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