In the United States, there are approximately 3 million people with glaucoma, and approximately 90 percent of those are over the age of 40, according to recent statistics. Eye health nonprofits, research groups and ophthalmologists promote the importance of increasingly frequent glaucoma testing for people over the age of 40. The month of January is dedicated to raising glaucoma awareness among older individuals.
But glaucoma is not just a disease that strikes people of advanced age. Though far rarer, glaucoma occurs in newborn infants, toddlers and children as well. Parents or caregivers of a child who has recently received a glaucoma diagnosis may be concerned about what the future holds. To help address some concerns, here are three helpful items for the care of children with glaucoma.
1. A glaucoma diagnosis in childhood does not automatically mean a child will live with blindness.
There are two main forms of glaucoma affecting children. The first, primary congenital glaucoma (PCG), presents in an infant at birth and is typically diagnosed between 3-to-6 months, though it can be diagnosed up to 3 years of age. “Primary” denotes the condition is not caused as a side effect of some other condition, while “congenital” means the eyes did not develop in utero as typical. PCG can be hereditary and is responsible for 50-to-70 percent of childhood glaucoma cases.
The other main form of glaucoma affecting children is juvenile-onset open-angle glaucoma (JOAG). It is generally diagnosed in children older than 5 years of age, although people as old as 35 years of age can also be diagnosed with JOAG.
As with cases of glaucoma in people of advanced age, both PCG and JOAG can be treated, preventing a child from experiencing vision loss. Also like glaucoma in older patients, the primary methods of treatment for cases of childhood glaucoma are medications, eye drops, surgery or a combination of these.
The key to maintenance of healthy vision in children with glaucoma depends on two things: 1) how early the condition is diagnosed, and 2) how well parents/caregivers and children work together to develop and adhere to treatment routines. When identified early, and with dedicated treatment, children can generally maintain their eyesight.
2. Involving a child in a consistent treatment regimen can help build good habits and confidence.
A child with glaucoma will likely not recognize the critical importance of maintaining a treatment regimen, including daily eye drops or the routine ingestion of oral medications. Maintenance of the disease will be life-long and it is important to help a child start to learn the importance of treating the disease.
To do this, a helpful guide on childhood glaucoma from the Glaucoma Research Foundation recommends several tips for parents/caregivers when administering daily medication. First, it is helpful to establish a clear, repeatable, daily routine for a child to follow. Oral medications and eye drops should be administered at the same time every day and in the same order, and the child should be involved in the process as much as possible. For example, a young child can help by shaking the bottle of eye drops, holding the cap while the drops are put in and then replacing the cap once the procedure is finished. The more that treatment is seen as a part of the child’s daily routine, the easier it will be to help build healthy habits to last a lifetime.
Another way to help a child with glaucoma develop independence and confidence is to understand what a child is seeing, especially if there has been some vision loss. Making observations about light sensitivity versus dark conditions, responses to different colors and reactions to objects large and small can help give a parent/caregiver an idea of what a child is seeing. This knowledge can be used to help more effectively teach the child standard life skills the same as a child without any vision impairment learns, fostering confidence.
3. Enlist the help of the right pediatric ophthalmologist
Medical doctors of all disciplines who specialize in the care of children bear the extra requirement of having significant reserves of patience, compassion and excellent communication skills. An ophthalmologist is the medical specialist a child with glaucoma will work with for many years, so it’s important to focus on working with a doctor who maintains these qualities. Though doctor’s visits can be overwhelming and even frightening for children in even the best of circumstances, it’s important the child receives care from an experienced professional who has a positive rapport with children.
It is equally important for parents and caregivers to work with a pediatric ophthalmologist who is comfortable answering questions. It is vital to find a doctor who is patient and takes the time to answer any questions about a child’s glaucoma diagnosis.