The things you wonder when you find out your child has cataracts
Here are the questions I could not wait to ask Adam's doctor/surgeon, and the answers I received:
1.What kind of cataracts are these? They're called "lamellar".
2. If they are congenital, why did neither his pediatrician nor the surgeon who did two surgeries on his tear ducts to open them up not see them? They're not congenital (i.e., they've not been there since birth). Which caused me to ask - Then how did this happen?! They're likely genetic. They're not likely due to a metabolic issue but blood will be taken after Adam is put under for his surgery. The blood will be tested to identify any underlying issue. I reported that Adam's paternal grandfather had cataracts as a "middle aged" adult and both Dr. B and another MD in the room thought that was noteworthy.
3. How many other 2-year-olds have you seen/operated on with these type of cataracts? Dr. B. estimated doing about 50 surgeries a year to remove pediatric cataracts. A handful of those are similar to Adam's.
4. Can a cataract be "removed" from the lense and the "natural" lense left in Adam's eyes? No. They must be replaced with intra-ocular lenses (IOLs). The eye's lense is akin to an M&M. During the surgery, holes will be made in the "front" and "rear" candy shell and the chocolate middle will be sucked out. The chocolate middle will be replaced with an IOL.
5. Is Adam in danger of permanently losing his sight in his right eye? No. As long as surgery is scheduled in the next 3 to 4 weeks. Since it seems he has had good sight in both eyes for the first approximately 2 and a half years of his life, even if he were in an accident where he lost sight in both eyes for a month - when the sight was restored, his brain would still function correctly and he'd have normal vision.
6. Will he have IOLs placed? That question was answered above.
7. How will the strength of the IOLs be determined? Babies and young children are naturally "far-sighted" as their eyes develop. Dr. B. will do some calculations and make an estimated guess about what his normal vision would have been at this point and make Adam a bit "far-sighted" so that his eyes will develop as they would have.
8. Will Adam also have to wear glasses if he has IOLs placed? Yes. He will need to wear bi-focals in order to have good "near-sighted" vision. Some day in the future, he may wear contacts or possibly even have Lasik surgery so that he no longer needs to wear glasses.
9. What are the risks associated with surgery? Some typical surgical risks like infection. The possibility of finding other unexpected eye physiological issues. I think Dr. B. told me more risks but I didn't write fast enough and don't remember them.
10. What are the possible side effects of having this surgery/IOLs placed (e.g., glaucoma, more cataracts, additional surgeries)? There is a less than 1% chance that Adam will develop glaucoma and a less than 5% chance that he will develop amblyopia. If his IOLs develop "cataracts", laser surgery can be used to correct that.
11. Will Adam have outpatient or inpatient surgery? Outpatient. The surgery takes about an hour and a half and he will be able to go home that afternoon.
12. How many days should I plan to be off work to be with Adam while he recovers? Only two. The day of the surgery and the day after. After that, Adam will be fine to return to daycare.
13. What precautions will we need to take? Adam will have to wear a patch over the operated eye for 2 weeks. It is essential he keeps the eye covered as the incisions are basically left open and it would be very bad if he "busted the eye open" after surgery. With the patch on, we will not have to worry about normal rough and tumble 2-year-old behavior.
14. Could our siblings' children be at risk for this issue? (I forgot to ask this! But I'm assuming so since they feel Adam's issue is genetic).
15. After surgery, will Adam be in a lot of pain? Very little. If he has discomfort, Tylenol will help.
16. Since he will have changed vision after the surgery, will he be dizzy, disoriented, or nauseous? No. Young children just don't react that way to these vision changes.
17. Does his situation seem to be "deteriorating" more rapidly than typical? Dr. B. didn't necessarily say his situation was atypical but he did say that he believes his cataract in the right eye developed very quickly and believes the one in the left eye will develop just as quickly. He thinks that Adam's vision in his left eye will be very compromised or non-existent by about April. He also remarked that Adam's situation is "urgent" but not an "emergency".
Here are more questions I've thought of, that I plan to ask:
1. Will Adam always need bi-focals? How will we know when his eyes are done developing and he just needs "regular" glasses to help him see close up?
2. I've heard that an adult who is a friend of my aunt has IOLs and that sometimes they catch the sunlight or a bright light in a room and flash at people. Will that occur with Adam's IOLs?
3. Will Adam's eyes look a different color after the surgery?
4. What tips does Dr. B. have for keeping a patch on Adam's eye for two whole weeks? I worry that he will lay in bed at night and peel the sucker off!
5. How will we bathe Adam/wash his hair while the patch is on?
6. What tips does Dr. B. have for encouraging children Adam's age to wear their glasses? And to not destroy them?
7. When/how will we decide the date for Adam's surgery on his left eye?
8. How often should we expect to be seeing Dr. B. for follow ups after both surgeries are complete?
9. Will we wait until both surgeries are complete and Adam's eyes are completely healed before having him fitted with glasses? Or will he need glasses as soon as his right eye is healed (to wear while his left eye is patched, since as I understand he will be "far-sighted" with the new IOL)?
So many questions, so much fear, so much sadness. But also jubilation and THANKS that we have the technology we have in this day. When I told my grandmother-in-law about Adam's situation, she shared with me that a neighbor child she knew (can't remember if this was when she was a child or my husband's mother was a child) was diagnosed with pediatric cataracts. At that time, there was no treatment, no surgery, so eventually that child was declared legally blind.
