

Newborns are more vulnerable to certain eye problems that can affect their visual development, and one of the most serious conditions is glaucoma. This disease increases eye pressure and can damage the optic nerve if not detected and treated early. Detecting glaucoma in infants is not always easy, but careful observation by parents and early eye examinations can protect the child from permanent vision loss.In this Dalili Medical article, we’ll explain the main causes of glaucoma in newborns, the most important signs and symptoms to watch for, how doctors diagnose the condition, and the latest treatment and prevention methods to ensure your baby’s vision develops normally and safely.
Glaucoma, often called “the silent thief of sight,” is commonly associated with older adults, but newborns and infants can also develop it. In babies, it is usually a type called congenital glaucoma, which appears at birth or during early childhood (up to age 5).
Congenital glaucoma happens when there is a defect in the eye’s drainage system from birth, causing fluid buildup and increased intraocular pressure. If untreated, it can damage the optic nerve and lead to permanent vision loss.
If not diagnosed and treated in time, glaucoma may cause irreversible optic nerve damage and even blindness.
But with early detection and proper treatment, children can maintain healthy vision and normal visual development.
After surgery, children usually need a few weeks to recover. Regular follow-ups with an ophthalmologist are essential to monitor eye pressure, healing progress, and prevent possible complications.
Some signs that should alert parents include:
Abnormally large or bulging eyes
Excessive tearing or watery eyes without reason
Sensitivity to light (baby keeps eyes shut or turns away from light)
Crossed eyes (strabismus) or misaligned eyes
Yes. Without early intervention, congenital glaucoma can cause permanent blindness due to optic nerve damage.
Some cases are genetic or congenital and cannot be fully prevented.
But reducing risk factors is possible by:
Regular prenatal check-ups
Preventing maternal infections during pregnancy
Avoiding harmful medications or toxins
Ensuring early eye screening after birth
Parents should watch for these red flags after surgery:
Persistent high eye pressure or enlarged eyes
Blurry vision or no improvement
Crossed eyes (possible amblyopia or weak vision)
Severe eye redness or pus-like discharge (may indicate infection)
Any of these require an urgent ophthalmology visit.
Yes. Since a child’s eyes are still developing, long-term monitoring is essential:
Regular eye pressure checks
Tracking visual development
Using glasses or corrective lenses if needed
Babies with the following factors are at greater risk:
Genetic factors: family history of glaucoma or congenital eye defects
Syndromes: Sturge-Weber, Axenfeld-Rieger, or other rare genetic conditions
Maternal health issues during pregnancy: rubella, syphilis, infections, or harmful medications
Premature birth or low birth weight
Birth complications: oxygen deprivation, trauma during delivery
Associated eye or metabolic disorders
If your baby falls into these categories, regular eye screening is strongly recommended.
Unlike adults, babies show different warning signs:
Enlarged eyes (Buphthalmos)
One or both eyes may look abnormally large.
Cloudy or hazy cornea
Instead of being clear, the cornea looks white, gray, or shiny.
Excessive tearing (Lacrimation)
Continuous watery eyes, sometimes with mild discharge.
Light sensitivity (Photophobia)
Baby squeezes eyes shut or avoids looking at light.
Eye misalignment or unusual head posture.
Feature | Infants | Adults |
---|---|---|
Cause | Congenital defect in fluid drainage | Age-related blockage or secondary eye disease |
Symptoms | Large eyes, tearing, light sensitivity, hazy cornea | Gradual vision loss, halos around lights, headaches |
Treatment | Surgery is almost always required | Medication first, surgery if needed |
Follow-up | Continuous, strict monitoring | Regular check-ups but less intensive |
The baby keeps their eyes closed or tries to avoid light.
Parents often notice this when the child is exposed to sunlight or strong indoor lighting.
The cornea appears less transparent or shows a faint bluish-white haze.
This can often be noticed when looking directly at the baby’s eyes or when taking photos.
The baby rubs their eyes frequently due to discomfort caused by high intraocular pressure.
Delay in tracking surrounding objects or difficulty focusing on faces or toys.
Sometimes accompanied by eye deviation or strabismus due to weak vision.
Diagnosis depends on early medical evaluation and close parental observation. Key steps include:
Medical and Family History
Asking parents about any family history of glaucoma or eye conditions.
Monitoring symptoms since birth, such as persistent tearing or light sensitivity.
Checking for complications during pregnancy or delivery that might affect the eyes.
