The treatment of congenital glaucoma.

THIS series comprises foturteen cases, in which 2F') eyes were operated on. The timile over which the eyes were under observation after operation varied from seven years to twxo miontlhs. Tlihree of the cases were reported in a previous coimniunicatioin (M\IcA.revev, 1948); their subsequenit history is now followsed up. As a cause of blindness in eairllife, congenital glaucoma has a high incidence. Aniiderson (1939) reported surveys from several countries, the incidence varying from 2.4 to 13 per Cent. of children admitted into schools for the blind. In Eire, in the sclhool of an Institute for the Blincd, seven out of 44 -were blind from congenital glaucoma, whiclh had by far the lighlest inicidence. An historical review of the treatmiienit of congenital glatucoma -would include the various operations for decompressing the eye, the results of which have Inot been good. The report by Barkai (1942) urgedl me to try goniotomy. Success in reducing the intra-ocular pressure in my first case gave mie further encouragement to proceed in the use of this operatioin. Congenital glauconma, wsith the subsequent enlargemenlt of the eve in untreated cases, can go on to buphthalmos; this emphasizes the importance of the early detection of the coinditioni in order to prevent damiiage by the increased intra-ocular pressure. A case treated earlv, will, by successful lowering of the intra-ocular pressure, give an eye wlhiclh to all appearances is within normal limits. Congenital glaucomna in early life, however, caII easily escape detection until the increased tension has caused great damage to the eye. The earliest symptoms are photophobia and oedema of the cornea; these small children will bury tlheir heads in the pillow, in a manner resembling phlyctenular disease.