Acquired childhood glaucoma more common than congenital types

Childhood glaucoma may most commonly be caused by trauma, surgery or other acquired or secondary cause, according to a report in the April issue of Archives of Ophthalmology. In one Minnesota county, the condition occurred in approximately one per 43,575 residents age 20 and younger.

"Childhood glaucoma is an uncommon pediatric condition often associated with significant visual loss," the authors write as background information in the article. It is categorized into three subtypes: primary glaucoma, including primary congenital glaucoma (present at or soon after birth) and juvenile primary open-angle glaucoma; secondary glaucoma, which includes other syndromes or medical conditions present at birth; and acquired glaucoma, which is the result of other processes not present at birth, including inflammation, drugs, trauma or surgery.

Elisabeth P. Aponte, M.D., and colleagues at Mayo Clinic, Rochester, Minn., reviewed the medical records of all pediatric patients younger than 20 years living in Olmstead County, Minn., who were diagnosed with childhood glaucoma between 1965 and 2004. During this 40-year period, 30 children were diagnosed, for an incidence of 2.29 per 100,000 residents younger than 20 years.

Glaucoma affected both eyes in half of the children, for a total of 45 affected eyes. There were 16 boys and 14 girls, who were diagnosed at an average age of 10.4 years.

Of these cases, 19 (63 percent) were acquired, six (20 percent) were secondary and five (17 percent) were primary. The prevalence of primary congenital glaucoma at birth was 1.46 per 100,000, a rate lower than that reported in the Spanish, British or Australian general population, the authors note. Twenty-four individuals with suspected childhood glaucoma were also identified, for an incidence of 1.9 per 100,000 residents younger than 20.

"This study provides population-based incidence rates for childhood glaucoma diagnosed during a 40-year period," the authors write. "Childhood glaucoma was found in one per 43,575 patients younger than 20 years. The most common type of glaucoma was acquired glaucoma (traumatic, surgical, uveitic or drug-induced), accounting for 63 percent of patients with glaucoma, whereas the secondary and primary forms were less common."