Advanced juvenile open-angle glaucoma in an 8-year-old Haitian girl

Glaucoma can afflict infants and children in several ways. Conditions such as inflammation or trauma can contribute to elevated intraocular pressure in secondary glaucoma, whereas congenital abnormalities of the trabecular meshwork development can result in infantile glaucoma. Lesser known, however, is juvenile open-angle glaucoma, which afflicts children and young adults in a manner similar to primary open-angle glaucoma, with no identifiable trabecular meshwork abnormalities or other secondary causes.

An 8-year-old Haitian girl was referred for suspicion of a left optic neuropathy. Examination found markedly elevated intraocular pressure with open angles and advanced glaucomatous neuropathy in each eye without evidence of signs of infantile or secondary glaucoma. Medical therapy was instituted before surgical consultation. Clinical features of patients with juvenile open-angle glaucoma are presented along with a discussion of genetic expression and management of the condition.

Juvenile open-angle glaucoma, although uncommon, can cause significant visual morbidity in children. In that children represent a unique and atypical glaucoma population with special therapeutic needs, all treatment options must be clearly understood.