Primary Congenital Glaucoma (cont.)
The most favorable outcome is seen in infants who undergo surgery between the second and eighth month of life. As the child gets older, surgery tends to be less effective in preserving vision.
IOP is a significant factor in determining the child’s future vision. However, even when IOP is well controlled, approximately 50% of children do not achieve vision better than 20/50. Reduced vision may result from the following:
- Corneal swelling: The cornea may remain swollen for weeks even after successfully reducing IOP. This swelling can affect vision.
- Nystagmus: The eye repeatedly moves up and down and/or from side to side. This continuous drifting of the eye can cause vision to become unstable or blurry.
- Amblyopia (also known as lazy eye): Vision is impaired and cannot be corrected with glasses.
- Large refractive errors: Vision is impaired but can usually be corrected with glasses. For large refractive errors, a very powerful lens is often needed to improve vision.
The worst prognosis occurs in infants with elevated pressures and cloudy corneas that are present at birth.
Francisco Talavera, PharmD, PhD
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