Cutting Edge Glaucoma - Issue 2

Introduction The surgical management of childhood glaucoma is one of the biggest challenges in the field of glaucoma and an even greater challenge in the developing world. Despite its rarity, childhood glaucoma is one of the leading causes of admission to schools for the blind in both developed and developing countries. Glaucoma accounts for 3–5% of blindness in children worldwide [1, 2], but in certain regions such as Latin America and the Caribbean, it is the cause of blindness in 7% of cases. Overall, the number of blind children in the world is estimated to be 1.4 million, with a disproportionate number, approximately three-quarters, living in the poorest regions of Africa and Asia [3]. Surgery is the main modality of treatment for childhood glaucoma, and a proportion of patients need multiple surgical interventions for long-term control of intraocular pressure (IOP). While early diagnosis and appropriate surgical technique are important in the management of this condition, the treatment does not end there. It is almost a lifelong commitment for both the parents and doctors caring for these children. Childhood glaucoma blindness in the developing world can be minimized by earlier detection and treatment and by strategies to reduce cases that are lost to follow-up. Although therapies have improved the prognosis of many childhood glaucomas, the number of complex glaucoma cases being seen has increased, needing expert care and multiple interven- tions. Although there is paucity of data on the surgical management of childhood glaucoma from the developing world, the aim of this chapter is to highlight the challenges of managing childhood glaucoma in developing countries, the different surgical options available, and their outcomes. Childhood Glaucoma Surgery in Developing Countries Anil K. Mandal, Sirisha Senthil A. K. Mandal, S. Senthil (  ) Department of Glaucoma and Pediatric Ophthalmology, L. V. Prasad Eye Institute, Hyderabad, Telangana, India e-mail: sirishasenthil@lvpei.org