Question by Valerie B: Clinical medical question regarding congenital cataracts?
I am studying and doing research on this clinical question and have two questions I am having difficulty with. Any help would be great, thank you. By the way-this is NOT a real clinical case.
The parents of a newborn infant have been told that their son has congenital cataracts in both eyes and will require cataract surgery to prevent losing his sight.
Why is the infant at risk for losing his sight if the cataracts are not removed? I don’t understand this?
When should this procedure be done to prevent loss of his vision?
Best answer:
Answer by eric w
I’m not sure about the difference in congenital cataracts, so to speak, but have a lot of personal experience.
My father, my brother and I all had cataracts, and we all had surgeries for them.
My father had the surgeries in the early 60’s, when it was a lot more difficult, and the recovery time took a lot longer.
My brother is diabetic, and needed some laser cauterization of the retinas due to damage from the diabetes, and they took care of his cataracts at the same time.
I had two cataract surgeries about four years ago. The first one was successful, the second one was not. They said that there was a defect in the capsule that held the lens, and while trying to implant the new lens in my eye, it slipped down into the eye, and they had to fish it out, which pulled the retina out and allowed the vitreous humor to get behind the retina. I have 20/200 vision now in my right eye.
They wanted to operate again, but I didn’t want to risk it. It would have required a vitrectomy, which would remove the gel–the vitreous humor—from the eye, and the scar tissue would be peeled from the retina, and then the eye refilled, and a gas bubble injected. I didn’t like the risk, so I declined additional surgeries. I have enough vision left in the right eye for depth perception, at least.
I would assume that in the case of an infant, the loss of eyesight would be years in the future, as cataracts get worse. The lens grows more cloudy with time, and eventually vision would be completely occluded. I was diagnosed as a teenager with the cataracts, but told that they wouldn’t require surgery for years, which was trul.
My own vision was declining so gradually that I never even realized it until I went to get glasses, and the optometrist told me that my vision was 20/200 in both eyes. I was almost blind, and didn’t even realize it.
Exposure to UV light, normal daylight, will make the cataracts worse.
To this day, I always wear sunglasses. I’m very sensitive to light, and before the surgeries, I had to wear dark glasses, even at night, as the street lights would obscure my vision. Flourescent lights still bother me, the glare from them is almost intolerable.
Only the doctors can tell you when this procedure should be done, but I would assume that it would be years in the future.
It was unusual that I had the one surgery that turned out badly. The surgeries themselves weren’t difficult, and recovery was not difficult, either. Cataract surgery has come a long way, and is relatively safe and without complication, I just had bad luck, I guess.
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