Cataracts | Overview
Cataracts | Diagnosis & Treatments
How are cataracts diagnosed?
To diagnose a cataract, your child’s doctor will perform an eye exam any may run some tests, including:
- dilating your child’s pupils with eye drops to examine the back of the eye
- an ultrasound to look in the back of the eye
What are the treatment options for cataracts?
Depending on the size of the cataract, treatment may involve patching the eye or surgery. Each child and cataract is different, but a general rule is that the older the child, the less urgent it is that the surgery be done right away. This means that some cataracts can be managed without surgery for months or years.
Children born with a dense cataract will need surgery to remove it as soon as possible. If the cataract isn’t removed, it can block light from getting to the retina (the back of the eye) and prevent the retina from sending visual information to the brain. If this happens during the development of sight, the brain may never learn to see, even after the cataract is removed.
Patching
If the cataract is only a tiny dot on the lens, the lens may not need to be removed. Instead, the doctor may recommend simply placing a patch over the “good” eye, and possibly having your child wear glasses or contact lenses. Patching the unaffected eye forces the eye with the cataract to develop better vision.
A patch is an adhesive covering that completely blocks the eye. They are available in fun, kid-friendly designs. Typically, the patch is worn anywhere from one hour a day to fifty percent of waking hours.
Patches are also commonly used after cataract surgery, to help the eye that had the cataract “catch up” to the other one. Your child’s doctor will determine if this is necessary.
Surgery
During surgery, a small incision is made in the eye and the cloudy lens is removed with a special instrument.
Your child may have the lens replaced with a clear, plastic permanent lens, called an intraocular lens, during the surgery. But this type of lens isn't always an option for children. This is because lens implants in young children are more likely to cause complications and it can be hard to determine the best lens power to use in a young child's eye that will also serve them best as an adult.
Most children who don’t have a lens implanted during surgery are fitted with specialty contact lenses a few days later. In some cases, this is a temporary solution used until it's time for intraocular implants. In other cases, the contact lenses work great and there's no need for more surgery.
Cataracts | Frequently Asked Questions
Why must my baby's cataract be treated right away?
An eye with a cataract can’t provide visual information to the brain. If this occurs while the brain is “learning to see,” it may learn to ignore that eye. And since vision occurs when the brain and the eye work together, your child may never be able to see with that eye, even if the cataract is eventually removed.
Do all cataracts need to be removed?
No, in some cases, the cataract may be just a dot in the middle of the lens that doesn't have to be removed because there’s room for light to get around it. Sometimes figuring out whether a cataract needs to be removed requires lots of experience and expertise, so it’s crucial that your child be evaluated by an eye doctor who sees many babies and children with cataracts.
Will my child require ultrasonography to break up her lens before it can be removed?
Probably not. Ultrasounds are used in cataract surgery for adults to break up hard lenses that are usually caused by aging. Most children don’t need ultrasound because their lenses are soft.
Do all cataracts affect vision?
No – sometimes a cataract may be so small that your child perceives no blurriness at all. But one thing to keep in mind is that unlike your circulatory or respiratory system, your experience of your visual system completely depends on how you use it.
Will my child’s cataract get worse?
This is hard to predict – some cataracts progress, and some don’t. And sometimes a child’s vision might seem like it’s starting to worsen because their visual needs are changing, even if the cataract itself isn’t changing.
Can cataracts be prevented?
Not really, although it’s important that kids wear eye protection when playing sports to lessen the chance of eye injury.
Are intraocular lenses noticeable?
Most often, the implant is invisible. Some parents say that the eye with the implant seems to have a “sparkle” or “glint” if light catches it just right, but that certainly doesn't cause any problems for your child.
Will my child need to wear glasses?
Most children will need to wear glasses after intraocular lens implants. Natural lenses can shift focus from far to near, but intraocular lenses can only focus on one place. Once children can sit up, they may need bifocals to help them focus up close and far away. If your child has been prescribed reading glasses or bifocals, they might not need to wear them all the time.