Timely care for a rare but sight-threatening condition

Childhood Glaucoma – Signs, Diagnosis and Treatment

Glaucoma is far less common in children than in adults, but because it can threaten sight permanently if missed, it’s important for parents to know what to look for.

What is childhood glaucoma?

Glaucoma occurs when pressure inside the eye rises to a level that damages the optic nerve, which carries visual information to the brain. In children, this is usually due to the eye’s drainage structures not developing normally, so fluid inside the eye can’t drain properly.

Types

• Primary congenital glaucoma — present from birth or infancy, due to abnormal development of the eye’s drainage angle; the most common form in children
• Secondary glaucoma — develops as a result of another condition, such as certain genetic syndromes, previous eye surgery (including after cataract removal), trauma, or inflammatory eye disease
• Juvenile glaucoma — presenting later in childhood or adolescence

Signs to watch for

Because young children can’t describe symptoms, glaucoma often shows itself through physical signs:

• Excessive tearing without an obvious cause
• Light sensitivity — squinting or avoiding bright light, sometimes burying the face
• Eyelid squeezing (blepharospasm)
• Cloudy or hazy-looking cornea (the clear window at the front of the eye)
• Enlarged eyes — in infants, raised pressure can cause the whole eye to stretch and appear larger than normal, sometimes with an enlarged, bulging appearance
• General irritability or discomfort in an infant, particularly if paired with the above

Why prompt diagnosis matters

Unlike in adults, where glaucoma typically develops slowly over years, congenital glaucoma can cause rapid and severe optic nerve damage in infancy if untreated. The good news is that it’s also treatable — but outcomes depend heavily on how early it’s diagnosed and treated.

Diagnosis

Diagnosis involves measuring eye pressure, examining the drainage angle and cornea, assessing the optic nerve, and measuring the size of the eye — often requiring examination under anaesthesia in young children, since accurate assessment needs a still, cooperative eye.

Treatment

Childhood glaucoma is primarily treated surgically, as the underlying drainage abnormality usually needs to be corrected directly rather than managed with drops alone (though eye drops are often used alongside surgery, or while awaiting it). Several surgical techniques are available depending on the type and severity of glaucoma, and children typically need long-term follow-up to monitor eye pressure, optic nerve health and visual development throughout childhood.

The key message

Persistent watering, light sensitivity, or a hazy or enlarged-looking eye in a baby should always be assessed promptly rather than watched and waited on — early treatment gives children the best chance of preserving their vision.

If you notice any of these signs, please contact Bright Sight Eye Specialists for a timely assessment.

Book a paediatric eye consultation

For specialist children’s eye care in Randwick, contact Bright Sight Eye Specialists to arrange an appointment.

This information is general and does not replace an individual medical assessment.