Pediatric Glaucoma

Glaucoma is a group of diseases that are caused by damage to the optic nerve because eye pressure is high.  Most of the time, the pressure is too high because the eye is unable to drain the fluid it makes out properly.   Optic nerve damage can result in severe vision loss or blindness, if not treated early.  It is more common in the elderly, but can develop at any age.  

Types

  • Congenital- Is present at birth
  • Infantile- Develops between the ages of  1-24 months
  • Juvenile- Onset after the age of 3

Symptoms

Congenital/Infantile

  • Excessive tearing
  • Light sensitivity
  • Large cloudy cornea (the normally clear front surface of the eye) which causes the iris (the colored part of the eye) to look dull

Juvenile

  • Most often a family history
  • Develops without any obvious signs, similar to adults
  • Elevated eye pressure with possible signs of optic nerve cupping (enlargement of the center cup portion of the optic nerve)

Causes/Treatment

The causes of pediatric glaucoma fall into two categories, primary or secondary.  Primary is usually caused by abnormal development of the ocular drainage system.  This is the most common form and it occurs in about 1 out of 10,000 births in the United States.  Secondary glaucomas result from disorders of the body or eye and may or may not be genetic.

Treatment for pediatric glaucoma is different than for adults.  Surgery is the first option for children whereas medications are usually given first for adults.  With prompt surgical treatment, long term care and frequent well checks, 80-90% of children with glaucoma will do well and have normal to near-normal vision.  Unfortunately, 2-15% of primary congenital glaucoma results in blindness.

Teaching Strategies

There are many different strategies that a teacher can use to help a student with low to no vision.  An Individual Education Plan (IEP) would first be developed to list the goals of the student and what he/she is capable of doing.   Some strategies would be:

  • Multi-sensory-using verbal, tactile, and kinesthetic approaches when teaching
  • Keyboarding software that includes speech
  • Large print books and handouts
  • Using descriptive language when teaching topics
  • Hand over hand techniques when demonstrating certain skills
  • Encouraging independence to avoid the student from becoming dependent on others

Assistive Technology

Teachers have a multitude of options for using assistive technology in the classroom to aid a student with vision problems.

  • Voice Access- allows the student to interact with the computer by using voice commands instead of the keyboard (DragonDictate and Naturally Speaking are examples)
  • Screen Readers- provide auditory feedback when using a computer (Intellitalk and IBM Screenreader are examples)
  • DVS (Descriptive Video Service- describes the visual elements of a movie
  • Language Master- is a speaking reference guide with definitions, spellings and a thesaurus
  • Low tech adaptions- keyboard access can be maximized through enlarged keyboard labels and tactile indicators

Laws

VRA-Vocational Rehabilitation Act

This 1973 law is one of the first laws to address students with disabilities and prohibited discrimination against them.  It also added Section 504 which said that students with disabilities must receive a comparable education to that of a student without disabilities

IDEA- Individuals With Disabilities Education Act

This 1990 law which has been reauthorized twice, in 1997 and 2004, prohibits discrimination against people with disabilities.  It includes FAPE (Free and Appropriate Public Education), IEP (Individual Education Plan) and LRE (Least Restrictive Environment).  These were a part of the 1975 Education for All Handicapped Children Act, which was replaced by IDEA


Family Resources

There are many resources available to parents and caregivers of children with Pediatric Glaucoma.

  • Pediatric Glaucoma and Cataract Family Association

            PO Box 144   27 St. Clair Ave. E.

            Toronto, ON  M4T2L7  Canada

             416-444-4536

            www.pgcfa.org

  • Glaucoma Research Foundation                                                                         

            251 Post Street, Suite 600

            San Francisco, CA 94108

            800-826-6693

            www.glaucoma.org

  • National Eye Institute/National Eye Health Education Program (NEHEP)

             National Institutes of Health

             31 Center Drive, MSC 2510

             Bethesda, MD 20892

             301-496-5248

              www.nei.nih.gov

  • The Glaucoma Foundation

            80 Maiden Lane Suite 700

            New York, NY 10038

            212-285-0080

            www.glaucomafoundation.org

References

American Association for Pediatric Opthamology and Strabismus.  

        (2014).  Retrieved from http://www.aapos.org/terms/conditons/55

Carney, S., Engbretson, C., Scammell, K., Sheppard, V. (2003). Teaching

        Students with Visual Impairments:  A Guide for the Support Staff.   

        Retrieved from  http://www.education.gov.sk.ca/vision

Glaucoma Foundation.  (2015).  Childhood Glaucoma.  Retrieved from

        http://www.glaucomafoundation.org/childhood_glaucoma.htm

Sidoti, P.,  (2015, January 15).  Why Parents Need to Know the Signs of

        Childhood Glaucoma.  Huffington Post.  Retrieved from

        http://www.huffingtonpost.com

Taylor, R., Smiley, L., Richards, S. (2009).  Exceptional Students

        (2nd ed) New York, NY.  McGraw-Hill Education

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