Further Outpatient Care

The follow-up care of patients with primary congenital glaucoma has several important facets. In the early postoperative period, close observation is required regarding success of the procedure. This may require multiple examinations under anesthesia.

Complications

Serious complications of surgical intervention include hyphema, infection, lens damage, and uveitis.

The most serious complications in children often are caused by general anesthesia. Because of anesthetic risks, bilateral procedures are indicated in some children.

Prognosis

Corneal edema may persist for weeks after successful reduction of the intraocular pressure. Changes in the optic nerve head provide the most important indicator of the course of the disease. Cupping can reverse in successfully treated cases.

The intraocular pressure also is a significant factor in postoperative visual capacity, with substantially better vision among those patients whose pressures remain no higher than 19.

Even when the intraocular pressure is well controlled, approximately 50% of children do not achieve vision better than 20/50.

Reduced visual acuity may result from persistent corneal edema, nystagmus, amblyopia, or large refractive errors.

Patient Education

The patient and family must understand that intraocular pressure elevation can recur at any age in individuals with primary congenital glaucoma, and these patients must receive follow-up care throughout their lives.

For excellent patient education resources, visit eMedicineHealth's Eye and Vision Center. Also, see eMedicineHealth's patient education articles Primary Congenital Glaucoma and Glaucoma Overview.

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Author

Andrew A Dahl, MD, FACS Assistant Professor of Surgery (Ophthalmology), New York College of Medicine (NYCOM); Director of Residency Ophthalmology Training, The Institute for Family Health and Mid-Hudson Family Practice Residency Program; Staff Ophthalmologist, Telluride Medical Center

Andrew A Dahl, MD, FACS is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, American Intraocular Lens Society, American Medical Association, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, Medical Society of the State of New York, New York State Ophthalmological Society, Outpatient Ophthalmic Surgery Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Simon K Law, MD, PharmD Clinical Professor of Health Sciences, Department of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, American Glaucoma Society

Disclosure: Nothing to disclose.

Martin B Wax, MD Professor, Department of Ophthalmology, University of Texas Southwestern Medical School; Vice President, Research and Development, Head, Ophthalmology Discovery Research and Preclinical Sciences, Alcon Laboratories, Inc

Martin B Wax, MD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, Society for Neuroscience

Disclosure: Nothing to disclose.

Chief Editor

Inci Irak Dersu, MD, MPH Clinical Professor of Ophthalmology, State University of New York Downstate College of Medicine; Attending Physician, SUNY Downstate Medical Center, Kings County Hospital, and VA Harbor Health Care System

Inci Irak Dersu, MD, MPH is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society

Disclosure: Nothing to disclose.

Additional Contributors

Gerhard W Cibis, MD † Clinical Professor, Director of Pediatric Ophthalmology Service, Department of Ophthalmology, University of Kansas School of Medicine

Gerhard W Cibis, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, American Ophthalmological Society

Disclosure: Nothing to disclose.

Neil T Choplin, MD Adjunct Clinical Professor, Department of Surgery, Section of Ophthalmology, Uniformed Services University of Health Sciences

Neil T Choplin, MD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, Association for Research in Vision and Ophthalmology, California Association of Ophthalmology, San Diego County Ophthalmological Society, Society of Military Ophthalmologists

Disclosure: Nothing to disclose.

Robert C Urban, Jr, MD Medical Director, Glaucoma Associates, Oaklake Medical Center

Robert C Urban, Jr, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology

Disclosure: Nothing to disclose.