Paediatric Cataract

Super-speciality centre for treatment of cataract in children in Navi Mumbai

Best centre for treatment of Cataract in Children in Navi Mumbai

 

Paediatric Cataract

Cataract-in-children-in-navi-mumbaiI did not know that even children can get cataracts?!!

It is indeed uncommon for a baby to get a cataract, but it does happen. The difference is that in kids, the lens clouds over because it didn’t form properly. In adults, a normal lens just gets old and hard and yellow and finally clouds over. If you think about it, and especially if you learn how the eye develops before birth, it’s amazing that anyone ever ends up with a crystal clear lens in each eye. The process of lens formation is an intricate and miraculous ballet of cells that takes place early in the third to fourth month of pregnancy. Anything going wrong during this period of lens formation can lead the lens to become opaque.

Why did my child get cataract?

Congenital (present at birth) cataracts occur when the lens didn’t form properly. Acquired cataracts are caused by abnormal interactions among the proteins that make up the lens. Over time, these abnormal interactions cause clumping, specks, opacities and/or cloudy areas to form.

About 25 percent of the time, congenital cataracts have a genetic cause, and may accompany a metabolic, hormonal or chromosomal abnormality (e.g., Down syndrome).  Another 25 percent of the time, cataracts are hereditary, which means that the child’s mom or dad also had a cataract in childhood.

Acquired cataracts can be caused by trauma to the eye, use of steroids over a long period, diabetes or other metabolic diseases, long standing inflammation of the eyes (uveitis) or radiation therapy after cancer.

Often no reason can be found for the development of the cataracts.

Is there a way other than the surgery to correct the cataracts?

Every case is different, and our pediatric ophthalmologist comes up with creative solutions to fit each child. Sometimes, if the cataract represents a tiny dot on the lens, the doctor might recommend placing a patch over the unaffected or strong eye, to help strengthen vision in the affected eye, maybe with glasses if the focus is off. In other cases we use eye drops or contact lenses to dilate the pupil enough to get more light in but still keep the eye in focus. Either way, your child will be routinely monitored, to be sure that vision isn’t slipping. Only if the opacity is the lens is significant enough to cause a reduction in the vision, surgery would be required.

What is the best time to get the cataracts operated in children?Cataract-in-children-in-navi-mumbai

If your child is born with a dense cataract, we would like to remove it within the first two months of life, and definitely by four months. Often, the sooner we take the cataract out, the better the vision your child will be able to develop afterwards.

Will the doctor be implanting a lens in my child’s eye after removing the cataract?

In adults, surgically inserted intraocular lenses are used routinely in cataract surgery. In children, these lenses aren’t always an option for several reasons. A child’s growing and developing eye is much more aggressive about rejecting foreign invaders than an adult eye. So lens implantation in young children is more likely to cause complications such as inflammation. The other difficulty is determining what lens power to use in a young child’s eye that will be useful now and 20 years from now in adulthood.
Presently, intraocular lenses have been successfully implanted in babies as young as 6 months old. Our doctors are on the forefront of latest surgical techniques that have improved tremendously in recent years. The incisions are smaller, so there is less trauma and disruption to the eye during surgery. However, because of the potential complications mentioned above and the difficulty in predicting lens power in young babies, not every child is a candidate for a lens implant.

Our doctors will discuss the pros and cons of lens implantation with you and will determine whether or not a lens implant is appropriate for your child at this point in time. In some cases, the doctor will recommend waiting until your child is older and using contact lenses or glasses in the meantime. Our doctors at Utsav Eye Clinic, Kharghar have implanted intra-ocular lenses in babies as young as 6 months in cataract in children in Navi Mumbai.

Will my child require to wear glasses even after cataract surgery?

Usually glasses are needed to perfect the focus. We often have to leave the eye a little farsighted at first to allow for the eye to grow. Also the formulas, while quite exact, can never predict the final power of the eye perfectly. So a lens is added to promote the best possible vision development. One other thing – natural lenses adjust to shift focus from distance to near, but plastic intraocular lenses are going to focus at one place. They cannot shift focus, so once children are able to sit up, we tend to put them in bifocals. These glasses will help your child focus up close and far away.

My 70 year old father underwent his cataract surgery the last month. It seemed to be a pretty simple affair. I hope it is going to be the same for my child too.

Cataract surgery in adults is very different from that in children. In general, it will not be wrong to say that cataract surgery in children is far more complex than in adults.

In adults, timing of cataract surgery won’t affect vision over the long-term, but in babies delaying surgery can mean permanent vision loss. That’s because when a cataract forms, the lens isn’t focusing light for the brain and the brain, in turn, gets no visual experience. The brain is deprived of images during the critical time when it is supposed to be learning how to see. If the brain continues to get no input from the affected eye, it may completely ignore the eye and never learn to pay attention to it.
Also, children’s eyes are growing eyes. They tend to re-act more aggressively to the surgical trauma as well as to the “foreign” plastic intra ocular lens. Hence they need to be put on aggressive anti-inflammatory eye drops for a longer period of time. The calculation of the power of the Intra-ocular lens to be implanted too needs to be judiciously decided for the same reason.

Most children need to be seen by the doctors for a much longer period of time after the surgery. During these visits, the glasses power, the pressure of the eye and the clarity of the visual axis has to be assessed.

To read more about surgery for cataract in children, click here…..