Early Clues to Long-Term Outcomes in Childhood Glaucoma

A data-based staging system for childhood glaucoma does not currently exist but would obviously be beneficial. Chang and colleagues indicate that early findings can predict long-term visual acuity and IOP (eye pressure control) outcomes in youngsters.

 This study suggests that in children with glaucoma, poor final IOP control was associated with the presence of media opacities and failed angle surgery. Factors associated with poor final visual acuity were anterior segment dysgenesis, nystagmus and failed amblyopia therapy. 

While some of us manage such complex pediatric cases, it is a reminder to us all to remain vigilant regarding disease detection in children. This can be better achieved utilizing the technology at our disposal to screen IOP and carefully evaluate the nerves of younger patients. Existing alternatives to Goldmann tonometry and noncontact tonometry (as well as fundus imaging) should be employed as young as possible. The association of failed vision therapy with poor final visual acuity in young glaucoma patients reaffirms a critical role for optometry in preventing vision loss. It also opens the possibility of a highly specialized optometric practice with both pediatric glaucoma and binocular vision services working in concert.