Secondary Congenital Glaucoma Workup
- Author: Inci Irak Dersu, MD, MPH; Chief Editor: Hampton Roy, Sr, MD more...
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- Aniridia: Chromosome analysis and genetic counseling are important parts of the workup.
- Axenfeld-Rieger syndrome: Patients may need workup for associated systemic abnormalities.
- Many other systemic anomaly – associated glaucoma conditions require appropriate workup including genetic analysis, laboratory studies, and imaging to diagnose and manage the patient's systemic diseases.
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- The most serious complication of neurofibromatosis type 1 (NF-1) is optic nerve and/or chiasm glioma (in 15% of patients).
- An MRI of the orbit and brain is needed to screen for the tumor.
- Sturge-Weber syndrome
- In Sturge-Weber syndrome, calcium deposits located predominantly in the occipital lobe of the brain parenchyma can be detected by a CT scan. These deposits follow the cerebral convolutions and give the appearance of a railroad track.
- Angiomatous malformations, decreased cerebral volume, and increased choroidal plexus volume are the other findings of Sturge-Weber syndrome. An MRI can delineate these findings better than a CT scan.
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- Peters anomaly
- B-scan is needed to evaluate intraocular structures that are obstructed by the corneal opacity.
- Electrophysiologic tests occasionally are needed to evaluate the visual potential of the eye prior to making decision on intervention.
- Nanophthalmos: Pachymetry, A- and B-scan ultrasonography, and ultrasound biomicroscopy (UBM) are useful in helping to establish a diagnosis.
- All glaucoma types
- Pachymetry readings are important in all types of glaucoma, including childhood glaucoma, to adjust for IOP readings.
- In a small study, the mean central corneal thickness of children with different types of childhood glaucoma was measured. According to this study, in 34 children with glaucoma, IOP was overestimated by 3 mm Hg or more in 41.2% of them. In children with Sturge-Weber syndrome, the mean central corneal thickness was 591.9 +/- 23.1 µm, and, in children with aniridia, the mean central corneal thickness was 754.5 +/- 92.6 µm.
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