Neuro-ophthalmic Disease in Pediatric Glaucoma Practice

Area of Science:

• Ophthalmology
• Neurology
• Pediatrics

Background:

• Limited research exists on neuro-ophthalmology referrals in pediatric glaucoma patients.
• Adult studies show utility, but pediatric patterns are unexamined.
• Understanding pediatric referral patterns can optimize care and outcomes.

Purpose of the Study:

• To analyze pediatric glaucoma referral patterns to neuro-ophthalmology.
• To identify clinical characteristics associated with these referrals.
• To guide future referrals and improve patient management.

Main Methods:

• Retrospective review of medical records at Bascom Palmer Eye Institute (2013-2018).
• Included pediatric patients evaluated by both glaucoma and neuro-ophthalmology services.
• Data collected on demographics, clinical findings, imaging, and diagnoses.

Main Results:

• 59 pediatric patients analyzed; 52 referred from glaucoma to neuro-ophthalmology.
• Common referrals: suspected nonglaucomatous optic neuropathy, optic disc swelling, color vision deficiency.
• Neuroimaging performed in 42.3% of referred patients, revealing pathology in 13.7%.
• 73.1% of referrals had diagnoses unrelated to glaucoma.
• Referrals from neuro-ophthalmology to glaucoma found no glaucoma cases.

Conclusions:

• Pediatric glaucoma referrals to neuro-ophthalmology have a high diagnostic yield for neurological disease.
• Neuroimaging is valuable, often uncovering intracranial abnormalities.
• Many pediatric glaucoma patients referred to neuro-ophthalmology have nonglaucomatous conditions requiring subspecialty care.