Childhood glaucoma profile in a Southwestern Ethiopia tertiary care center: a retrospective study

Abstract

Background: World Glaucoma Association and United States Board of Ophthalmology defined childhood glaucoma as disease onset at <18 years of age, characterized by elevated intraocular pressure (IOP)-related damage to ocular structures. It is responsible for 5% of blindness in children worldwide. In African regions, it accounts for 10% of childhood blindness. An appropriate and correct diagnosis of glaucoma and its etiology is essential to enhance visual outcomes and guide proper treatment for children. However, there is little knowledge regarding profile of childhood glaucoma in our setup. Objective: To ascertain demographics, clinical characteristics, and the treatments of glaucoma in children aged 18 years or below at Jimma University Medical Center (JUMC) from 2020 to 2022. Methods: A retrospective cross-sectional study in which the medical record review and analysis was done regarding demographics, clinical characteristics, and the treatments of glaucoma in children aged 18 years or below at Jimma University Medical Center (JUMC) from 2020 to 2022. Results: Of the 105 children (181 eyes) with glaucoma during this 3-year period, primary glaucomas constituted 57.5% (n = 104 eyes of 58 children), including 76 eyes (42%) of 42 children with primary congenital glaucoma (PCG), and 28 eyes (15.5%) of 16 children with juvenile open angle glaucoma (JOAG). Among these, 72.4% (152 eyes of 76 children) had bilateral involvement. Glaucoma suspect was the second most common type of childhood glaucoma constituting 22.1% (n = 40 eyes). Secondary glaucomas constituted 20.4%; they were glaucoma associated with acquired conditions 7.7% (n = 14 eyes) (steroid induced glaucoma alone 5% [n = 9 eyes]), glaucoma associated with systemic or syndromic conditions 6.1% (n = 11 eyes), glaucoma following cataract surgery 4.4% (n = 8 eyes), and glaucoma associated with nonacquired ocular anomalies 2.2% (n = 4 eyes). In both primary and secondary glaucomas, boys were affected more than girls, in ratio of 2:1 and 2.7:1, respectively. Close to 93.4% PCG eyes were managed surgically, of which majority underwent combined trabeculotomy and trabeculectomy (CTT). Majority of secondary glaucomas were managed medically. Conclusion and recommendation: In this study, PCG was the most common childhood glaucoma and CTT was the most common surgery performed in these eyes. Steroid‑induced glaucoma was the most common secondary glaucoma; appropriate measures should be taken to avert this preventable glaucoma in children.