Thursday, December 28, 2006

Section 10-D: Importance of team approach in pediatric glaucoma

It takes a whole team of physicians, nurses, and family to provide an optimal treatment for patients with pediatric glaucoma. For example, a glaucoma specialist may provide care for pediatric glaucoma, while a pediatric ophthalmologist may simultaneously treat a “lazy eye” (amblyopia). Lazy eye is a condition in which the visual part of the child’s brain does not develop properly due to abnormalities of the eye (for example, glaucoma) or eye alignment (strabismus). Pediatric glaucoma patients are at a high risk for development of amblyopia, unless they are closely monitored and treated. If amblyopia is detected, he/she needs to be promptly treated because the amblyopia becomes irreversible and not amenable to treatment after the age of approximately 10 years.

It is critical to have a total commitment of the family as well. The family is asked to bring the patient to multiple doctors over many months or years for the treatment of glaucoma. The child may undergo multiple sedations or anesthesia, just to check the intraocular pressure and perform adequate ocular examination. The family is often asked to administer multiple eye drops every day as part of the glaucoma treatment. All of these activities can add a significant amount of stress to the family as well as the patient. On the other hand, when everyone works together to provide an optimal treatment, there is a good chance that the child with glaucoma can grow up with good eyesight.

Section 10-E: References

  1. Allingham RR, Damji K, Freedman S, Moroi S, Shafranov G. Ch 13: Congenital Glaucomas. In: Shield’s Textbook of Glaucoma. 5th Ed. Lippincott Williams and Wilkins, Philadelphia, p235-251, 2005.
  2. Alward, WLM. Ch 9: Glaucomas of Infancy and Childhood. In Glaucoma: The Requisites in Ophthalmology, Mosby, St. Louis, p111-127, 2000.

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