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Primary congenital glaucoma (PCG) is a rare disorder with an incidence of about 0.38–5.4 in 100 0001 ,2 but it can result in significant visual morbidity.3 PCG is usually diagnosed during infancy and treated with angle surgery; however, patients usually need monitoring for life as up to 57%1 may still need chronic treatment with drops or secondary procedures. The gold standard for monitoring glaucoma in adults and children includes intraocular pressure measurements, monitoring of the optic nerve cup-to-disc ratio and visual fields. Although children have been reported to be able to perform visual fields, the results are not always reliable or reproducible.4 ,5
It is therefore essential to have a test that can reliably diagnose and monitor for possible progressive vision loss in children and infants with PCG before they are able to perform functional tests such as visual acuity and visual fields, and prior to the development of other ophthalmological signs such as nerve cupping. An objective test that would detect the presence and progression of glaucomatous optic atrophy in the eyes of children with PCG would be desirable. Visual evoked potential (VEP) testing would be equally difficult to obtain at young age, and flash VEP would not correlate well with visual field defects.
The development of new imaging devices, such as optical coherence tomography (OCT), has …
Competing interests None.
Provenance and peer review Commissioned; internally peer reviewed.