The treatment of congenital glaucoma is
C i.e. Trabeculotomy with trabeculectomy - Marked photophobia, blepharospasm, watering with blue and large eye (bupthalmos), hazy frosted glass large cornea with Habb's striaeQ and backward subluxated anteroposteriorly flat lensQ are seen in congenital or infantile glucoma. - Congenital glaucoma is characterized by - Therefore, enlarged eye globe (causing lid lag) with enlarged corneal diameter (>_13 mm) with characteristic double contour round opacities concentric to limbus (i.e. Habb's stria) suggest the diagnosis of congenital glaucoma. - 5 Bs: Boys (more affected), Bilateral, Blepharospasm, Blue, Bull (ox or large) eye. - Photophobia & lacrimationQ - Cornea is large, hazy (frosted glass appearance) with Habb striae (double contoured opacities concentric to limbus) & diminished sensation.Q - Lens is anteroposteriorly flat & backward subluxated Q On the basis of cause Primary congenital glaucoma is due to failure or abnormal development of trabecular meshwork e.g. Presence of cellular Barkan's membrane Abnormal cleavage of anterior chamber Iris may not completely separate from the cornea so that the angle remains closed by persistent embryonic tissue Secondary congenital glaucoma is developmental glaucoma with associated ocular anomalies e.g. - Aniridia (50%), iridocorneal dysgenesis - Ectopia lentis syndrome (eg Marfan/Weil-Marchesani syndrome, homocystinuria) & phakomatosis (Sturge weber/ Von RecklingHusen syndrome) - Neurofibromatosis - Sturge - Weber Syndrome (cavernous haemangiomas of eye & brain and cutaneous angioma of face) - Rubella syndrome, Lowe's syndrome, Congenital Microcornea, naevus of ota. Mesodermal dysgenesis (Rieger's & Peter's anomaly)
Essentially topical medications
Trabeculoplasty
Trabeculotomy with trabeculectomy
Cyclocryotherapy