Glaucoma can occur in children, although it is rare. Early diagnosis and treatment are essential to prevent permanent vision loss.

Glaucoma is an eye condition that damages the optic nerve. Without treatment, glaucoma can cause vision loss.

Most cases of glaucoma occur in adults, and glaucoma in children is rare. The incidence of childhood glaucoma is roughly 2.29 per 100,000 people under the age of 20 years in the United States.

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Childhood glaucoma is an eye condition that can occur in babies and children. It occurs due to increased eye pressure, which damages the optic nerve.

Aqueous humor is the fluid that nourishes and inflates the eye. Excess aqueous humor increases eye pressure.

Glaucoma can be more severe in children than in adults, and can quickly become aggressive. If amblyopia (“lazy eye”) and cornea scarring occur before glaucoma treatment, a child can experience permanent vision loss.

Early diagnosis and treatment can help prevent vision loss with childhood glaucoma.

In babies, symptoms of glaucoma can include:

  • unusual eye shape or size
  • cloudy or dull appearance of the eye
  • watery eyes or tears that are not due to crying
  • redness in the whites of the eye
  • increased blinking
  • sensitivity to light

In older children or teenagers, symptoms of glaucoma may include:

  • blurry vision
  • difficulty with peripheral vision, which is seeing things off to the side
  • worsening nearsightedness
  • headaches

In some cases, childhood glaucoma may not cause obvious symptoms. This is why regular eye exams throughout childhood are important.

There are two types of glaucoma: primary and secondary.

Primary glaucoma

Primary glaucoma has no known cause and is not due to any other condition. Around 50% to 70% of childhood glaucoma cases are primary glaucoma, occurring in roughly 1 in every 10,000 children.

In around 10% of primary glaucoma cases, people inherit the condition. Certain genetic mutations may cause primary glaucoma.

Read more about congenital glaucoma.

Secondary glaucoma

Secondary glaucoma occurs as a result of other health conditions or injuries affecting the eyes, such as:

  • surgery to remove cataracts present at birth
  • Axenfeld-Reiger syndrome, a rare genetic disorder that can affect the eyes
  • Sturge-Weber syndrome, a rare neurological disorder present at birth
  • aniridia, an eye disorder that causes the iris to be absent at birth
  • neurofibromatosis, a rare genetic disorder that causes benign tumors in the spinal cord, nerves, and brain

People who have one of the above conditions may not develop glaucoma. However, the risk of developing glaucoma is significantly higher compared with people who do not have one of those conditions.

Doctors may refer to someone who has one or more risk factors for developing glaucoma as a “glaucoma suspect.”

Risk factors include having any of the following:

A 2022 study found that the risk of children with one or more risk factors going on to develop glaucoma appears to be low. Factors such as family history of glaucoma were not predictors of a glaucoma diagnosis.

Intraocular pressure of 24 or more and lesions within the eye may link to a higher risk of the condition developing in people doctors consider glaucoma suspects.

To diagnose childhood glaucoma, a doctor will examine the eyes in an office examination. This may include:

  • a visual acuity test, in which a doctor asks a child to read different-sized letters on a wall chart
  • testing how the pupils react to light
  • checking for any atypical eye movements
  • inspecting the front of the eye with a magnifying lens or slit lamp
  • ophthalmoscopy, which is a test to examine the back of the eye
  • tonometry to measure eye pressure
  • ultrasonography, which uses ultrasound technology to create an image of the inner eye
  • gonioscopy, which checks how well the eye drainage system is working

Children younger than 3 years of age may require anesthesia so that a doctor can carry out a full eye examination. Examination under anesthesia can also help confirm findings from an office examination.

Why is early detection important for childhood glaucoma?

Early detection of childhood glaucoma is important to help prevent declining vision or vision loss.

Childhood glaucoma can progress quickly. Early diagnosis and treatment help reduce eye pressure and prevent further damage, which may improve long-term outcomes.

Read about how the eyes work.

Treatment for childhood glaucoma includes medications and surgery. Glaucoma treatments help drain excess fluid out of the eye, reducing eye pressure.

Medications are generally the main treatment in most cases of secondary glaucoma, while primary glaucoma cases may require surgical treatment.

Surgery for childhood glaucoma

There are different types of surgery for controlling eye pressure with childhood glaucoma, including:

  • Trabeculotomy: A trabeculectomy creates an opening in the trabecular meshwork, a tissue within the eye that allows fluid to drain. To access the trabecular meshwork, a surgeon makes an incision in the sclera, the white part of the eye.
  • Goniotomy: Goniotomy is a type of trabeculotomy surgery. A surgeon creates an opening in the cornea to access the trabecular meshwork and makes small incisions for drainage.
  • Trabeculectomy: A surgeon creates a flap and drainage pathway in the sclera, under the top eyelid, to allow fluid to drain from the eye.
  • Iridotomy: A surgeon makes a small drainage incision in the iris, usually with a laser.
  • Glaucoma implant surgery: A surgeon implants a small tube within the eye that drains fluid.
  • Cycloablation: Cycloablation destroys part of the ciliary body, a part of the eye that creates aqueous humor. Surgeons may use cycloablation in severe cases if other surgical procedures have not helped.
  • Enucleation: In rare cases, if an eye becomes blind, it may be painful or disfigured. Enucleation removes the eyeball and replaces it with a prosthetic eye.

Medications to control intraocular pressure

Medications can help lower eye pressure, either by reducing the amount of fluid the eye produces or increasing fluid drainage. This may involve:

  • eyedrops
  • oral medications in pill or liquid form

Regular monitoring and follow-up care

After treatment, a doctor will monitor eye pressure and perform follow-up tests to determine whether treatment is working.

Some children may require repeat glaucoma treatments to keep eye pressure under control.

Learn more about glaucoma treatments.

Many children with glaucoma can live full, healthy lives. While it is not possible to restore any vision a child loses due to glaucoma, treatment can help preserve remaining vision.

Early diagnosis, treatment, and adherence to a treatment plan can help prevent glaucoma progression and permanent vision loss.

Eye health resources

Visit our dedicated hub for more research-backed information and in-depth resources on eye health.

Childhood glaucoma is a rare condition that affects vision. Children may inherit it from a parent or it may occur due to anomalies in eye shape or size or conditions present at birth.

It is not possible to recover vision a child loses due to glaucoma. However, early diagnosis and treatment, such as medication or surgery, can help preserve vision.