Juvenile open angle glaucoma –A case series study

Abstract

Juvenile open angle glaucoma is a rare form of glaucoma that differs from primary open angle glaucoma in its age of onset and magnitude of intraocular pressure.Juvenile open angle glaucoma has its onset between 3-40 years of age with relatively high intraocular pressure. For the documentation and describe clinical manifestations management and outcome of management of the patients diagnosed as Juvenile open-angle glaucoma at the glaucoma department, CEITC, Chittagong, Bangladesh. This is a hospital based prospective observational case series review. 20 patients who were diagnosed as Juvenile open-angle glaucoma from November 2010 to December 2011 were included in this study.Patient particulars history with main causes of hospital presentations were recorded. Ophthalmic examinations and management given were documented. Similar relevant details were recorded for different follow-up periods. 40 eyes of 20 patients were included in this study. There were 16 male and 4 female. All cases were bilateral. Age more than 18yrs. (18-35) in 16 patients and below 18yrs. (5-18) in 4 patients. 15 patients came from rural area and 5 patients from urban. Pretreatment average IOP in the both eyes was 32±3mmhg, which was 15±1mmhg after treatment. 24 of 40 eyes were presented with advance field defects. 85% (17 patients) had myopic refractive error. In 18eyes pre treatment presenting visual acuity was <6/60 and >6/60 in the rest of the eyes. Visual acuity was improved after treatment. In 21 patients (53%) IOP was controlled with 2-3 medications. In 19 eyes (48%) IOP was controlled with filtration surgery. As Juvenile open-angle glaucoma presented with high IOP and advance field defect, early diagnosis, appropriate investigations and medical or surgical management is mandatory to stabilize IOP and to prevent progression of field defects.