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Tips from pediatric glaucoma treatment may aid in adult treatment
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WAILEA, Hawaii — Several methods for successfully treating glaucoma in infants may translate well to the adult treatment world, according to a speaker here.
The tricks come from some of the added difficulties that are associated with treating young children, Ken K. Nischal, FRCOphth, said at Hawaiian Eye 2012.
"When you're dealing with an adult, you're pretty sure they have a Schlemm's canal," Dr. Nischal said. "But when you're dealing with a child, infant ... you're not sure they have a Schlemm's canal. So you have to have some tricks that tell you very quickly whether you can pursue an external approach to do trabeculotomy."
The Schlemm's trick involves asking an aide, such as the anesthetist, to compress the patient's external jugular, he said. The result is an engorgement of blood into Schlemm's canal, making it simple to locate.
"That works every time," Dr. Nischal said.
Dr. Nischal also offered tips for goniotomy, including the need for a completely clear cornea for success.
"If it's not clear, you can try tricks like debriding the epithelium," he said. "You can use alcohol to do that."
These tips demonstrate the value of sharing between pediatric and adult physicians, he said.
"These are techniques we might be able to utilize in the adult world," he said. "There are things that we could show you that you might find helpful in your practice."
- Disclosure: Dr. Nischal has no relevant financial disclosures.
Hawaiian Eye and Retina 2013 will be held January 20-25, 2013, at the Hilton Waikoloa Village on Hawaii's Big Island. Learn more at OSNHawaiianEye.com or RetinaMeeting.com.