Sunset Eye: Congenital Glaucoma in Children

Q: Sunset Eye: Congenital Glaucoma in Children

Hello： Regarding your question, the answers are as follows： 1. <br>The downward rotation of the eyeball, with more exposure of the upper sclera, is commonly referred to as "sunset eye." 2. <br>In children with hydrocephalus, this condition occurs due to the obstruction of cerebro

Sunset eye

My son has congenital glaucoma.
Will this lead to the appearance of sunset eye? Thank you, doctor.

You worried mom, 30~39 year old female. Ask Date: 2004/07/05

Dr. Lan Yuwen reply Ophthalmology

Hello: Regarding your question, the answers are as follows: 1.
The downward rotation of the eyeball, with more exposure of the upper sclera, is commonly referred to as "sunset eye." 2.
In children with hydrocephalus, this condition occurs due to the obstruction of cerebrospinal fluid pathways, leading to an accumulation of excess cerebrospinal fluid, increased intracranial pressure, and passive dilation of the ventricles.
Symptoms include a bulging anterior fontanelle, increased head circumference (macrocephaly), thinning of the scalp, engorged veins, eyelid retraction, and downward displacement of the eyeball, commonly known as the "sunset eye sign." 3.
Congenital glaucoma, commonly referred to as "buphthalmos," is a congenital eye disorder that manifests at birth or within the first three months.
Its incidence is quite low and is often related to genetics, typically occurring before the age of three, affecting both eyes, with a higher prevalence in boys than girls.
It is primarily caused by congenital abnormalities in the structure of the eye's drainage system, resulting in abnormal aqueous humor drainage from birth.
Because the eye tissues of infants are more elastic than those of adults, increased intraocular pressure leads to the enlargement of the eyeball, with corneal edema causing cloudiness, excessive tearing, photophobia, redness, or eyelid spasms.
Infants often prefer to hide under blankets or in darker places.
The affected eye experiences elevated intraocular pressure, causing the eyeball to enlarge, making it appear larger than that of a normal person, hence the term "buphthalmos." In summary, the mechanisms of occurrence for the two conditions are different, and their clinical manifestations also vary! Wishing you good health.
Dr.
Liu Jing-Hsi of the Ophthalmology Department, Taipei City Hospital, responds on behalf of the department.

Reply Date: 2004/07/05

More Info

Sunset eye, also known as "sunset sign" or "sunset phenomenon," is a clinical term used to describe a specific eye appearance in children, particularly those with certain neurological conditions, such as hydrocephalus. This phenomenon is characterized by the downward displacement of the eyeball, which can result in the upper part of the sclera (the white part of the eye) being more visible, giving the appearance of a sunset.
In your case, you mentioned that your son has congenital glaucoma. Congenital glaucoma is a rare eye condition that occurs due to abnormal development of the eye's drainage system, leading to increased intraocular pressure (IOP). Symptoms typically manifest in infancy, and they can include excessive tearing, light sensitivity, corneal clouding, and an enlarged eye appearance, often referred to as "buphthalmos" or "cow eye."
While both congenital glaucoma and the sunset eye phenomenon involve the eyes, they are not directly related in terms of their underlying mechanisms. The sunset eye appearance is primarily associated with increased intracranial pressure, often due to conditions like hydrocephalus, where cerebrospinal fluid accumulates in the brain, leading to swelling and pressure that can affect the optic nerve and eye positioning.
In contrast, congenital glaucoma is primarily an ocular condition that affects the eye's ability to drain fluid properly, resulting in elevated IOP. The two conditions can coexist, but the presence of congenital glaucoma does not inherently lead to the development of sunset eye symptoms.
If your son is experiencing symptoms such as changes in eye position or appearance, it is crucial to consult with a pediatric ophthalmologist or a specialist in pediatric neurology. They can perform a thorough examination to determine if there are any additional underlying issues, such as increased intracranial pressure or other neurological concerns.
In summary, while congenital glaucoma can lead to significant eye changes and complications, it does not directly cause the sunset eye phenomenon. If you have concerns about your son's eye health or any changes in his eye appearance, it is essential to seek professional medical advice for appropriate evaluation and management. Regular follow-ups with an eye specialist are crucial for monitoring his condition and ensuring the best possible outcomes for his vision and overall health.

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