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Intolerance to sunlight and tearing in a one year old

Posted by - Posted on 07/27/2015 00:59:21 Glaucoma


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One year old presents with tearing and h/o intolerance to sunlight.  What one drug would you avoid in the treatment of this condition and why? 



Diagnosis :  The clinical picture suggests enlarged globe with h/o tearing and photophobia would suggest congenital glaucoma.  This will be conformed with IOP, corneal diameter and axial length measurements.  

Treatment: Congenital glaucoma is a surgical disease and is usually treated with goniotomy if the cornea is clear and trabeculectomy/trabeculotomy or AGV when the cornea is cloudy. Medical management is used either before or after the surgery and includes beta blockers and CAIs.

Drug to avoid: Alpha 2 adrenergic agonsts such as Bromonidine should be avoided in children below 3 years  as it can induce CNS side effects such as apnea and siezures. 


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