Clinical Eye Examination
Eye size: Checking for abnormal enlargement (Buphthalmos).
Cornea: Looking for clouding or scarring.
Pupil reaction: Ensuring a normal light response.
Eye movements: Examining for strabismus due to weak vision.
Measuring Intraocular Pressure (IOP)
Elevated eye pressure is the main indicator.
Usually measured with special devices for infants, often under light anesthesia or during sleep.
Retina and Optic Nerve Examination
Assessing optic nerve health to check for glaucoma-related damage.
Retinal imaging or ultrasound may be needed if the cornea is too cloudy.
Additional Tests (if necessary)
Ultrasound Biometry: Measuring eye size and corneal thickness.
Anterior Segment Imaging: Detecting congenital malformations.
Glaucoma in newborns progresses in different stages depending on eye pressure levels and optic nerve damage:
Early Stage
Mild to moderate eye pressure.
Slightly enlarged eye.
Clear or mildly cloudy cornea.
Symptoms: persistent tearing, mild light sensitivity, occasional eye rubbing.
Moderate Stage
Noticeably high eye pressure.
Enlarged eye with cloudy or bluish cornea.
Symptoms: strong photophobia, frequent tearing, constant eye rubbing, mild strabismus.
Advanced Stage
Very high eye pressure affecting retina and optic nerve.
Cornea fully cloudy.
Significant eye enlargement.
Symptoms: vision loss (partial or severe), noticeable strabismus, difficulty tracking objects, eye deformities.
Long-Term Complications
Permanent blindness.
Structural deformities in cornea or eye shape.
Developmental delays due to impaired vision.
If untreated, the condition can lead to serious complications:
Vision loss or blindness: Ongoing optic nerve damage from high pressure.
Corneal and eye deformities: Eye enlargement (Buphthalmos), corneal scarring, reduced vision clarity.
Strabismus (Crossed eyes): Caused by weak or uneven vision.
Delayed visual development: Clear vision is essential for infants’ brain and eye development.
Learning and developmental difficulties: Older children may struggle with concentration, learning, and play activities.
Medical complications: Chronic pain, infections, or intraocular bleeding in advanced cases.
Performed as early as possible after diagnosis, especially if intraocular pressure is very high or there are signs of optic nerve damage.
Early surgery in the first few months can prevent eye enlargement and permanent vision loss.
Complete eye exam: pressure measurement, cornea and retina health check.
Blood tests and organ function checks before anesthesia.
General anesthesia is required, performed by a pediatric anesthesiologist.
Small incision in the eye to access fluid drainage channels.
Techniques:
Goniotomy: Opens the anterior drainage channel (mild/moderate cases).
Trabeculotomy: Used for larger obstructions or failed goniotomy.
Ahmed Valve Implantation: For severe cases resistant to other surgeries.
Closure: Usually without stitches or with very fine sutures.
Short hospital monitoring to check eye pressure and rule out bleeding or infection.
Eye drops prescribed:
Antibiotics (infection prevention).
Anti-inflammatory drops (reduce swelling).
Regular follow-up eye pressure checks (weekly at first, then every few months).
Eye protection: shield or cover, especially during sleep.
While congenital glaucoma cannot always be prevented, early care and monitoring reduce risks:
Regular maternal check-ups during pregnancy.
Prevent infections like rubella, syphilis, or severe eye infections.
Avoid harmful medications without doctor approval.
Eat a healthy diet rich in vitamins and minerals for eye development.
Routine newborn eye check-up to rule out glaucoma or congenital defects.
Watch for early signs (red eyes, constant tearing, white spot in the eye).
Prevent head or eye trauma during play.
Use protective glasses in older children for sports or risky activities.
Wash hands before touching or cleaning the baby’s eyes.
Clean eye discharge with sterile cotton.
Avoid sharing towels, pillows, or baby items.
Treat eye or respiratory infections promptly.
Vitamin-rich foods: carrots, sweet potatoes, citrus fruits, spinach, nuts.
Omega-3s: fish (for older kids) or doctor-approved supplements.
Limit processed foods and sugars.
Routine pediatric ophthalmologist visits, especially if there’s a family history of glaucoma.
Early detection ensures treatment before vision damage occurs.
⚠️ Parental Alert:
Prevention and early detection are more effective than late treatment. Any unusual eye symptoms in your baby should be checked immediately by a pediatric eye specialist.