Cataracts affect children's eyesight; more research is needed

By Sarah St. John

December 30, 2004 | I remember not wanting to go to town with that dumb patch over my eye. I hated it, despised it. It smelled like bandages, hospitals, glue and it made it impossible for me to see. Everything was blurry and my parents would still drag me around Blackfoot. I stumbled over everything, ran into walls and tripped over my shoes. Essentially, I looked and behaved like a drunken 3-year-old. (I guess anything is possible in a redneck town).

While in town, my parents had to go grocery shopping. I was riding in the cart and through my hazy vision I could make out a shape of a girl about six laughing at me and calling me names. Her mother tried to quiet her, but it was too late. I might not have been able to see her but her words still stung. I was devastated. I huddled at the bottom of the shopping cart and cried. I was only three, yet I still remember how humiliated I felt and how angry I was that my parents made me go out in public looking like a deformed pirate.

You see, I was born with a cataract in my left eye and to make my vision stronger, doctors made me wear a patch over my good eye. A cataract is a clouding of the lens. Usually the lens is transparent so it can focus on objects, but a cataract distorts that clear image. Instead of seeing sharp focused images, the vision is blurry and hazy.

Cataracts are usually considered to be a disease obtained with age. However, on occasion it does affect children. Doctors estimate that up to six out of every 10,000 babies are born with cataracts. Unfortunately, doctors often fail to detect the potentially serious matter. The doctors didn't notice anything about my eye until my mom went in and pointed it out. My lens was completely covered so the doctors removed it.

I was lucky. Around 43 percent of children do not have their cataracts discovered in time, and as such they lose all vision. This is outrageous when we live in a time when doctors can operate on children before they are born. Early detection is crucial. When a child is born the central nervous system is still growing. It needs visual stimulation for sight to develop. If it is not caught, according to Laura Michels, "The brain may ignore the images in the affected eye, interfering with visual maturity and leading to severe amblyopia (lazy eye)."

Once caught, there are about three options. If the cataract is small, the doctor may suggest continual monitoring. If it is large, the lens might be removed and the child will have to wear thick glasses if the cataract is in both eyes, or a thick contact lens if it is in one. The contact lenses, however, are very uncomfortable. It took three people to hold me down and put it in my eye as a child. Third, the doctor can remove the lens and place an intraocular lens inside the eye. The problem with this solution is the eye is still growing, so the doctor must estimate what the future focusing power will be. This intraocular implant is highly complex and many kids have complications.

The operation is the easy part, but the continual eye exercises are time consuming and painful. To strengthen the bad eye, doctors recommend two things. First, patching the good eye, which as you know I am not fond of. Second, eyedrops. These drops blur your vision forcing you too see the world from the cataract perspective. These sting and are very painful (I wasn't a big fan of this treatment either). Although not fun, both have proven successful in improving vision. However, in an age of surgical miracles, using the same technique prevalent 20 years ago seems outdated.

I don't want to complain, life with one eye is not that bad. It wasn't until I was19 and starting my sophomore year of college that I realized I literally didn't see the world like everyone else. How was I to know that everyone else had a panoramic view, or that 3-D images really existed? I have been able to live a relatively normal life. Sure my depth perception may be a little off, and I can only see hazy shapes of color out of my left eye, but they still give me a driver's license every four years.

Although I have been able to maintain a normal life, many children are not that lucky. Cataracts need to be discovered earlier. As Dr. Jugnoo S. Rahi and Carol Dezateux of the Institute of Child Health in London said, "new strategies are clearly needed to achieve earlier diagnosis and increase the proportion of cataracts detected through screening in the first three months of life."

More research is always needed and doctors need to create better alternative surgeries that do less damage and help to restore sight to something better than 20/2000 with a corrected lens. It is preposterous to still be relying on 1980 technology in the year 2004.

Every day I am grateful for my good eye. The thought of being blind terrifies me. As a child I used to cry myself to sleep because I thought I would have to learn how to read Braille. Seeing a sunset is a miracle. By being aware of this situation we may be able to put pressure on researchers to develop new techniques and skills that will make cataract surgery and recovery more effective and less painful.

Please be aware, often times parents are the first ones to notice the problem. So when you have children, look them in the eyes and see if they are looking back.

NW
MS