Dr Honassys Responde #21 – Glaucoma Juvenil


Hello! I´m Honassys Rocha, Clínica do Olho Medical Director, and today I´ll talk about juvenile glaucoma. Raquel Josino asked us through Facebook: – We are Clinica do Olho patients and my son has got juvenile glaucoma suspect. I really would like to see a video about this theme, thank you. Raquel, it´s me who thanks you the opportunity to talk about this theme. These diseases are part of glaucoma spectrum that happens since birth. Most of the cases are determined by genetic load that provokes a bad formation of aqueous humor drain system. Most of these cases are sporadic and frequently happens when there is a consanguinity among parents. They can be cousins, for exemple. Juvenile glaucoma term should be set aside to open angle primary glaucoma cases that happens during adolescence without structurals changes that can be seen by gonioscopy exam. There are many syndromes related to infantile-juvenile glaucoma: for exemple Dawn Syndrome, among other syndromes we can see listed in the following tables. Once diagnosed, it is important to examine this patient siblings, because they can have a less clear expression of this disease. Differently from glaucoma that happens with elderly population, most of juvenile glaucoma patients have some clinical manifestation. The patient can, for exemple, show some cornea turbidity expressed by a white coloration, in the central part of the eye. Besides that, because of the high-level intraocular pressure, many young people presents big eyes accompanied by miopia. That´s why these eyes still present some elasticity so the eye grows more than the same age population average. It is possible to occur nonspecific signs and symptoms like red eyes, lacrimation and light sensitivity. Some times these signs can lead parents to think that it is just a conjunctivitis. The existence of these changes doesn´t suggest, from the beginnig, that the patient has glaucoma, but specifies the need of an ophthalmologist assessment, including intraocular measure, as we know: tonometry, and gonioscopy. The syndomes that can cause juvenile glaucoma, they also cause changes that are visible in gonioscopy. It is treatable through surgery. Medicines are secondary because childreen and teenagers have low answer to this treatment modality, like eyedrops. However, clinical treatment in important until it is possible to treat with surgery. It is good to remember that this observations are for general cases. Most important thing is for you to take your child to an ophthalmologist assessment. Vision is the most important human being sense. Best regards and see you next video.

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