Normal-Pressure Congenital Glaucoma: Introducing New Entity
Purpose
To re-evaluate the role intraocular pressure (IOP) measurements play in the diagnosis, choice of management modality, and follow-up in infants with early onset developmental glaucoma (EODG, primary congenital glaucoma).
Methods
A series of 6 EODG suspect infants, who had an IOP of 8-18mmHG associated with one or more of the following: a C/D ratio of 0.2 or more, corneal enlargement and/ or epithelial edema causing photophobia or corneal cloudiness. Cases were operated in one eye by modified trabeculotomy, with close follow up of both eyes.
Results
All cases showed regression of the main presenting symptom/sign as well as other EODG parameters: regression of cupping, resolution of corneal edema/cloudiness/photophobia and further lowering of IOP as compared to preoperative parameters and those in the un-operated eye, which was subsequently operated if needed.
Conclusion
Though playing a role in the pathogenesis and diagnosis of EODG, IOP is not the hallmark for diagnosis, management decision, and follow up of some cases with EODG. EODG cases do exist with no significant IOP rise. We introduce the term: Normal Pressure Congenital Glaucoma.