Cataract
Cataracts in Children
A cataract is a clouding of the
eye's normally clear lens. The lens of the eye plays an
important role in focusing images on the retina, the
light-sensitive nerve cells lining the back of the eye.
If the lens loses its clarity, light rays do not focus
clearly and vision is blurry. Just as it is hard to see
through a dirty window, it is hard to see through a
cataract. Although most cataracts occur in older adults,
they can appear in children, in one or both eyes, often
at birth. They look like a white or gray spot in the
pupil.
Cataracts in children may be inherited or develop
because of an infection or a disease acquired before
birth, or as a result of an injury. In most cases, no
specific cause is found.
Children may lose vision permanently because of
amblyopia (lazy eye) if a severe cataract is not removed
quickly. The better eye may also need to be patched.
Mild cataracts may not need treatment.
The focusing power of the original lens, removed during
cataract surgery, must be replaced to restore vision.
Intraocular lenses (IOLs), permanent plastic lenses
placed inside the eye, are implanted in older children
much as they are in adults. In infants, IOLs are
controversial because the eyes grow and change their
prescriptions during the first few years of life. Many
surgeons prefer contact lenses or even glasses for
younger children.
Regardless of the type of correction, children need
follow-up exams to avoid possible complications,
including glaucoma, scar tissue forming in the pupil,
and amblyopia. Often, children will need eye muscle
surgery because the eye turns or crosses.
Despite these problems, cataracts are the single most
treatable cause of childhood blindness. After surgery,
most children can see the blackboard in school
(20/60-20/100). While some do not do as well, with
appropriate correction, many children see almost
normally. |
Phacoemulsification (Phaco)
A cataract is a loss of
transparency, or clouding, of the normally clear lens of
the eye. As one Phacoemulsification is a surgical method
used to remove a cataract, which is a clouding of the
eye's naturally clear lens. A cloudy lens interferes
with light passing through to the retina, the
light-sensing layer of cells at the back of the eye.
Having a cataract can be compared to looking at the
world through a foggy window.
In phacoemulsification, an ultrasonic oscillating probe
is inserted into the eye. The probe breaks up the center
of the lens. The fragments are suctioned from the eye at
the same time. A small incision that often does not
require sutures to close can be used since the cataract
is removed in tiny pieces. Most of the lens capsule is
left behind and a foldable intraocular lens implant, or
IOL, is placed permanently inside to help focus light
onto the retina. Vision returns quickly and one can
resume normal activities within a short period of time.
|
Posterior
Capsulotomy
A posterior
capsulotomy is a surgical laser procedure that may be
necessary after cataract surgery.
During cataract surgery part of the front (anterior) capsule
that holds the lens is removed. The clear back (posterior)
capsule remains intact. As long as that capsule stays clear
one has good vision. But in 10 to 30% of people, the
posterior capsule loses its clarity. When this happens, an
opening can be made in the capsule with a laser (posterior
capsulotomy) to restore normal vision.
Before the laser procedure, the ophthalmologist does a
thorough ophthalmic examination to make sure there is no
other reason for vision loss.
A posterior capsulotomy is painless and takes five minutes.
Eye pressure is taken a half hour after the operation to
make sure it is not elevated and antibiotic drops are
usually prescribed for three days following the procedure.
Vision should improve within hours.
Potential but rare complications following laser posterior
capsulotomy are increased intraocular pressure and retinal
detachment. |
