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    Pediatric glaucoma can have impact beyond clinical effects

    Multifaceted approach takes into account psychological, social burdens as children age

    Take-home message: After childhood glaucoma has been treated, ophthalmologists expect to follow patients for years, monitoring them for a host of anatomical problems that can affect their vision.

    Reviewed by Alana L Grajewski, MD

    Miami—What happens to children treated for glaucoma as they grow older?

    The short answer is that life goes on. Just like other kids, they want to be active, get an education, have a career, date, get married, and have children. But even if their glaucoma has been effectively cured, the impact lingers.

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    “They have anatomical things that have followed them, and they have other baggage that has followed them,” said Alana L Grajewski, MD.

    While the anatomical issues have been well studied, literature on the psychological-social burden of childhood glaucoma on children and families is limited, and these quality of life issues should be examined more formally, she said, noting that this is one goal of the Childhood Glaucoma Research Network (CGRN), an international group she helped found several years ago.

    Providers need more information on the relationship between the care burden and other effects of childhood glaucoma, such as depression in caregivers and visually impaired children, she said.

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    “It should be an essential part of our holistic approach to the management of glaucoma,” said Dr. Grajewski, director, Samuel and Ethel Balkan Pediatric International Glaucoma Center, Bascom Palmer Eye Institute, and professor of ophthalmology, University of Miami Miller School of Medicine.

    She observed that glaucoma experts who have treated very young children and then continued to follow them for years are uniquely positioned to understand the importance of such a multifaceted approach. As part of a longstanding patient-parent-provider relationship, they have become familiar enough to be invited to graduations and weddings and may have fielded questions from now-grown patients on the risks of inherited glaucoma in the next generation.

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    All of use who take care of kids see where having grown up with something that needs monitoring constantly does affect them, although not necessarily adversely,“ Dr. Grajewski said. “They look back on that experience and make decisions based on it.”

    Impact beyond clinical factors

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