Nip glaucoma in the bud.

NINE-YEAR-OLD Hajra visited the paediatric ophthalmology department at our hospital with complaints of decreased vision. An examination revealed that her visual loss was significant and irreversible in both eyes. All that could be done at this stage was to prevent further loss of vision by surgery.

Hajra is one of the many unfortunate children whose vision has been compromised because of the injudicious use of over-the-counter steroid eye drops. These potent topical anti-inflammatory medicines are frequently prescribed for ocular irritation, including seasonal allergy, owing to their remarkable healing properties. They are prescribed by salesmen at pharmacies, relatives, quacks, sometimes even unwary general practitioners, who are ignorant of these medicines' potential for raising intraocular pressure, leading to glaucoma and irreversible blindness.

At our hospital, we see around five patients every week with vision loss that stems from steroid-induced glaucoma. This response, though also seen in adults, is most commonly seen in the paediatric patient population. Our GPs should always counsel patients to see an ophthalmologist if an eye pathology persists beyond a week. Pharmaceutical companies should also mention the side-effects of these medicines on their packaging.

World Glaucoma Week, held every year in the third week of March, aims to raise awareness about this eye condition. Although various platforms are actively engaged in educating people about adult glaucoma, public knowledge regarding paediatric glaucoma is scarce. A significant proportion of glaucoma patients in Pakistan are children - from every age group.

A significant ratio of glaucoma patients in Pakistan are children.

Glaucoma is also (though rarely) diagnosed in neonates. Congenital glaucoma is a sight-threatening condition which presents with light aversion, watering and an unusually large diameter of the cornea or a bluish/cloudy cornea at birth. It is the outcome of genetic mutation and is sometimes linked with other ocular and systemic conditions. Left untreated, it can cause permanent corneal scarring and irreparable damage to the optic nerve. Examination at birth by an ophthalmologist is recommended for every child to rule out any eye abnormalities. The earlier the condition is diagnosed, the greater the chances of preserving vision.

Ocular trauma is another factor that can raise pressure inside the eye and lead to silent visual loss, sometimes over many years. Eye...