The prevalence of congenital glaucoma in China is 0.002%~0.004%, which can occur before birth, at birth or in the first three years after birth, but more than 80% develop within one year after birth, with more male children and about 60%~75% involving both eyes. Congenital glaucoma can cause such a severe loss of visual function that it can affect the quality of life of the baby for the rest of his or her life. So how do you find out if your baby has congenital glaucoma? The term “big watery eyes” is a good description of congenital glaucoma. This is because the eye and body are still actively developing during infancy, and therefore have unique signs and symptoms unlike those of other age groups with glaucoma. Because the wall of the eye is not yet mature, the elevated intraocular pressure enlarges the diseased eye and dilates the cornea, so congenital glaucoma was once called “bull’s eye” or “watery eye” due to corneal edema, and the first sensation at the time of consultation is that the baby’s eyes are large. The first symptoms are photophobia, lacrimation, and blepharospasm. In the early stages, photophobia occurs in strong light, and later, as the disease progresses, lacrimation, blepharospasm, inversion of the eye, and a feeling of “watery” eyes. Since infants do not complain, they often rub their eyes with their hands, are irritable, and like to bury their heads, etc. In severe cases, they show photophobia even in normal light, and their faces are hidden in their mothers’ arms in bright light. When the disease worsens, photophobia and tearing may suddenly increase, and the child may become irritable and cry, unwilling to open his eyes and bury his head. In addition, the cornea may turn white or gray, with white lines of cloudiness. Some parents may notice enlargement of the eyeball and corneal enlargement, especially in children with monocular disease. The lateral diameter of the cornea of a normal newborn is 10-10.5mm, increasing by 0.5-1.0mm in the first year of life, that is, to 10.5-11.5mm. If it exceeds 12mm, infantile glaucoma should be highly suspected. At the same time, the sclera will be dilated and a “blue sclera” will appear, which is often referred to as a blue white eye. In addition, children with refractive errors, especially myopic refractive errors, should be aware of glaucoma. Does “big, watery eyes” necessarily mean congenital glaucoma? The large cornea and high myopia also show “big eyes”, and congenital hereditary corneal endothelial dystrophy and tear duct obstruction also make the eyes “watery”, so what exactly is congenital glaucoma? In addition to large eyes and photophobia, congenital glaucoma also has signs such as elevated intraocular pressure, abnormal development of the atrial angle and enlarged visual cup, but these cannot be detected with the naked eye and require some relevant tests to confirm whether the baby really has congenital glaucoma. Since the baby is too small to cooperate with the examination, a full examination is usually done under general anesthesia or with oral chloral hydrate to sleep. This includes corneal diameter, degree of corneal edema and cloudiness, rupture of the posterior elastic layer of the cornea, corneal thickness, corneal topography, measurement of intraocular pressure, examination of the anterior chamber and anterior chamber angle, fundus examination, visual field, refraction, and analysis of the optic nerve fiber layer thickness of the optic disc. For congenital glaucoma, the principle is to operate as soon as possible once the diagnosis is made. The safety of anti-glaucoma drugs is difficult to evaluate for babies, and children do not complain of adverse reactions, so they are only used for short-term overtreatment or for children who cannot be operated on. In terms of the results of surgery, the success rate of the first surgery is high, especially at 3 to 12 months of age, and the surgery can be performed several times.