Research shows that studies on childhood glaucoma are lacking. Photo: Joseph W. Sowka, OD. Click image to enlarge.

A literature review published earlier this year identified three high-quality clinical practice guidelines (CPGs) relevant to childhood glaucoma but reported that none specifically addressed the condition in this young population. Compounding this lack of guidance is the little evidence-based data on this rare but devastating disease.

The researchers screened guidelines for relevance to childhood glaucoma and rated them for quality. All three relevant guidelines recommended that children undergo eye screening or a comprehensive eye assessment for pediatric disease and that children at high risk for childhood glaucoma undergo additional screening. The researchers reported that one CPG suggested interventions such as tube surgery and topical beta-blockers or carbonic anhydrase inhibitors; however, these recommendations were based on low- and moderate-quality evidence.

“A coordinated effort is needed to address this lack of quality data with standardized disease terminology and management strategies to improve outcomes for children with childhood glaucoma,” the researchers wrote in their paper. However, they noted that because it’s such a rare disease, a very large number of children would need to be screened to detect even a single case. “From a public health perspective, the costs may not outweigh the benefits,” the researchers stated. “A potential alternative to lower the cost and optimize delivery of these annual screenings would be to combine these visits with vaccination programs or other currently implemented programs.”

They added that while the United States recommends screening be performed by primary care doctors, children at high risk would benefit more from examination by an ophthalmologist in a secondary or tertiary care setting.