Approach Considerations

Treatment of juvenile glaucoma involves lowering of intra-ocular pressure pharmacologically or/and surgically.

Medical Care

Glaucoma medications may temporally control IOP. Often, a rising eye pressure over 1-3 years may become resistant to all medications and dictate a need for eye surgery.

Surgical Care

Operations found useful for adult-onset open-angle glaucoma are useful in juvenile glaucoma. In addition, goniotomy is an effective procedure for this disease in both children and adults.

Consultations

Consultation with an ophthalmologist familiar with this rare type of glaucoma may be helpful.

Activity

No limitations on activity are necessary. When vision remains only in one eye, protection of the remaining seeing eye is mandatory.

Long-Term Monitoring

Repetitive regular eye examinations are indicated indefinitely after the diagnosis of juvenile glaucoma.

Reexamination of the eyes is indicated for those candidate children with a family history of juvenile glaucoma or with myopia and borderline IOPs.

Further Inpatient Care

Careful observation is indicated after glaucoma surgery.

Inpatient and Outpatient Medications

As dictated by IOPs, antiglaucoma medications may be indicated.

Medication

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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

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

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

Hampton Roy, Sr, MD † Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy, Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, Pan-American Association of Ophthalmology

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.

David Sellers Walton, MD Clinical Professor of Ophthalmology, Harvard Medical School; Surgeon in Ophthalmology, Massachusetts Eye and Ear Infirmary; Assistant Pediatrician, Massachusetts General Hospital

David Sellers Walton, MD is a member of the following medical societies: American Academy of Ophthalmology, American Academy of Pediatrics, American Association for Pediatric Ophthalmology and Strabismus, American Ophthalmological Society

Disclosure: Nothing to disclose.