The spontaneous resolution of Primary congenital Glaucoma - Healio 2026

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While congenital glaucoma is not completely reversible, it can be controlled, and total vision loss could be prevented. With early treatment, babies with congenital glaucoma can maintain some degree of vision, and some may even have excellent vision.
Primary congenital glaucoma (PCG) is a rare form of childhood glaucoma resulting from abnormal development of the eyes drainage system, leading to elevated intraocular pressure (IOP). This increase in IOP damages the optic nerve, potentially causing irreversible vision loss if left untreated.
The prognosis for untreated PCG is almost always buphthalmos and blindness, except in the rare case of spontaneously arrested PCG. When PCG is being managed, the prognosis seems to depend on the age of onset, which depends on the severity of the angle anomaly.
At 5 years, visual outcome was good in 68%, moderate in 17% and poor in 15%. At the final follow up, visual outcome was good in 58%, moderate in 20% and poor in 22%. There was follow-up data available from 60 eyes at 5 years, 58 eyes at 10 years, 46 eyes at 15 years and 32 eyes at 20 years.
The mainstay of treatment is angle surgery, either goniotomy or trabeculotomy, to lower IOP by improving aqueous outflow. If angle surgery is not successful, trabeculectomy enhanced with mitomycin C or glaucoma implant surgery with a Molteno, Baerveldt, or Ahmed implant can be performed.

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