Sights set on easing congenital glaucoma

Parents of newborns often are told that their baby has big, beautiful eyes.

It’s a common compliment, but it’s one that a Vanderbilt ophthalmologist cautions could be a warning sign for congenital glaucoma.

“When the pressure in the eye is high, the eyes enlarge,” said Karen Joos, M.D., Ph.D., associate professor of Ophthalmology at the Vanderbilt Eye Institute. “A child may also show signs of light sensitivity and a cloudiness of the cornea. Sometimes these are subtle changes that can easily be missed.”

Congenital glaucoma is a rare condition affecting one in 10,000 births. Sullivan Pardee, 8 months, is one of those cases. Thankfully his mother, Tracy, noticed a change in his eyes when he was about 3 months old.

According to Joos, the best prognosis is found in patients whose symptoms develop between the age of 3 and 12 months, while those occurring earlier than 3 months typically experience more severe signs of the disease and a tougher outcome.

Sullivan was quickly scheduled to see Joos, but before making that appointment he was whisked to the emergency room at Monroe Carell Jr. Children’s Hospital at Vanderbilt.

“We woke up the next morning and my husband, Tyson, looked at Sullivan,” said Pardee. “His eye was totally clouded over. It looked like someone had spilled milk in it. The pressure in his eye had built up so high, it burst the membrane that covers and protects the iris.”

Within three days, Sullivan underwent a goniotomy in both eyes to remove the fluid buildup caused by the improper development of the eye’s drainage channels. Because the channels were defective, fluid was continually produced with no way to exit. This caused high pressure inside the eye.

A second surgery was performed a few weeks later because the pressure in Sullivan’s eye did not decrease as much as Joos hoped.

“Sullivan has clear, clear eyes,” said Pardee.

Nearly 75 percent of congenital glaucoma cases occur in both eyes and is most often seen in boys (65 percent). The success rate for congenital glaucoma is about 90 percent for up to five years. VM
-JESSICA PASLEY