Q. 18-weeks-old baby diagnosed with congenital glaucoma and aniridia. Kindly help.

Answered by
Dr. Rahul Vaswani
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 11, 2018 and last reviewed on: Oct 09, 2018

Hi doctor,

My 18 weeks old second daughter was diagnosed to have congenital glaucoma with aniridia and corneal opacities bilaterally at birth for which she underwent bilateral trabeculectomy within 15 days of birth. She achieved peripheral clearance of cornea in both the eyes within few days of surgery after which there is not much improvement. Her photophobia has reduced now and she is attracted by lights, reflective surfaces, hanging toys in the baby gym, musical toys, etc. Her other milestones are normal except reaching for toys which she does occasionally. Her eye movements seem to be coordinated, at times shake while trying to fix.

At 14 weeks of age, EUA was done after which doctors advised to wait for further corneal clearance as she does not require any surgical intervention for glaucoma right now and procedures like PKP has guarded prognosis till two years of age. Her IOP was variable during EUA but the corneal diameter and axial length of the globe were within normal range. She has a tongue tie, anteriorly placed anus, mild redundant periumbilical skin. Echocardiography and USG abdomen done were normal. We are planning to do a genetic test for her. There is no family history of such illness. We parents are E.N.T specialists practicing in India.I was 37 years old during my delivery and obstetric history was uneventful. Amniocentesis done during pregnancy showed normal FISH report. I would like to know about the prognosis of the disease, availability of advanced treatment options and about any early intervention services required for her. Currently, she is taking Timolol and Dorzolamide eye drops BD, Atropine eye drops and steroid eye drops OD.



Welcome to icliniq.com.

It is a good sign that glaucoma is under control and cornea has started clearing out. But the main problem here is to stop development of amblyopia which is basically a state where due to prolong blurring of vision brain. Basically starts rejecting images after a certain time if the hindrance in vision is not corrected which in this case is corneal opacity. I am of an opinion that if we wait for two years chances of amblyopia are too high. You can consult a specialist for the management. Let me tell you in advance, chances of corneal transplant in infants is low and that too combined with glaucoma makes. Prognosis is poor.

For more information consult an eye care ophthalmologist online --> https://www.icliniq.com/ask-a-doctor-online/eye-care-ophthalmologist

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