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Cataracts in Children

Management of Cataracts in children is a whole different world than cataracts in adults. While technically still called "Cataract" , assessing , anticipating , operating , improvising and managing cataracts in children and then managing the visual outcomes in children is a huge deal.

Dr.Daljit Singh Eye Hospital has been dealing with Cataracts in children for more than 35 years. 

In many instances we have had the opportunity to treat several children of the same family suffering from congenital cataracts . In some families , we have treated patients spanning three generations , suffering from same kind of congenital cataracts.

 

What are the types of Cataracts in Children ?

There are two broad types of cataracts in children

1. Cataracts caused due to injuries.

2. Congenital Cataracts (acquired by birth)

 

Are the cataracts in children any different than adults ?

While they share the same common name "Cataract ", the presentation of Cataracts in childhood is immensely varied in form and structure. The congenital cataracts may be :

Zonular Cataract

Mature Cataract

Peripheral Cataract

Blue dot cataract

Membranous absorbed cataract

Cataract associated with Persistent hyaloid blood vessels

Cataract with thick capsular membranes

Cataract with a pre-existing hole in the posterior capsule

Cataract with Microcornea

Cataract with Megalocornea

Microspherophakia 

Subluxated Cataracts in Marfan's Syndrome

Congenital cataract with stony hard elements 

..........just to name a few

 

Every different type of cataract challenges the doctor to showcase his skill , experience and ingenuity.

 

What type of anaesthesia is used while operating on children with Congenital Cataracts ?

All children with cataracts are operated under General Anaesthesia by a team of expert Pediatric Anaesthesiologists. The latest anaesthesia equipment and the safest agents are used for the children.   

 

Are both eyes operated at the same time ?

We operate only one eye at a time . The second eye is operated after a minimum period of 1 month.

 

Is an Intraocular Lens implanted during cataract surgery in children ?

Yes . An Intraocular Lens is implanted during surgery for cataracts in children .

 

Does the lens need to be changed when the child grows up ?

Generally if the lens is implanted well and if the recovery has gone well , the lens stays in place for the entire life of the child.

 

Does the child need to wear glasses after Cataract surgery ?

Yes. Most children would need to wear glasses after cataract operation and intraocular lens implantation. The spectacle power may undergo changes as the child grows up , which may need frequent changes in the glasses. When the child crosses the age of 18 years , Lasik Laser treatment may be used to even out any high spectacle numbers. Even after that some form of glasses may still be needed.

 

What are the visual results after surgery for cataracts in children ?

While the operation of cataract in children is a very important event , visual rehabilitation with glasses and vision stimulating processes is an equally important part of rehabilitation of children operated for cataract and lens implantation. The parents have to work very closely with a pediatric ophthalmologist who then looks after these children for many years .

Visual results in children are quite gratifying , though results vary from child to child. 

 

At what minimum age should a child be opearted for cataract ?

For a fact , children with congenital cataracts should be operated as soon as possible . Average age of surgery in children is about the age of 7 months, though experts share widely varying opinions. Inadvertant delay may affect post operative visual improvement .However , there could be constraints regarding challenges in administering general anaesthesia in extremely young children . Hence children with extremely opaque cataracts may be operated earlier than children with incomplete cataracts.