A cataract is cloudiness on the lens of the eye. The lens is found behind the iris, it’s transparent and its role is to focus the light rays on the retina. The retina absorbs the light rays and passes the stimulation to the brain, which reads the image. When the lens is clouded, it prevents the light rays from focuses on the retina, causing blurry images. It is more severe when this happens during childhood. This cloudiness can severely impair a child’s visual development.
Symptoms include blurry sight, strabismus (cross-eyed), nystagmus, inability to focus or follow, white reflexes in the iris. To confirm the diagnosis, the ophthalmologist will use a slit lamp.
Why do children get cataracts?
Cataracts among children can be congenital or as a result of an infection in the uterus, a metabolic defect or similar. In most cases, the exact cause of the cataract is unknown. If the child is a little older when he develops the cataract, it may be the result of an injury, or a later manifestation of a hereditary disease.
A cataract can present mildly or severely. If it presents severely, it threatens the proper development of the child’s sight and requires immediate medical attention. The younger the child, the more urgent the medical attention.
Treatment of cataract
Treating a cataract is a lengthy process and takes years. Treatment is divided into three stages: diagnosis, surgery and post-surgical treatment.
Diagnosis of cataract
After diagnosing the cataract, the main thing doctors look at is the extent of the cloudiness. Age is also an important factor, as is the involvement of one or both eyes. Surgery may cause children to lose their far-sightedness.
The cataract surgery
The pediatric ophthalmologist performs advanced laparoscopic surgery to remove the lens from the eye. The surgery is done under general anesthesia. As with all surgeries, it is important to understand the risks and possible complications.
The natural lens is very powerful. After removing the cataract, the child will require optical repair to refocus the light rays on the retina. The repair methods are glasses, contact lenses or Intraocular Implants (IOL).
Glasses are a safe and easy optical repair method for children, especially those who’ve had cataracts in both eyes. The lenses in these glasses are generally a high number, and are very thick. When the child isn’t wearing the glasses, his vision is very blurry, so he needs to wear them all the time. A child who had a cataract in only one eye cannot wear glasses and will either need IOLs or contact lenses. The natural lens of the eye enables a person to see all different distances – it’s very flexible. Therefore, the child can wear either multifocal glasses or bifocal glasses.
Special contact lenses can be made specifically for children who’ve undergone cataract surgery. Most lenses are hard. Finding suitable lenses usually takes more than one appointments. Lenses need to be worn every day and need to be taken out every night before the child goes to sleep. The lenses may need to be switched every once in a while due to the child’s development.
IOLs act as replacements for the natural lens that was removed during surgery. This lens can be implanted during the cataract surgery or at a later date. IOLs are fitted so that they will grow based on the child’s projected growth. The child will need glasses in order to see far distances. The surgery is especially suited for children who had cataracts in only one eye.
Cataracts can cause lazy eyes among children. While baby’s brains are developing, it is important for the brain to receive the image from both eyes. If not, than one eye will not develop properly, causing a lazy eye to develop. Treating a lazy eye can take a number of years.
For more information, please call the Center for Pediatric Eye Diseases, +972-2-6776397