Pediatric Glaucoma Suspects

Pediatric glaucoma suspects comprise an important subset of children who undergo evaluation for glaucoma in clinical practice. For many of these children, accurate intraocular pressure measurement in the office, obtaining reliable visual fields, and clinical interpretation of optic nerve cupping pose unique challenges for glaucoma diagnosis. The clinician should always consider glaucomatous and non-glaucomatous causes for many of the clinical findings that arouse suspicion for glaucoma to prevent irreversible visual impairment. Judicious use of examinations under anesthesia, optic nerve imaging with optical coherence tomography, and work-up for central nervous system pathology that may cause glaucomatous-appearing optic nerve alterations form the basis of approach to pediatric glaucoma suspects.