An Insight into Primary Congenital Glaucoma

Glaucoma is the second most prominent cause of impaired vision in the world. Over 60 million individuals are presently affected, and 12 million are sightless as a result. Primary congenital glaucoma (PCG) is a childhood disease that can lead to blindness in newborns and very young children. The rate of occurrence of PCG varies in different communities and across geographical boundaries, and its etiology is unknown. It is caused by genetic structural defects in the trabecular meshwork and makes its appearence in newborns and children no older than three years. PCG is most prevalent in populations with high rates of consanguineous marriages. It is categorized by inappropriate development of the eye's aqueous outflow system, causing increased intraocular pressure (IOP) and leading to swelling of the cornea, epiphora, discomfort or pain, enlargement of the eyeball (buphthalmos), corneal opacity, and optic nerve damage. PCG is classified as an autosomal recessive disorder involving four loci. The main culprit is CYPIBI, at locus GLC3A. PCG is also linked with loci GLC3B and GLC3C; however, their genetic factors have only recently been recognized. The gene LTPB2 at locus GLC3D, plays an important role in tissue healing and cell attachment. Trabeculectomy and gonioscopy are effective treatments for PCG. Additional efforts are essential to provide timely screening of children and, most important, to assign sufficient resources to allow healthcare workers to reduce the rate of avoidable blindness in developing countries.