Hold the anesthesia—this baby-flying scan may spot glaucoma before nap time’s even over.
A new imaging approach using swept-source anterior-segment optical coherence tomography (SS-ASOCT) could give eye care professionals a way to detect early childhood glaucoma without having to put tiny patients under general anesthesia, according to a study published May 22 in JAMA Ophthalmology.
Researchers from a tertiary care center in Northern India found that when the trabecular meshwork (TM) isn’t visible on SS-ASOCT scans, it’s a strong clue that glaucoma may be present in children under two.1
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Study details
To capture these images, they used the “flying baby” technique, holding infants in front of the imaging device just long enough to snap a usable shot. The team applied this method to 30 children with early-onset glaucoma and 23 age-matched controls without the condition.1
Here’s what they saw: in every child without glaucoma, the TM shadow showed up clearly (100%). In glaucomatous eyes? Just 26.7%. That gave the method a sensitivity of 73.3%, but a specificity of 100%, which is about as definitive as diagnostic tools get.1
To double-check their findings, they included nine additional children with cloudy corneas from non-glaucomatous causes. Even through the haze, the TM structure appeared in all nine, ruling out glaucoma in each case.1
The study also confirmed what’s already known anatomically: glaucomatous eyes tend to have deeper anterior chambers. Measurements like angle opening distance (AOD) and angle recess area (ARA) were consistently larger in affected eyes.1
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Promise (and practical limits)
Traditionally, diagnosing early-onset glaucoma requires anesthesia—hardly ideal when the patient is barely walking, let alone consenting. If this new approach pans out, clinicians could have a much safe, swifter option in the exam room.
SS-ASOCT has a few technical perks that make it well-suited for pediatric patients. Its longer wavelength (1310 nm) lets it see deeper into tissue, and its rapid speed (50,000 A-scans per second) helps minimize the need for stillness, which, as any pediatric clinician knows, is in short supply.1
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In an accompanying commentary, Dr. Silvia Groth and Dr. Rachel Kuchtey praised the technique’s potential but offered a dose of realism, saying, “The imaging staff needed for the flying baby technique may not be available in all settings,” and SS-ASOCT “is not widely in use.”2
Study authors acknowledged the method’s current limitations—namely the small sample size and its focus on clear-cut cases—but said larger studies are in the works. They also flagged a few conditions (like congenital hereditary endothelial dystrophy and Hurler syndrome) that might muddy the diagnostic waters over time.1
Still, for clinicians, this study offers a glimpse of a less invasive, more accessible way to diagnose a potentially blinding disease. If confirmed in future research, SS-ASOCT might just let providers catch childhood glaucoma earlier, and more comfortably, for everyone involved.
Editor’s Note: This content is intended exclusively for healthcare professionals. It is not intended for the general public. Products or therapies discussed may not be registered or approved in all jurisdictions, including Singapore.
References
- Kaushik S, Singh AK, Thattaruthody F, et al. Utility of Swept-Source Anterior-Segment OCT as an In-Office Biomarker for Early Childhood Glaucoma. JAMA Ophthalmol. 2025:e251009. [Online ahead of print.]
- Groth SL, Kuchtey RW. Flying Babies and Swept-Source OCT-An Innovative Technique to Detect Childhood Glaucoma. JAMA Ophthalmol. 2025 May 22. [Epub ahead of print.]
