A cataract is a clouding of the lens of the eye. When a child has a cataract, the lens cannot focus the rays of light onto the retina normally. Instead, the lens produces blurry images, which reduce the child’s vision. If the cataract is more serious, the child will need surgery to remove it. Cataracts cannot be removed with medication or lasers. Surgery is important because it will allow the child’s vision to develop as normally as possible. After surgery, the child will need a corrective device such as a contact lens, intra-ocular lens, or, eye glasses. The child may also need to wear a patch to help both eyes develop equally strong vision.
Causes of cataract
- Hereditary (inheriting a cataract from a parent)
- Illnesses or conditions
- Genetic (Down syndrome, trisomy 13/15)
- Metabolic (Lowe syndrome, galactossemia)
- Infections (Rubella, CMV, HSV, Toxoplasmosis)
- Trauma (injury) to the eye
- Radiation (treatment for cancer)
In many cases, however, the cause of a cataract is not known
What happens during cataract surgery?
Before the surgery, your child will have special drops to dilate (widen) the pupil of the eye.
Your child will have a special “sleep medicine” called a general anaesthetic for the surgery. This will make sure they sleep through the operation and do not feel any pain.
The surgeon takes out the cataract by removing the lens of the affected eye(s).
The surgeon will use special stitches to repair the eye wound. These stitches are absorbable and will dissolve on their own over the first six to eight weeks after surgery.
In young children with cataracts in both eyes, surgery is often done on the second eye as soon as possible after the first eye. This is to make sure that the vision in both eyes develops evenly.
The operation is usually done as a day surgery if your child is over 18 weeks old. If your child was born prematurely or if the surgery is within the first 18 weeks of life, they will usually stay in the hospital for observation overnight.
What to expect after the surgery
Eye patch and shield
Immediately after surgery, an eye shield will be placed over the operated eye for protection. Your child will continue to wear the shield over the operated eye to protect it while they are sleeping. Your doctor will tell you when your child can stop wearing the shield.
Redness, swelling, and discharge
The operated eye will be red and slightly swollen after the surgery. It will also produce a clear discharge. These should decrease over the next few days.
Without the lens, your child’s eye is no longer able to focus clearly. Objects will be very blurry at first until your child receives a corrective device to improve their vision.
How to care for your child after cataract surgery
Antibiotic and steroid drops
The doctor will order a combination of antibiotic and steroid drops for the operated eye(s). It is important to ensure that the drops are administered according to the doctor’s instructions.
Long-term effects of cataract surgery
Scar tissue or slight cloudiness
Cataracts do not re-appear after surgery, but sometimes the lens capsule may develop scar tissue or slight cloudiness. If this happens, your eye doctor will explain how it will be treated.
Other eye conditions
Even after patching, and being fitted with a corrective device, your child may develop other eye conditions after surgery. These include strabismus, inflammation (irritation or swelling), glaucoma and retinal detachment.
You will need to take your child for regular check-ups to let the eye doctor monitor your child’s vision closely and check for any of these conditions as early as possible. It is important to keep all your follow-up appointments.