Dr. Rick : Hi. I'm online and happy to answer your question today.
Dr. Rick : Glaucoma secondary to the dermal capillary vascular abnormalies found in Sturge-Weber syndrome can be very, very difficult to treat.
Dr. Rick : The primary cause of increased intraocular pressure in patients such as your daughter are usually secondary to anomalies of the front part of the eyeball (anterior chamber and outflow channels), especially when they occur before one year old.
Dr. Rick : In children who first present with the port wine stain and elevated eye pressure after one year of age, the abnormalities usually involve problems with elevated episcleral venous pressure rather then anatomical malformations of the eyeball itself.
Dr. Rick : In any event it is important to lower her eye pressure as soon as possible. In patients such as your daughter surgery, rather than eye drops, is the first step in controlling her glaucoma.
Dr. Rick : In many cases eye drops are needed to keep the pressure low enough, even after surgery...
Dr. Rick : Why is it so important to have the glaucoma treated as soon a you can? That is because any vision lost to the disease can never be restored. All the surgery/drops can do is prevent future loss of vision.
Dr. Rick : What surgery is usually done for children like your daughter? There are two common procedures: Trabeculectomy and trabeculotomy.
Dr. Rick : Sometimes goniotomy can be tried although it may not be as successful in Sturge-Webber associated glaucoma....
Dr. Rick : Here is a good webpage that discusses childhood glaucoma in more detail:
Dr. Rick : http://www.chop.edu/healthinfo/childhood-glaucoma.html
Dr. Rick : A study in the medical journal Ophthalmology a few years ago looked at the treatment of patients like your daughter with glaucoma. They found that in patients with early onset glaucoma (which your daughter has) did best when they were treated using a combined trabeculotomy-trabeculectomy.
Dr. Rick : Is there anything else you would like to discuss at this point or have all your questions been answered to your satisfaction
Dr. Rick : I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.Thanks in advance,Dr. Rick MD FACS