Problèmes diagnostiques et thérapeutiques

The management of glaucoma in young patients has made considerable progress over the recent years. Its treatment is essentially surgical, mainly filtration procedure. Use of antimetabolites combined with filtration is highly recommended. Medical treatment has a limited place, but should not be neglected. The number of topical pressure-lowering treatments permits a large therapeutic choice, but their clinical efficacy and tolerability should be assessed on an individual patient's basis. These topically applied treatments have not been tested in sufficient, adequate, clinical studies to guarantee their efficacy and safety in children and adolescents. Consequently, their approved labelling indicates “not recommended for use in these patients”, which means that they are prescribed outside of their granted marketing authorization. Therefore, such clinical studies appear particularly needed. Indications of cyclodestruction or drainage implants has to be confined to refractory glaucoma and complicated cases.