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The Baby with the Big Eyes

Afreen*, a 5 day old child, was brought to our hospital. Afreen’s mother had noticed that Afreen would not open her eyes in bright light. Her parents also felt that both her eyes were bigger in size and had a whitish opacity in the black of her eye. There seemed to be no redness or excessive watering or discharge.

When the Eye Specialist at Advanced Eye Hospital, Navi Mumbai enquired about Afreen further, it was found that she was the fourth child of a consanguineous marriage. However, no other sibling had a similar complaint. Also Afreen’s birth had been a normal one, being born at term without any significant injury or illness or eye drops being required.

When Afreen was examined, she did not seem to have any other abnormality from her head to toes. When Afreen’s eyes were examined, it was indeed found that she had an enlargement of her eyeballs which was equal. Her cornea seemed enlarged in both vertical and horizontal diameters. She also had increased sensitivity to bright light where she would squeeze her eye lids (Photophobia). Her white of eye or sclera appeared thinned out and blue. Her cornea had a haze because of which the back of her eye (retina) could not be examined.

Because of all these, a provisional diagnosis of congenital glaucoma was made.

A Glaucoma Specialist at Advanced Eye, Sanpada, performed Examination under anaesthesia followed by glaucoma surgery in Afreen’s right eye. This was followed by the same surgery in her left eye one week later.

 

Microscopic picture of right eye and left eye before surgery showing corneal haze, stromal edema..

 

Take Home Message:

Congenital Glaucoma may be present at birth or may not be recognised until infancy. Improper development of the eyes drainage system leads to raise in eye pressures and damage to the eye structures. Since their cornea and sclera are still developing, they stretch in response to the raised eye pressure. Although uncommon, congenital glaucoma can have a severe impact on the child’s visual development. Untreated, it can go on to cause permanent blindness.

*name changed to protect privacy

About Advanced Eye Hospital and Institute:

Advanced Eye Hospital and Institute (AEHI) in Sanpada, Navi Mumbai, conducts detailed eye tests for babies, toddlers as well as children in hygienic atmosphere. Well-trained and gentle staff of AEHI conduct pediatric eye exam. Children’s eye doctors examine children with Congenital Glaucoma and provide them best treatment for glaucoma after detailed eye test.