If your child was recently diagnosed with cataracts, you probably have a lot of questions, from wondering about the cause to having concerns about vision later in life. Consulting with a qualified optometrist is a good way to address your concerns, but in the meantime, here's what you need to know to put your mind at ease.
1. It isn't your fault
Whether your child was born with cataracts or they developed a little later in childhood, you shouldn't blame yourself. About 50% of the time, cataracts can be attributed to either a congenital birth defect or heredity. For instance, if you had cataracts as a child, or the father did, your child has a greater risk of developing cataracts as well. Congenital problems that can cause cataracts include genetic conditions like Down syndrome, congenital rubella, Lowe syndrome, and other uncommon birth defects.
Approximately 40% of the time, cataracts can be attributed to trauma like a blow to the eye while playing sports, during a fight, or when involved in a car accident. Other types of "trauma" include chemicals or sharp objects penetrating the eye and radiation.
On some occasions, your child's doctor won't be able to determine a cause for the cataracts, and they will be known as idiopathic.
2. Surgery may not be necessary
To fully understand why surgery may not be indicated in your child's case, it's important to understand why it would be necessary.
In order to have healthy vision, light has to hit the retina, which lines the innermost surface of the back of the eye. If anything obstructs light from penetrating the eye, the brain is unable to form a clear image and tell you what you're seeing. If your child's cataract is small enough that light is still able to enter, or if it is off center from the lens, the optometrist may say that surgery is not necessary. However, regular visits to the doctor will be recommended so that the cataract can be closely monitored for changes down the road.
An anterior polar cataract is a perfect example of a type of cataract that often can be managed without surgery. There are several subtypes of anterior polar cataracts, some of which are small white dots that appear at the center of the lens and rarely grow. Others are also small but appear away from the center of vision, therefore still allowing light to enter the eye. These rarely impact vision and don't always require surgery.
3. If surgery is recommended, it's generally very safe
If your child's doctor recommends surgery, the benefits usually outweigh the risks. When performed by a surgeon that is skilled, the procedure itself is pretty safe. Skipping the surgery because you're worried about infection or other complications are actually riskier.
When some cataracts go untreated, they interfere with your baby's ability to see, and the vision system—which involves the eyes and the part of the brain that processes images—isn't able to develop normally. As a result, your child will likely have vision problems down the road, and possibly develop glaucoma, even if the cataracts are removed at a later date. That's why it's important to follow the recommendation of the doctor and allow your child to have surgery as early as possible. This is sometimes done in as little as 3 days after birth. Having the surgery done as soon as it's recommended gives your child the best chance at developing normal vision.
4. Your baby may or may not need glasses
If your child has surgery, they may or may not need glasses afterwards. Most of the time, glasses are not recommended in young infants or in children with a cataract in only one eye. The doctor may instead recommend contacts or the placement of an IOL (intraocular lens). Some surgeons will recommend the placement of an IOL to improve your baby's vision because of concerns that the contacts may not stay in place. Or the parents may express concerns about being able to handle putting in the contacts on a regular basis.
Other surgeons prefer to put in IOLs in older children as they are better able to communicate how well they can see. Having a candid discussion with an eye surgeon at a clinic like Discover Vision Centers is a good place to start when making a decision about what's best for you and your child.