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Congenital Glaucoma :@0:10
→From birth to three years
→Buphthalmos is seen (Large eyes)
→Barkan’s membrane → blocks aqueous flow→ Thereby ↑IOP
→Congenital anomaly →Autosomal Recessive (AR)→ ↑IOP cause of block in the angle
→Associated with consanguineous marriage (marrying second cousins)
Congenital glaucoma Classic Triad :@1:42
Lacrimation (mother c/o watering eyes)
Blepharospasm (firmly closing of eyelids)
Photophobia(Sensitive to light )
Signs :@2:42
Large eyes (Abnormal finding)
Hazy cornea due to corneal edema
Haab’s striae (Horizontal breaks in the Descemet membrane associated with congenital glaucoma)
Treatment :@4:19
If Cornea is Clear:
Goniotomy: Safer method, but rare in India as:
Gonioscopy should be used to look at the angle
As pt. usually comes to the doctor very late
And the cornea is no more clear and hazy.
In hazy cornea its difficult to perform Goniotomy.
If Cornea is Hazy:
Trabeculotomy
Trabeculotomy + Trabeculotomy(TRAB+TRAB)
Goniotomy:@5:28
Barkan’s membrane is punctured by a needle allowing aqueous outflow through trabecular meshwork & helps in ↓IOP
Trabeculotomy :@6:04
Scleral approach to trabecular meshwork → small hole is made in trabecular meshwork→ Normal aqueous flow → ↓IOP
Trabeculotomy+Trabeculectomy :@6:39
TRAB+TRAB →Along with a small hole, a piece of Trabecular mesh work is removed for the normal aqueous flow - ↓IOP
