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.