Features of the Development of Pediatric Glaucoma and a System for Preoperative Testing of Drainage Valves

In Eastern European countries, cases of complete loss of visual function in children due to increased intraocular pressure (IOP) have recently been detected, and their number is constantly growing. Glaucoma is an ophthalmic disease that is detected at birth or during the child's subsequent life, where the progression of the disease without treatment leads to significant complications, including blindness. For every 2,500 newborns, 1-3 cases of congenital vision problems are registered. The registration of this disease depends on the timely detection of intraocular pressure, which at birth is registered within the range of 9–14 mm Hg and with reduced tension of the eye shell (150 kPa) and an increase in intraocular pressure, reaching a maximum in the range of 14-45 mm Hg in adolescents and adults. The purpose of this study is to model pressure changes in children with detected glaucoma and to consider individual parameters and dimensions of the eye shell thickness for making a decision on surgical intervention. It is known that with age, during a child's development, the dimensions of the orbit and other eye parameters change, including the thickness of the eye shell and its elasticity, which significantly affect the distribution of tension, accelerate the development of glaucoma, and this process requires more precise modeling, the use of additional fluid drainage devices, and individual implant selection. The authors conducted modeling and calculations that allowed for establishing the optimal pressure range for children: 9 mm Hg – 14 mm Hg, and the eye shell thickness of 0.1–0.3 mm (normal), ensuring individual internal tensions less than 100 kPa. Furthermore, the authors proposed and described the operation of an original automated system for individual preoperative testing of valves before their use in critical cases of pediatric glaucoma. Therefore, solving the problems of treating pediatric glaucoma and detecting it in the early stages of eye disease is an extremely important issue that requires modeling the process of individual selection of drainage parameters (valves) before surgical intervention. This is especially important when impaired functioning of the trabecular meshwork and lack of regular preventive examination with intraocular pressure control, and changes in the eye shell thickness are detected.