Thursday, 31 January 2019

Can you please talk a bit about Cataract, Children and Treatment.


Can you please talk a bit about Cataract, Children and Treatment.

There is a clear lens hanging in the eye, when this lens gets dirty it is called cataract, and the lens has to be changed.
Imagine a window, when it gets dirty, this simple process prevents you from seeing things clearly, you have to replace the window.

Now Cataract is usually an age related problem.
Hence seen in Children in a very small percentage.
But when seen in Children it is a Medical Emergency.

If this is not treated urgently, and with utmost knowledge and precision, it will surely lead to Weak eyes, Blind Eye, Squint, Glaucoma and many other problems.

The first step of treatment of Cataract is removal of the cataract.
In the past it was deferred to a further age as the Anaesthesia and its equipment for very small babies could not guarantee the safety of the childs life. Not so now. Therefore Cataract removal is taken as soon as Pediatrician gives clearance.

The further treatment plans may differ depending upon age and eye size of the child :
Lens to be implanted or at a later date.
Treatment with glasses, follow up every 4 months.
Contact lenses.
Glaucoma surgery.
Glaucoma treatment.
Eventually Lens implantation.

Yes the journey will be long.
But the Child will get back very good workable vision.
Your Pediatric Ophthalmologist will be with you all through this journey.


MYOPIA


What is myopia ?
It is a Refractive error of the eye which is corrected by minus number glasses (eg -2.25 D spherical).
In very layman terms, near objects are seen clearly and distant objects , or things far away are seen blurred.

What is the best treatment ?
Myopia can  easily and commonly corrected with (a) glasses (b) contact lenses. There are also newer surgeries for Myopia but they have to be taken up only after a certain age of the patient , after thorough assessment and after reviewing the side effects.

How does age affect myopia ?  or
Why do numbers increase ?
Normally every one is born with a little plus (+) numbers and as we grow (till  10-12 years) due to changes or growth in the eye this becomes zero (emmotropia).
But suppose you are detected with minus numbers (myopia) at age 4-10 then these numbers will increase till you grow to 18-21 years of age and then they will stabilize. Usually there is no change in numbers after this.  

Why should a myopia patient get a Retina check regularly ?
Retina, as it is is a very thin and delicate , innermost layer to the eyeball. In myopia it is extra thin. Further more there are some extra thin, frayed areas, called as Lattice found majorly in Myopes. These have to be specially looked for by a Retina Specialist.
These make a myope more prone or liable to Retina Problems (especially Retinal Detachment).

Cautions or Self Tests in Myopia ?.
Decrease in vision
Decrease in field of vision
Sudden increase in floaters (black spots)
Flashes of lightening
Curtain of darkness (Retinal Detachment)
The above 2 ** are an Emergency and you should contact and see your eye doctor immediately.

Why do I see these Black spots (Floaters) or Wiggly lines ?
In certain conditions the jelly that fills your eye (vitreous) it starts converting to liquid. The strands that float in the pockets of liquid formed, you see them as black flecks (floaters)  or wiggly lines. They will not harm you. You will learn to ignore them.

What is Laser therapy sometimes advised to a Myopia patient, even children?
When the thin areas, Lattice, seem likely to produce a potential to damage, they are welded more firmly to the eye by Laser. It is a very painless, OPD procedure.

Can Myopia be cured by “Special medicines” / Yoga / exercises ?
Myopia can be treated, it can not be cured. Patients can lead a normal life with the aid of glasses and contact lenses and should enthusiastically do so.

Updated February 2019: American Academy of Paediatric Ophthalomology has published that the new figures for Myopia in USA are 40% of kids below 15 years of age. Use of iPads, Phones and TV being the main culprit again.