Juvenile Glaucoma Clinical Presentation

Updated: Dec 14, 2016
  • Author: Andrew A Dahl, MD, FACS; Chief Editor: Hampton Roy, Sr, MD  more...
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Presentation

History

Because patients with juvenile glaucoma are often asymptomatic, the diagnosis is sometimes made on routine ophthalmological examination when optic nerve abnormalities are noted. Symptoms of visual loss and headache may lead to discovery of the disease.

A family history of glaucoma with occurrence over 2 generations or in a parent and sibling often is responsible for an early diagnosis of juvenile glaucoma. Patients are asymptomatic until glaucoma is advanced. Myopia is present in 50% of persons with juvenile glaucoma.

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Physical

General physical examination findings are normal.

  • Eye examination
    • Elevated eye pressures - Both eyes
    • Myopia
    • Optic disc damage (cupping)
    • Visual field loss
    • Slit lamp examination - Normal
    • Gonioscopy - Normal, open angles, occasionally prominent uveal processes
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Causes

Juvenile glaucoma is caused by a genetically determined defect in the trabecular meshwork with autosomal dominant transmission (see Pathophysiology).

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Physical Examination

Physical examination of the visual system may include elevated intra-ocular pressures, optic nerve atrophy or cupping, asymmetry of the optic nerve heads, and visual field loss. 

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