Visual Impairment Secondary to Congenital Glaucoma in Children: Visual Responses, Optical Correction and Use of Low Vision Aids

Abstract

INTRODUCTIONCongenital glaucoma is frequently associated with visual impairment due to optic nerve damage, corneal opacities, cataracts and amblyopia. Poor vision in childhood is related to global developmental problems, and referral to vision habilitation/rehabilitation services should be without delay to promote efficient management of the impaired vision.OBJECTIVETo analyze data concerning visual response, the use of optical correction and prescribed low vision aids in a population of children with congenital glaucoma.METHODThe authors analyzed data from 100 children with congenital glaucoma to assess best corrected visual acuity, prescribed optical correction and low vision aids.RESULTSFifty-five percent of the sample were male, 43% female. The mean age was 6.3 years. Two percent presented normal visual acuity levels, 29% mild visual impairment, 28% moderate visual impairment, 15% severe visual impairment, 11% profound visual impairment, and 15% near blindness. Sixty-eight percent received optical correction for refractive errors. Optical low vision aids were adopted for distance vision in 34% of the patients and for near vision in 6%. A manual monocular telescopic system with 2.8 × magnification was the most frequently prescribed low vision aid for distance, and for near vision a +38 diopter illuminated stand magnifier was most frequently prescribed.DISCUSSION AND CONCLUSIONCareful low vision assessment and the appropriate prescription of optical corrections and low vision aids are mandatory in children with congenital glaucoma, since this will assist their global development, improving efficiency in daily life activities and promoting social and educational inclusion.

Low Vision Aids in Glaucoma

“…4 Sixty-eight percent received optical correction for refractive errors. Optical low vision aids were adopted for distance vision in 34% of the patients and for near vision in 6%.…”

Changing patterns in paediatric optic atrophy aetiology: 1979 to 2015

“…In the educational setting, another magnification strategy is enlargement of hardcopy printed text; however, LVAs have the additional advantage of providing children with greater independence of access to printed material . Multiple studies document the subjective benefit of LVAs in children, in particular the use of magnifiers …”

Familial congenital glaucoma and epilepsy: a case series.

“…6 The pathogenesis of primary congenital glaucoma has been attributed to impaired aqueous outflow as a result of trabeculodysgenesis.…”