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The shape of the eye, or globe, is formed by the cornea (the clear, watch glass cover like front of the eye which we see through), the white sclera (firm shell of the eye), and by the internal fluid pressure maintaining the proper inflation.
Measurement of the intraocular pressure is particularly important when we are concerned that the pressure of the eye is too high. When the pressure of the eye is too high this disease state is called glaucoma. Fortunately, this problem occurs very rarely in children.
There is a very serious disorder we call infantile glaucoma. Infant’s eyes are special since the outermost layers of the eye, the cornea and sclera, are distensible and stretchable until the age of around 3 years.
When an infant has glaucoma the eye is stretched and enlarges faster than occurs during the natural growth and development of the eye. This causes the eye or eyes to appear larger than normal. However, the cornea does not stretch as easily as the sclera. As the cornea stretches too much, the internal membranes leak fluid into the cornea. This initially causes the infant to have teary, watery eyes and significant light sensitivity (photophobia). As the fluid leak increases, the clear cornea becomes hazy or partially opaque. If these symptoms were to occur, immediate Pediatric Ophthalmology evaluation is indicated. Urgent surgical treatment is often required.
When the intraocular pressure measurements are needed in infants and children, examination under anesthesia is almost always required. In older children and teenagers, intraocular pressure measurements are easily accomplished in the office. An anesthetic eyedrops are necessary prior to the measurement because the instrument briefly touches the eye.
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