1.What kind of cataracts are these? They're called "lamellar".
2. If they are congenital, why did neither his pediatrician nor the surgeon who did two surgeries on his tear ducts to open them up not see them? They're not congenital (i.e., they've not been there since birth). Which caused me to ask - Then how did this happen?! They're likely genetic. They're not likely due to a metabolic issue but blood will be taken after Adam is put under for his surgery. The blood will be tested to identify any underlying issue. I reported that Adam's paternal grandfather had cataracts as a "middle aged" adult and both Dr. B and another MD in the room thought that was noteworthy.
3. How many other 2-year-olds have you seen/operated on with these type of cataracts? Dr. B. estimated doing about 50 surgeries a year to remove pediatric cataracts. A handful of those are similar to Adam's.
4. Can a cataract be "removed" from the lense and the "natural" lense left in Adam's eyes? No. They must be replaced with intra-ocular lenses (IOLs). The eye's lense is akin to an M&M. During the surgery, holes will be made in the "front" and "rear" candy shell and the chocolate middle will be sucked out. The chocolate middle will be replaced with an IOL.
5. Is Adam in danger of permanently losing his sight in his right eye? No. As long as surgery is scheduled in the next 3 to 4 weeks. Since it seems he has had good sight in both eyes for the first approximately 2 and a half years of his life, even if he were in an accident where he lost sight in both eyes for a month - when the sight was restored, his brain would still function correctly and he'd have normal vision.
6. Will he have IOLs placed? That question was answered above.
7. How will the strength of the IOLs be determined? Babies and young children are naturally "far-sighted" as their eyes develop. Dr. B. will do some calculations and make an estimated guess about what his normal vision would have been at this point and make Adam a bit "far-sighted" so that his eyes will develop as they would have.
8. Will Adam also have to wear glasses if he has IOLs placed? Yes. He will need to wear bi-focals in order to have good "near-sighted" vision. Some day in the future, he may wear contacts or possibly even have Lasik surgery so that he no longer needs to wear glasses.
9. What are the risks associated with surgery? Some typical surgical risks like infection. The possibility of finding other unexpected eye physiological issues. I think Dr. B. told me more risks but I didn't write fast enough and don't remember them.
10. What are the possible side effects of having this surgery/IOLs placed (e.g., glaucoma, more cataracts, additional surgeries)? There is a less than 1% chance that Adam will develop glaucoma and a less than 5% chance that he will develop amblyopia. If his IOLs develop "cataracts", laser surgery can be used to correct that.
11. Will Adam have outpatient or inpatient surgery? Outpatient. The surgery takes about an hour and a half and he will be able to go home that afternoon.
12. How many days should I plan to be off work to be with Adam while he recovers? Only two. The day of the surgery and the day after. After that, Adam will be fine to return to daycare.
13. What precautions will we need to take? Adam will have to wear a patch over the operated eye for 2 weeks. It is essential he keeps the eye covered as the incisions are basically left open and it would be very bad if he "busted the eye open" after surgery. With the patch on, we will not have to worry about normal rough and tumble 2-year-old behavior.
14. Could our siblings' children be at risk for this issue? (I forgot to ask this! But I'm assuming so since they feel Adam's issue is genetic).
15. After surgery, will Adam be in a lot of pain? Very little. If he has discomfort, Tylenol will help.
16. Since he will have changed vision after the surgery, will he be dizzy, disoriented, or nauseous? No. Young children just don't react that way to these vision changes.
17. Does his situation seem to be "deteriorating" more rapidly than typical? Dr. B. didn't necessarily say his situation was atypical but he did say that he believes his cataract in the right eye developed very quickly and believes the one in the left eye will develop just as quickly. He thinks that Adam's vision in his left eye will be very compromised or non-existent by about April. He also remarked that Adam's situation is "urgent" but not an "emergency".
Here are more questions I've thought of, that I plan to ask:
1. Will Adam always need bi-focals? How will we know when his eyes are done developing and he just needs "regular" glasses to help him see close up?
2. I've heard that an adult who is a friend of my aunt has IOLs and that sometimes they catch the sunlight or a bright light in a room and flash at people. Will that occur with Adam's IOLs?
3. Will Adam's eyes look a different color after the surgery?
4. What tips does Dr. B. have for keeping a patch on Adam's eye for two whole weeks? I worry that he will lay in bed at night and peel the sucker off!
5. How will we bathe Adam/wash his hair while the patch is on?
6. What tips does Dr. B. have for encouraging children Adam's age to wear their glasses? And to not destroy them?
7. When/how will we decide the date for Adam's surgery on his left eye?
8. How often should we expect to be seeing Dr. B. for follow ups after both surgeries are complete?
9. Will we wait until both surgeries are complete and Adam's eyes are completely healed before having him fitted with glasses? Or will he need glasses as soon as his right eye is healed (to wear while his left eye is patched, since as I understand he will be "far-sighted" with the new IOL)?
So many questions, so much fear, so much sadness. But also jubilation and THANKS that we have the technology we have in this day. When I told my grandmother-in-law about Adam's situation, she shared with me that a neighbor child she knew (can't remember if this was when she was a child or my husband's mother was a child) was diagnosed with pediatric cataracts. At that time, there was no treatment, no surgery, so eventually that child was declared legally blind.
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