I still remember, the year 1999 when parents of a 2-year-old noticed some unusual visual behaviors. Their daughter shut her eyes tight in bright light, covered her eyes with toys and was unable to recognize faces from far. Her parents, vexed by her behavior, brought her to the hospital to find the reason.
After detailed diagnosis, I, with a team of doctors understood that she had Cataract in both her eyes. Parents could not believe the fact, “How can such a small child have Cataract! Is it not a condition seen in elderly people?” We explained Cataract by birth, developmental cataract due to metabolic disorders, intrauterine insult, nutritional factors, etc.
But the parents were still in disbelief. So, we had to explain what is a cataract and how even children get a cataract. To understand that, we first need to know how our eyes function.
Our eyes are like a camera. They captures images. These images are then transported to the vision center in our brain where they are processed. As a result of this, the eyes recognize the object. This is known as the visual pathway. A clear lens performs the function of focusing the image on the retina. The condition wherein this lens becomes cloudy is called Cataract.
In an Adult with Cataract, surgery with an intraocular lens implant restores vision immediately, since the vision is already developed during childhood. In adult eyes, surgery maybe postponed for a while, but for a child having a cataract, immediate surgery is the need of the hour. There is no other cure to cataract than surgery. No eyeglasses, medicines or dietary supplements can either reduce or cure the cataract. For a child, early surgery is crucial. The reason is because a large portion of our vision as adults develops during the first 6 months of life, and most of it is done by the time a child turns five.. And for vision to develop, a clear visual input from the eyes to the brain is required.
A child with Cataract cannot capture clear images. Thus, blurred images are then transported from the cataractous eye to the vision center in the brain, This prevents normal development of vision in a child. The problem is that once the critical age of the first few years has passed, then later, even removing the cataract cannot improve the vision beyond a certain extent. Hence, it becomes critical to remove cataract at the early age and either implant an artificial intraocular lens or provide corrected glasses to allow vision development.
At times, parents ignore early symptoms or rationalize that the child is young to operate. What they do not realize is that delay in surgery causes a delay in vision development. This results in a lazy eye or permanent blindness.
Therefore, it is very important that an infant’s eyes be examined within the first month of life. In fact, in countries such as Sweden, it is mandatory for a newborn infant to be examined by an ophthalmologist within the first 30 days of life.
Pediatric Cataract surgery requires a very dedicated and specialized team of skilled professionals. It is a collaborative team effort of an the pediatric cataract surgeon, anaesthesiologists, optometrists, low vision specialists for vision rehabilitation. However, no pediatric surgery can be successful without cooperative parents.
Having understood all this, the parents gave their consent for her cataract surgery.
Today, after 16 years, she is a normal 18-year-old pursuing graduation. Her parents, despite living in another city, had made it a point to come for the half yearly check-ups. We measure her eye growth, check for corrections in her glasses, look for abnormalities like glaucoma, visual axis opacification etc. But, it is the nostalgia and that bond, that we have made with her which is hard to express in words. She was one of a kind patient and now we are proud to say that she is a healthy and happy young lady with normal vision.
This story is a result of the great teamwork which has cemented a lifelong bond.