Docyard | Watch your child’s eye

Dr Jitendra Jethani is MS, DO, DNB, FNB, FAICO & Medical Consultant at ENTOD International

Cataracts are normally associated with adults and that too elderly. However, this is not true. Children may also have cataracts and to add to this even the new borns may also have cataract. Contrary to popular view, these children are at a high risk of poor vision due to cataract because it may stop the development of the vision itself.

Development of vision in our eyes takes place rapidly in children especially in infancy and continues till the age of six-eight years. Any loss of vision due to causes like cataract, glasses etc. can lead to reduced development of the vision itself which is also known as lazy eye or amblyopia. Amblyopia can be treated only till a certain age and therefore managing cataract in children is semi urgent, specialised job and most importantly a long term association with the pediatric eye care specialist.

The lens of the child’s eye has a clouded region called a cataract. It may create hazy or even obscured eyesight if it is big or thick. The child may have a cataract in just one eye (unilateral) or in both eyes (bilateral). The majority of kids who have cataracts in just one eye have normal vision in the other but this reduces their chance of having a good vision in the affected eye.

Cataracts are present at birth in some newborns, while others develop them in the first six months of their lives. A congenital cataract occurs when a newborn is born with a cataract. The term infantile cataract refers to a cataract that develops in the first six months of a child’s life. It is important to understand that cataracts can be present since birth due to the problems during pregnancy especially in the first trimester. The lens and eye develops in the first six weeks of the embryo/foetus and any problems during this time like rubella infection can lead to congenital cataract. However, children may have developmental cataracts also which occur at a later date.

Depending on how hazy the lens is, where the cloudiness is in the lens, and whether one or both eyes are afflicted, the symptoms of paediatric cataracts might vary. It might also be difficult to detect indications of cataracts in your kid when he or she is young.

The following are signs that your kid may have cataract:

• You may notice that your youngster has difficulties recognising and tracking things or people with their eyes due to impaired eyesight.
• Nystagmus is a condition that causes fast, uncontrollable eye movements or ‘wobbling’ eyes which is a symptom of cataract.
• Your child may have a squint eye which is when the eyes point in separate directions.
• A white or grey pupil — this might be an indication of something more dangerous, such as retinoblastoma, and should be checked by a doctor immediately.
• Your child may have trouble seeing clearly in flashy bright light or when there is glare.
• Children with cataracts may also be extremely sensitive to light.
• If your kid has cataracts, they may try to view things by holding them near to their eyes.
• The management is urgent and time bound. Unlike adult cataracts, the treatment begins once the surgery is done. The child would need glasses and treatment for amblyopia after cataract surgery. Treatment for cataracts in children aims to:
• Maximize and improve your child’s visual development.
• If there is an underlying reason, to find it and cure it.

Treatment for cataracts is determined by the size, severity, and location of the cataract-caused lens clouding.