Congenital glaucoma (primary infantile glaucoma) differs from adult POAG in all of the following EXCEPT:

• A Buphthalmos (enlarged globe) occurs due to distensible infant sclera
• B Haab's striae — horizontal breaks in Descemet membrane — are pathognomonic
• C Goniotomy or trabeculotomy is the surgery of choice, not filtering surgery as first-line
• D Optic disc cupping does NOT occur and is not a diagnostic feature ✓

Explanation

Optic disc cupping DOES occur in congenital glaucoma — in fact, a distinctive feature is that disc cupping in infantile glaucoma may show early reversibility after IOP normalization (unlike adult glaucoma where cupping is permanent). Buphthalmos (ox eye) results from elevated IOP causing expansion of the distensible infant sclera. Haab's striae are horizontal (or curvilinear) breaks in Descemet membrane caused by rapid corneal stretching, pathognomonic of the condition. Goniotomy (Barkan) or trabeculotomy are preferred surgical treatments targeting the developmental anomaly (Barkan's membrane/trabecular dysgenesis).

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.