title: Update on congenital glaucoma.
abstract: Congenital glaucoma is a global problem and poses a diagnostic and therapeutic challenge to the ophthalmologist. A detailed evaluation under general anesthesia is advisable to establish the diagnosis and plan for management. Medical therapy has a limited role and surgery remains the primary therapeutic modality. While goniotomy or trabeculotomy ab externo is valuable in the management of congenital glaucoma, primary combined trabeculotomy-trabeculectomy offers the best hope of success in advanced cases. Trabeculectomy with antifibrotic agent and glaucoma drainage devices has a role in the management of refractory cases, and cyclodestructive procedures should be reserved for patients where these procedures have failed. Early diagnosis, prompt therapeutic intervention and proper refractive correction are keys to success. Management of residual vision and visual rehabilitation should be an integral part of the management of children with low vision and lifelong follow-up is a must.
authors.affiliation: VST Centre for Glaucoma Care, L V Prasad Eye Institute, L V Prasad Marg, Banjara Hills, Hyderabad 500 034, India. mandal@lvpei.org
authors.forename: Anil K
authors.initials: AK
authors.lastname: Mandal
authors.forename: Debasis
authors.initials: D
authors.lastname: Chakrabarti
mesh_terms: D018663:Adrenergic Agents / Q000627:therapeutic use; D018674:Adrenergic Antagonists / Q000627:therapeutic use; D002257:Carbonic Anhydrase Inhibitors / Q000627:therapeutic use; D017679:Cryotherapy / Q000379:methods; D005901:Glaucoma / Q000151:congenital* / Q000188:drug therapy / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D007231:Infant, Newborn; D008028:Light Coagulation / Q000379:methods; D016685:Mitomycin / Q000627:therapeutic use; D013508:Ophthalmologic Surgical Procedures; D011453:Prostaglandins / Q000627:therapeutic use; D014130:Trabeculectomy
chemical_list: D018663:Adrenergic Agents; D018674:Adrenergic Antagonists; D002257:Carbonic Anhydrase Inhibitors; D011453:Prostaglandins; D016685:Mitomycin