Austin, a 5-month-old boy in Richmond, Virginia, had tearing of his left eye, an issue not often considered alarming in young children.
“His left eye was watering a lot, and we first thought it was pink eye,” his parents Cory and Michael said.
After a round of antibiotic eye drops that provided no improvement, Austin was referred to Virginia Commonwealth University (VCU), where his pediatrician noticed that Austin’s left eye appeared larger than his right eye. At VCU, pediatric ophthalmologist Evan Silverstein, MD diagnosed Austin with primary congenital glaucoma, a condition where the pressure inside the eye is too high. While primary congenital glaucoma is a rare condition, it is important to make the diagnosis and provide treatment early.
“I like to explain that the eye is kind of like a sink, where there’s a faucet with fluid coming in and a drain where fluid comes out,” Dr. Silverstein said. “In primary congenital glaucoma the drain doesn’t form very well, and so the faucet keeps pouring fluid into the eye. The drain doesn’t work and so the pressure just builds up.”
In children, primary congenital glaucoma can cause the eye to enlarge due to increased pressure. This can lead to stretching of the clear front part of the eye, the cornea, as well as nearsightedness. More importantly, if left untreated it can also lead to irreversible vision loss, including blindness.
“At first, we give eye drops to bring the pressure down as much as possible, but you absolutely need to do surgery as quickly as possible. For him to see a pediatric ophthalmologist was essential,” said Dr. Silverstein.
Austin underwent a goniotomy procedure, a delicate surgery designed to decrease the pressure in the eye to prevent additional damage from occurring. The procedure opens the drain of the eye to allow fluid to escape.
“Dr. Silverstein was great. Austin was so tiny at the time, but they are buddies now”, said Austin’s mother. Austin’s father agreed. “Sitting here today thinking about how fortunate we are, it is remarkable.”
Austin is doing well since his eye surgery; his eyes have normal pressure and he no longer needs eye drops. Like many children his age, he wears glasses to see clearly and will continue to be monitored as he grows older. By catching this disease early and treating it successfully, Dr. Silverstein gave Austin the ability to have excellent vision and prevented a future of potential blindness.