Developing cataract, going in for surgery, wearing incongruous dark glasses, following an hourly eye-drop routine… one instantly associates these with grey hair, wrinkled skin and everything else that's part of the aging process. But, apparently, cataract (the development of opaqueness in the lens of the eye, which blocks or blurs vision), is not a problem that affects only the elderly. “In my practice, I see two or three kids with cataract turning up every two or three months, sometimes even two-week-old infants,” says ophthalmologist Gayathri Sreekanth, a specialist in cataract surgery. “Three to five per cent of cataracts are congenital. Some develop cataract in middle age too,” informs Lalitha Ganesh, consultant ophthalmologist, Fortis Malar.
Advances in surgery
Being a very small organ, even a minor eye problem affects the quality of life. So, early detection is essential to provide relief. While surgery remains the only cure for cataract, several advances have been made in the treatment of the condition. Already practised in the West is bladeless cataract surgery using a Femtosecond Laser. This zero complication procedure allows the eye to heal in minutes. It is likely to be made available soon in Chennai.
“Thereafter, it will not be regarded as cataract surgery, but just as a ‘procedure', and could evolve from ‘day-care' to a ‘minute-care' procedure,” says Dr. Gayathri. However, it is unfortunate that some hospitals and surgeons insist on corrective surgery for all elderly persons, regardless of their need for it.
Kids born out of consanguineous marriages, kids with metabolic disorders such as diabetes and galactosemia (allergy to galactose), kids whose mothers contracted measles, syphilis, candidiasis, etc., or the TORCH group of infections during pregnancy and those whose mothers took improper or un-prescribed medication during pregnancy are at risk of developing cataract. “Avoid even painkillers for headaches during pregnancy, especially during the first trimester”, says Dr. Lalitha, going on to elaborate, “it is best to develop natural immunity, for which nutrition and exercise are crucial. Taking folic acid (a B-Complex vitamin) tablets can help. And no slimming diets during pregnancy, please.”
Says D. Srinvasan, consultant ophthalmologist, “Sometimes kids develop cataract following physical injury in the eye, even months after the injury.”
As for cataracts in middle-aged persons, besides those genetically prone to it, people with diabetes, those who work in the glare of the sun for long, those who have suffered any injury in the eye region, those on steroid medication for asthma and skin diseases, those who are malnourished and suffer episodes of severe dehydration are at risk, as lens metabolism depends on protein metabolism.
“Since diabetes has become an epidemic in India, cataract occurs in more middle-aged persons than before, due to “sugar” accumulating in the lens,” says Dr. Gayathri.
“Likewise, since people don't wear sunglasses in our country, despite it being situated in the Tropics, cataract is more common here,” says Dr. Srinivasan. “Never look directly at the sun. Regular checking of the eyes can help detect cataract,” he advises.
Kids and cataract
How is cataract detected in kids and babies? “If a child or baby has cataract, the eyes will not be focussed, the gaze wanders, and the pupil will look white in a photograph. In older children, you might notice that their school work suffers,” says Dr. Gayathri.
“Normally, a baby is able to fix its gaze on its mother and then on colourful objects when it is around four weeks old; if you don't see this happening, it might be an alarm signal,” says Dr. Lalitha. There is a simple test mothers can try: Close one eye of the baby or child, and if it objects strongly to this, it could mean that the other eye is not seeing things clearly. Repeat the test for both the eyes. “This can be easily done; even elders can try it on themselves,” says Dr. Lalitha. Of course, this is not a conclusive test; consulting an eye specialist is best. If the child squints, this too can be indicative of cataract.
WATCH OUT FOR
* Wandering, unfocussed eyes
* Pupil of the eye looks white in a photograph
* Discomfort when seeing with one eye
* Squint
* Unsatisfactory school work
