Mum & Child

Glaucoma: Why your baby’s eyeballs’ shape, size matter

Babies are cute with their small bodies and big eyes. A baby’s eyes are about two-thirds smaller than in adulthood. Their big eyes make them irresistible so we fall in love with them and protect them.

But there is more to the cuteness of their big eyes. Prominent eyes may be a family trait. But prominent eyes are not the same as having big eyeballs. Having large eyes can be an indication of a very serious eye problem that should be checked by an eye expert for any condition that can lead to glaucoma.

Glaucoma is the silent thief of vision and some children are born with the condition. “A baby that is born and the eyes are white, watery, and sensitive to light need to see an ophthalmologist. Also, one eyeball may be larger than the other. These are abnormally and these could be a sign of congenital glaucoma,” Professor Adeola Onakoya, head of glaucoma Services at the Lagos University teaching hospital, Idi Araba, Lagos, said.

She added, “the black of the eye will be so big, usually bigger than normal and that is not so because the father’s eyes are big, that’s a sign of glaucoma”.

Normally, there should be no visible white between the top of the iris (the coloured part of the eye) and the upper eyelid. Seeing white in this area most often is a sign that the eye is bulging. Because eye changes most often develop slowly, family members may not notice it until the condition is fairly advanced. Photos often draw attention to the bulging when it may have gone unnoticed before.

Professor Onakoya stated that about a number of children are born with glaucoma even in Nigeria and such children need to be detected early and treatment commenced to prevent them from going blind. Because glaucoma in children is uncommon and harder to detect, seeking specialized care for its detection is essential.

According to her, “in children with glaucoma, there is an anomaly in the formation of the eyeball; the eyeball didn’t form well. The part of the eye through which the fluid drains out is absent. Normally, fluid flows in and out of the eye.

An alternate route for the fluid to drain needs to be created and that is why in children; mostly we do surgery for them.”

When the fluid drainage from the eye is blocked by abnormal development or injury to the drainage tissues, it results in an increase in the intraocular pressure, damage to the optic nerve, the structure that delivers visual information from the eyes to the brain, and loss of vision.

While glaucoma can’t be cured, early treatment can often control it. Experts say approximately 80 to 90% of babies who receive prompt surgical treatment will do well and may have normal or nearly normal vision for their lifetime.

Most babies who have glaucoma and do not obtain appropriate care quickly will lose their vision. Treatment may include medicines to cause the eye to make less fluid while others lower pressure by helping fluid drain from the eye.

Basically, while some glaucoma can run in families, most childhood glaucoma has no identifiable causes.

Howbeit, childhood glaucoma occurs more often in children who have medical conditions like Axenfeld-Rieger Syndrome (where there may be developmental issues with various parts of the eye), use of steroidal eye drops for various allergic diseases of the eye, those born premature or that had previous eye surgery or injury.

Professor Onakoya, however, declared that “beyond glaucoma, eye examination in children is important to be sure that vision is developing normally. Parents need to ensure that by age 3 or 4, their children’s eyes are examined. And if any anomaly is noticed, ensure that it is addressed by the specialists.

“When you take the child to see the eye doctors who are specialists for children and you are told this child needs to wear glasses, you should not say no and ask why he should wear glasses since you don’t wear one or have people in the family that wear it.

“It’s been discovered that a lot of them are going to develop myopia, which is short-sightedness. Even though their eyes are still developing, we are so quick to give tablets and other gadgets to play with and to keep them quiet. They stay on it for hours. This affects the growth of their eyes and may make them develop myopia or short-sightedness.”

Apart from that, increased screen time can also make children more prone to eye health problems like eye strain, dry eye, blurry vision and headaches.

Certainly, poor vision in children is common, but saving children’s sight starts with mothers getting fully vaccinated especially for rubella prior to pregnancy, avoiding drugs that can cause birth defects in unborn babies and drug abuse during pregnancy. Identifying common eye diseases in them is a step toward the prevention of poor eyesight and blindness in children who still have many productive years ahead.

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