Amblyopia and irregular astigmatism to be controlled and managed
Childhood glaucoma is a rather complex eye disease to treat and monitor. In fact, even when adequate control of intraocular pressure can be achieved, children with childhood glaucoma may have reduced visual acuity.
A study, carried out at the All India Institute of Medical Sciences in New Delhi (India) and published in the January issue of Ophthalmology, tested the hypothesis that these visual problems are linked to specific corneal changes.
The researchers took children with glaucoma, aged 5 years and older, (a total of 58 diseased eyes) and compared them with healthy children (a total of 28 eyes).
Glaucomatous children, whether treated surgically or managed with medical therapy alone, had greater posterior corneal elevation and a higher incidence of irregular astigmatism, detected by Orbscan topography.
The increase in posterior corneal elevation could be due to the mechanical effect of increased intraocular pressure on the posterior surface of the cornea, which is more flexible in children.
These corneal changes can result in an inability to form a clear image on the retina and can lead to stimulus deprivation amblyopia.
Amblyopia is, in fact, an important cause of visual loss in childhood glaucoma and the irregular anisometropia or astigmatism observed in asymmetric childhood glaucoma may also contribute to the onset of amblyopia. It is difficult, however, to quantify the component of visual loss due to each individual factor.
The authors conclude by recommending for patients with childhood glaucoma, in addition to adequate control of intraocular pressure, appropriate correction of refraction and, in particular, irregular astigmatism, and careful management of amblyopia.
For more details read theJanuary 2015 Ophthalmology article
Dr. Carmelo Chines
Direttore responsabile
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