**Core Concept**
Buphthalmos, also known as infantile or congenital glaucoma, is a condition characterized by increased intraocular pressure (IOP) in young children, often resulting from abnormalities in the development of the anterior chamber or trabecular meshwork. The primary goal of initial treatment is to reduce IOP and prevent further damage to the optic nerve and surrounding ocular tissues.

**Why the Correct Answer is Right**
The initial treatment of buphthalmos typically involves medications to decrease IOP, such as topical beta-blockers (e.g., timolol) or carbonic anhydrase inhibitors (e.g., acetazolamide), which reduce aqueous humor production. Another key treatment is topical or systemic corticosteroids to reduce inflammation and edema in the anterior chamber. These medications help alleviate symptoms and slow disease progression until more definitive surgical interventions can be performed. In some cases, miotics (e.g., pilocarpine) may be used to increase aqueous outflow.

**Why Each Wrong Option is Incorrect**

**Option A:** This option is incorrect because it is too vague and does not specify a treatment approach. Buphthalmos requires targeted interventions to reduce IOP and address underlying pathology.

**Option B:** This option is incorrect because it suggests a surgical approach as the initial treatment. While surgery is often necessary in buphthalmos, it is typically reserved for after medical therapy has been attempted to reduce IOP.

**Option C:** This option is incorrect because it implies a single medication or treatment approach, which is not sufficient for managing buphthalmos. A comprehensive treatment plan often involves a combination of medications and potentially surgical intervention.

**Option D:** This option is incorrect because it does not specify a treatment approach or medication that is commonly used in the initial management of buphthalmos.

**Clinical Pearl / High-Yield Fact**
In cases of buphthalmos, it is essential to monitor IOP regularly and adjust treatment as needed to prevent optic nerve damage and vision loss. Early recognition and treatment of this condition can significantly improve outcomes and preserve vision.

**Correct Answer: B. Topical beta-blockers or carbonic anhydrase inhibitors.**