glaucoma?

Juvenile glaucoma - symptoms

Juvenile glaucoma is usually asymptomatic. Sometimes only the following appear:

  • lack of appetite
  • changes in behavior
  • headaches and eyeaches

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  • periodic visual disturbances, e.g. fogging
  • chronic, difficult to treat conjunctivitis

The accompanying symptom is often vasospastic syndrome (cold hands and feet) and stress.

Some specialists report a strong relationship between adolescent glaucoma and manic-depressive psychosis.

Therefore, patients are referred for observation to pediatric, neurological or endocrinological departments, but rarely to ophthalmology.

Important

Juvenile glaucoma gives a bad prognosis

The chance that a patient with juvenile glaucoma will maintain good visual acuity for the rest of his life is small. Even 40 percent. people who contracted glaucoma in their youth, may lose their eyesight completely at retirement age.

Juvenile glaucoma - diagnosis

If glaucoma is suspected, the following tests are performed:

  • measurement of intraocular pressure with the use of pneumotonometer and applanation method
  • fundus examination
  • Gonioscopy (examination of the angle of filtration) with the use of a Goldmann triple mirror or AS-OCT laser tomography
  • computer field of view FDT
  • CT scan of the HRT optic nerve
  • GDx nerve fiber layer polarimetry
  • GCL / GCC layer tomography
  • optical tomography of the optic nerve OCT
  • corneal thickness measurement (pachymetry)

Additionally, in juvenile glaucoma, the eyeball when palpated (touched with the fingers) may be hard.

Unfortunately, non-specific symptoms or their absence mean that the disease is sometimes diagnosed accidentally during ophthalmological examinations performed for other reasons.

Juvenile glaucoma - treatment

The first step in treating glaucoma is usually medication. The patient drops eye drops to lower the intraocular pressure and improve the blood supply to the optic nerve. Unfortunately, juvenile glaucoma is often not amenable to drip treatment. Therefore, surgical treatment is recommended in order to unblock the fluid outflow path from the eye.

According to the guidelines of the Polish Ophthalmology Society of 2014 on the treatment of primary open-angle glaucoma, laser trabeculoplasty is not recommended in patients with juvenile glaucoma.

Juvenile glaucoma

Juvenile glaucoma is very difficult to diagnose, it affects even 10-year-olds. Juvenile glaucoma occurs in 7 out of 1000 patients. The reasons are not fully known, but 20 percent. caseshas a genetic basis. See an excerpt from the series "Operating Room", in which Sylwia, suffering from adolescent glaucoma, talks about her illness. Source: FOKUS TV

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Eye diseases and vision disorders