After a baby is born, doctors monitor the child’s vital signs, listen to its heart, conduct a hearing test and check the baby’s eyes. This helps the doctors to detect abnormalities that could hinder a baby’s development. One of things they look for are cataracts. While rare, cataracts in young children can be treated with the help of surgery and contact lenses.
Surgery
If a doctor detects any cloudiness in the eye, or there is a family history of congenital cataracts, the child will be sent to someone like Lisa Bohra, M.D., a pediatric ophthalmologist at Children’s Eye Care, which has locations in Clinton Township, West Bloomfield, Dearborn and Detroit. Bohra says she assesses the eyes, determines if both eyes are impacted and often does surgery to help the child see.
“If the surgery is done on an infant, we don’t replace the lens like we would in an adult. Once the child loses the natural lens through this surgery, they lose their focusing power. We fix this with a contact,” Bohra says. When the surgery is done on a child over the age of one, an implanted lens is often used.
The contacts for infants are different than the soft lenses that older children or adults use. Bohra says doctors often use a high-powered silicone polymer contact with high oxygen permeability to allow the eye and the cornea to breathe. The contact is also bigger than a regular contact. It sits on the cornea and drapes over a large part of the eye. The focusing power is in the center of the lens, but the rest is used to hold the contact lens in place.
The contacts, Bohra says, can stay in the eye for up to a week before they are taken out, cleaned and reinserted. There is another, more rigid, smaller lens that is rarely used it children. While it must be removed daily, it provides more flexibility in the power of the lens.
Contact care
The parents are responsible for the care and maintenance of the contact lenses.
“When a child gets contact lenses, we’ll insert the first and maybe second set for them in the office. They go through an insertion and removal training and are educated on how to take off the contacts and how to position the baby to take them out or put them in,” Bohra says. “The parents take them out, clean them and in the morning, put them back in. While this is often about a week, some babies develop a lot of protein deposits quicker than other kids, so they may need them changed every three to four days. Some parents become so good at it, they take them out daily,” Bohra adds.
The cataract diagnosis is a serious one that can threaten a child’s vision. The parents have a large responsibility when it comes to the care of their child’s eyes.
“Even if you have a perfect surgery, if the child doesn’t wear their contacts regularly and correctly, they will not develop good vision,” she says.
At a later date, the infants will often have an intraocular lens implanted. It all depends on how the child is handing the contacts and how the vision is developing, she says.
If the cataracts are identified closer to the age of one, doctors often elect to put in a lens implant and those children don’t require contact lenses.
Even after the lens implant, many children still require glasses – and even bifocals. The implanted lens is designed to last their whole life so the implant is fine-tuned to give them the best vision as an adult.
For more information on contact lens care for infant and toddlers, visit the Children’s Eye Care website.
