Why is it
important to treat childhood cataract early?
The presence of cataract in a child does not let the eye get proper
visual stimulus to develop. This prevents the normal development of the
eye, especially if the cataract is present in only one eye. This
condition is known as
amblyopia or
lazy eye. Therefore it is important to treat this condition at the
earliest to prevent and to treat amblyopia.
What are the methods of treatment for
childhood cataract?
The treatment options are:
- No surgery with periodic follow up
- Cataract removal without intraocular lens implant
- Cataract removal with intraocular lens implant
What factors decide the treatment
option and the timing of surgery?
The treatment option and the timing of surgery will be decided by the
ophthalmologist, based on the following factors:
- Age of the child
- Density of cataract
- Whether cataract involves one eye or both eyes
If the cataract is not very dense and the child is able to see through
it, then the surgery may not be required or it may be deferred till the
child reaches a age where a cataract surgery with lens implant can be
done safely.
Generally the lens implantation is not preferred in a child below 2
years of age because these eyes are still in growing stage, moreover
there is a tendency for severe inflammation (uveitis) in these young
children and the chances of aftercataract (opacification of the capsule
of lens) is almost 100%.
Cataract involving only one eye has to be treated more urgently because
the chance of
amblyopia is
greater in these cases.
What are the complications of surgery?
Cataract surgery is very safe, but as in any surgery, complications are
possible. There is a very small risk of serious bleeding or infection
after the surgery. If a lens has been implanted, there is a very high
chance of aftercataract formation, which may require laser treatment or
even a small surgery. Even years after surgery, related eye problems
such as retinal detachment can develop and threaten sight. For this
reason it is very important to have a regular follow up even after the
surgery is done. To examine the eye properly in an uncooperative young
child after cataract surgery, the ophthalmologist may occasionally give
sedative medicine or even general anesthesia.
What to do after surgery?
The care of the eye after surgery is the most important part of
treatment. As we remove the lens of the eye, the refractive power of the
same has to be compensated in some form to enable the eye to see
properly. Also, because the lens is not there, the eye can not change
the power for near work (
accommodation).
For this reason, the child will require to wear an additional near
addition (like in presbyopia) for doing near work. The various options
available for this purpose are:
- Glasses
- Contact lens
- Intraocular lens implant
The advantages of glasses are that they are very convenient and
simple to use and there is no chance of harming the eye. The
disadvantages are that they are very thick and heavy, and the child
(especially teenagers) may not like to wear them because of poor
appearance and because it hampers in sports. Moreover, they are
unsuitable for children who have cataract in only one eye, because the
vision from the two eyes cannot be properly combined in the brain, when
one eye focuses in the normal way and the other looks through a very
strong spectacle lens.
Contact lenses provide both vision and appearance that is normal. But
the main disadvantage is that they have to be properly cleaned and
maintained, or else there is a small risk of infection. It may be
difficult to place them in the eye and to remove them for cleaning
especially in small children between 1 to 5 years of age. Also the
chances of losing the contact lens is also very high in this age group.
Intraocular lenses are a very good option, as they do not require any
maintenance. But these are not preferred in children below 2 years of
age. They also have a higher chance of developing aftercataract.
The best form of visual rehabilitation for child is a very complex
decision and the ophthalmologist will decide after discussing these
issues with the parents.
Amblyopia therapy: In some cases
of cataract in children below 5-6 years of age, especially in those
where only one eye is involved, the child may have to be treated for
amblyopia.
Cataract Intro ||
FAQ-Cataract ||
Surgeries for Cataract ||
Phacoemulsification
What happens during Surgery? ||
Post-operative care ||
Complication of Cataract
Surgery 
