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Paediatric glaucoma in Hong Kong: a multicentre retrospective analysis of epidemiology, presentation, clinical
N B Baig1,2,3, J J Chan1, J C Ho4
1Hong Kong Eye Hospital, Kowloon Central Cluster, Hospital Authority, Hong Kong.
Insights
This study analyzed paediatric glaucoma in Hong Kong, finding primary congenital glaucoma most common. Early detection of signs like cloudy corneas and high intraocular pressure is crucial for timely intervention.
Area of Science:
- Ophthalmology
- Paediatric Medicine
- Public Health
Background:
- Paediatric glaucoma is a rare but serious condition affecting vision in children.
- Understanding its epidemiology and presentation in specific populations is vital for effective management.
Purpose of the Study:
- To document the epidemiology, clinical presentation, interventions, and outcomes of paediatric glaucoma in Hong Kong.
- To identify key clinical signs and inform referral pathways.
Main Methods:
- A multicentre, territory-wide retrospective study.
- Reviewed charts of 98 patients (150 eyes) with paediatric glaucoma from 2006 to 2015.
- Analyzed types of glaucoma, clinical presentations, treatments, and outcomes.
Main Results:
- Primary congenital glaucoma (23.3%) was most prevalent, followed by juvenile open-angle glaucoma (14.7%) and secondary glaucoma (62.0%).
- Common presentations included parental concerns (cloudy cornea, tearing), poor visual acuity, and high intraocular pressure.
- Surgical treatment was required for a significant proportion of eyes, particularly those with primary glaucoma.
Conclusions:
- Primary congenital glaucoma is the most common type in Hong Kong, necessitating surgical intervention.
- Parental observations and basic clinical assessments are key to early diagnosis.
- Prompt referral for signs like poor visual acuity, high intraocular pressure, and strabismus is essential.
Purpose:
To document the epidemiology, presentation, clinical interventions, and outcomes of paediatric glaucoma in Hong Kong.
Methods:
This multicentre territory-wide retrospective study was performed by reviewing charts of patients with paediatric glaucoma in six clusters of the Hong Kong Hospital Authority and The Chinese University of Hong Kong from 2006 to 2015.
Results:
This study included 150 eyes of 98 patients with paediatric glaucoma (presenting age: 5.2±5.7 years). Of them, 35 eyes (23.3%) had primary congenital glaucoma, 22 eyes (14.7%) had juvenile open-angle glaucoma, and 93 eyes (62.0%) had secondary glaucoma. The most prevalent types of secondary glaucoma were lens-related after cataract extraction (18.0%), Axenfeld-Rieger anomaly (5.3%), uveitis (5.3%), Sturge-Weber syndrome (4.7%), and traumatic (3.3%). The most common clinical presentations were parental concerns (20.7%) including cloudy cornea (12.7%) and tearing/photophobia (8.0%), followed by poor visual acuity (18.0%), high intraocular pressure (13.3%), and strabismus (6.0%). The follow-up duration was 8.46±6.51 years. Furthermore, 63.2% of eyes with primary glaucoma and 45.2% of eyes with secondary glaucoma were treated surgically. The final visual acuity was 0.90±0.98 LogMAR; intraocular pressure was 18.4±6.6 mm Hg; and number of glaucoma medications was 2.22±1.61.
Conclusion:
Primary congenital glaucoma was most prevalent, followed by juvenile open-angle glaucoma and aphakic glaucoma. Most eyes with primary glaucoma required surgical treatment. Parental concerns were important clinical presentations. Basic assessments by healthcare providers to identify glaucoma signs (eg, poor visual acuity, high intraocular pressure, and strabismus) warranted prompt referral to an ophthalmologist.
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