Last updated: 02/17/2009

The patient will continue to be given antibiotics, corticosteroids, and miotics for one to two weeks after surgery. If the surgeon believes that the procedure was not successful, then he or she may give the patient acetazolamide by mouth in addition...

to these medications for up to 10 days to lower the IOP.

The patient will be anesthetized again three to six weeks after surgery for a reevaluation of the anterior chamber of the eye. This examination is repeated every three months for the first year; every six months during the second year; and once a year thereafter. Once the child is older, usually three to four years old, the physician can perform the follow-up examination in his or her office without anesthesia or sedation. Since a visual field test is difficult or impossible to do on an infant or young child, the doctor measures the cornea to assess progression of the disease. An increase in corneal diameter indicates that the glaucoma is getting worse. Visual field testing will be performed when the child is old enough to understand it. A visual field test can establish the extent of vision loss that has occurred because of glaucoma.

An important aspect of managing glaucoma patients after surgery is assessing the degree of nearsightness and astigmatism, both of which result from the stretching of the eye caused by increased intraocular pressure. If the child needs eyeglasses, they should be given as early in life as possible to decrease the probability of amblyopia. Amblyopia is a condition in which the vision cannot be corrected completely, even with glasses, and is common for pediatric glaucoma patients. Although almost 80% of children with congenital glaucoma can have their vision corrected to 20/50 or better, patching of an eye and vision therapy is often required to achieve this level of correction.

About 10% of goniotomy patients will experience a recurrence of the glaucoma or have it develop in the unaffected eye. As a result, the patient will need periodic eye examinations for the rest of his/her life. If glaucoma does recur later in life, then either medical or surgical treatment is instituted depending on the cause.