Congenital Glaucoma – Case Reports

Congenital glaucoma is a rare sight threatening disease that is characterized by an autosomal-recessively inheritance. The high intraocular pressure in congenital glaucoma is due to abnormalities in the development of the anterior chamber angle and is not associated with other ocular or systemic anomalies. Typical findings are trabecular dysgenesis and glaucomatous changes of the ocular fundus. The involvement of gene mutations of GLC3A and GLC3B has already been proven to be a part  of the pathogenesis of the disease. Purpose: To present a clinical cases with proven congenital glaucoma and to analyze the outcome of treatment. Material: 7 months old male and 1 year and 5month female, admitted for a subsequent follow up in the Eye Clinic of the University Alexandrovska Hospital – Sofia. Methods: A complete ophthalmologic examination under general anesthesia, tonometry, echobiometry, gonioscopy and refraction. Results: One of the patient had unilateral glaucoma and have been operated twice with following topical therapy. The other child has bilateral disease, single surgery of both eyes and does not require additional topical medication. Both children are at risk of deprivation amblyopia. Conclusion: Congenital glaucoma is a socially significant disease because of the poor vision prognosis. More than one operation is often required, as well as maintenance conservative treatment. A lifelong monitoring of intraocular pressure and retinal nerve fiber layer is required.