Medical therapy of pediatric glaucoma and glaucoma in pregnancy

Although surgery remains the definitive treatment for congenital and other childhood glaucomas, medical therapy can be effective in lowering intraocular pressure as a temporizing measure before surgery or as long-term adjunctive treatment in disease refractory to surgical measures. Carbonic anhydrase inhibitors, beta-blockers, cholinergic drugs, and the prostaglandin-related drugs all play an effective role in pediatric glaucoma management. The usefulness and safety profile of the adrenergic agonists and the osmotic agents are less well established. In medically treating the pediatric patient or the pregnant woman for glaucoma, the clinician must be mindful of the possibility of adverse effects and be prepared to alter or terminate treatment if needed.