Congenital Glaucoma (Birth Defect Glaucoma)

Congenital glaucoma refers to glaucoma that is present at birth or appears any time during the first three or four years of life.  It occurs only in about one out of 10,000 infants. Elevated intraocular pressure is caused by an abnormal drainage canal (trabecular meshwork) in the eye. Although congenital glaucoma may be inherited, in most cases it is not. Most babies with congenital glaucoma are born to healthy parents. Although both eyes are most commonly affected, the glaucoma is often more severe in one eye than in the other.

Although it cannot be cured, congentital can usually be controlled. Vision loss may be minimized with early treatment.

The eye receives its nourishment from a clear fluid that circulates inside the eye.

 
Fluid circulating inside eye

This fluid must be constantly returned to the blood stream through the eye's drainage canal, called the trabecular meshwork. In the case of open-angle glaucoma, something has gone wrong with the drainage canal. When the fluid cannot drain fast enough, pressure inside the eye begins to build.

Excess fluid builds pressure

This excess fluid pressure pushes against the delicate optic nerve that connects the eye to the brain. If the pressure remains too high for too long, irreversible vision loss can occur.

Excess fluid pressure pushes
against the optic nerve, damaging it.
(Roll your mouse over the image to change it)

Treatments for congenital glaucoma:

To control glaucoma, your doctor will use one of three basic types of treatment: medicines, laser surgery, or filtration surgery. The goal of treatment is to lower the pressure in the eye.

	Glaucoma medication comes in many forms

Medicines come in pill and eye drop form. They work by either slowing the production of fluid within the eye or by improving the flow through the drainage meshwork. To be effective, most glaucoma medications must be taken between one to four times every day, without fail. Some of these medications have some undesirable side effects, so your doctor will work with you to find a medication that controls your pressure with the least amount of side effects. Medicines should never be stopped without consulting your doctor, and you should notify all of your other doctors about the medications you are taking.

Argon Laser Trabeculoplasty and Selective Laser Trabeculoplasty surgery treat the drainage canal. Requiring only numbing eye drops, the laser beam is applied to the trabecular meshwork resulting in an improved rate of drainage. When laser surgery is successful, it may reduce the need for daily medications.

Laser surgery can reduce
the need for daily medication

Endoscopic CycloPhotocoagulation (ECP) is another type of laser procedure. Instead of treating the drainage canal, it treats the ciliary body. Treating the ciliary body reduces the amount of fluid production thereby reducing the intra ocular pressure. ECP is most often performed along with cataract surgery but can be done as a single procedure when in the best interest of the patient. The majority of patients having ECP reduce or eliminate their need to take glaucoma medications.

Filtration surgery is performed when medicines and/or laser surgery are unsuccessful in controlling eye pressure. During this microscopic procedure, a new drainage channel is created to allow fluid to drain from the eye.

Filtration surgery