Synopsis
Recognise pressure-related changes in the infant eye, arrange urgent specialist assessment and understand surgical treatment, paediatric medicine restrictions and lifelong visual follow-up.
- Primary congenital glaucoma reflects abnormal development of aqueous drainage structures.
- The compliant infant globe can enlarge when intraocular pressure remains high.
- Epiphora, photophobia and blepharospasm are useful presenting clues.
Key red flags
Corneal clouding or enlargement, particularly with light sensitivity and persistent watering.
Investigation priorities
Measure intraocular pressure using an appropriate paediatric technique.
Management branches
An infant has corneal enlargement or haze with tearing, light aversion or lid spasm.
- Inspect both corneas and assess visual behaviour as far as the child comfortably allows.
- Contact the acute eye service and describe the observed signs rather than a presumed blocked duct.
Key medicines
Latanoprost 50 micrograms/mL eye drops — XalatanSpecialist paediatric use follows the licensed adult schedule: one drop in each affected eye once daily, preferably in the evening; do not increase beyond once daily.
Brimonidine-containing eye drops — safety exclusionDo not administer to neonates or infants younger than two years; no infant dose is appropriate because this age group is contraindicated.