Dr. Bhupesh Singh, Author at Eye Surgeon

We All Have A Lens In Our Eyes For Vision And When The Lens Of The Eyes Is Clouded, It Is Called Cataract. If A Child Has Cataract, Then It Is Called Paediatric Cataract. This Is What We Refer To As Cataracts In Children.

Cataract Does Not Allow Rays Of Light To Pass Through The Lens And Reach The Retina. Retina Is The Place Where Lights Get Focused And We Get Clear Focused Vision. It Is Made Up Of Tissue Lining And Situated At The Back Of The Eyes. The Retina Is Sensitive To Lights And If A Cataract Is Formed In Your Child’s Eye, Thenhe Or She Can Have Clear Eyesight. A Cataract Is Formed Due To The Cloudy Formation Of The Protein That Creates The Lens.

Causes

There Can Be Many Reasons Why A Child Is Born With Cataract. When There Are Cataracts In Babies Or New-Born, It Is Called ‘Congenital’. Sometimes, The Cataract May Develop Later In Them, Which Is Called ‘Acquired’.

Here Are The Causes For Cataracts In Children:

Glaucoma-
Sometimes, You May Experience Eye Cataracts Due To Other Eye Diseases Like Glaucoma. Other Eye Diseases Can Create Complications And Cause Eye Cataracts.
Rheumatoid Arthritis-
Other Illnesseslike Rheumatoid Arthritis Are Also Known To Cause Eye Cataracts.
Steroid-
You May Get Cataracts Due To Steroid Consumption. Sometimes, Steroids Can Be Present In The Medicine You Are Consuming, Which Can Be A Reason For Eye Cataracts.
Poison-
If You Unknowingly Consume Any Poisonous Substance, Then It Might Cause You An Eye Cataract Due To The Reaction In The Body And Eyes.
Diabetes-
If The Sugar Level Is Very High In Your Body, Then You Have High Chances Of Getting Cataract. Diabeticsare More Prone To Eye Cataracts. Make Sure To Keep Your Sugar Level In Check To Avoid Any Kind Of Eye Cataract Risk In The Future.
Injury-
Some Injuries Are Also Known To Cause Eye Cataracts. If You Have Got An Eye Injury, Then It May Cause An Eye Cataract.
Down Syndrome-
A Child Suffers Down Syndrome When He Or She Has An Extra Copy Of The 21st Chromosome. It Is Also Known As Trisomy 21. This Causes A Delay In The Development Of The Mental And Physical Abilities Of The Child. Eye Cataracts Can Be One Of The Illnesses Due To This Syndrome In A Child.
Radiation-
If The Child Has Undergone Any Treatment Through Radiation, Then He Or She May Develop A Cataract In The Eyes.

Symptoms

The Symptoms Of Cataracts Are Not The Same For Every Child. Here Are A Few Cataract Symptoms To Look Out For:

Halo Effect -You will notice a circle of light around objects.
Light Brightness -You may feel that the light is looking too bright to focus.
Light Glare–You might see a glare in light if you have an eye cataract.
Troubled Vision -Your vision will not be clear and you will have trouble seeing anything.
Blurry or Cloudy Vision -There will always be a blur in your vision when you see an object. It will feel like a cloudy vision due to the cloudy formation in your eye lens.
Nystagmus Eyes-There is a condition called Nystagmus where your eyes will be moving uncontrollably. It is an eye movement in a rhythm where eyes can move up & down, back & forth, mixed or around.
Misaligned Eyes- When the eyes are not in the right position, it is called Misaligned Eyes. If you have an eye cataract, it may be due to misaligned eyes.

Risks

Most Of The Time, Older People Get Eye Cataracts,But It Is Rare For Children To Get It. However, There Are Cases Of Cataracts In Babies And Children.

Children Have A Higher Risk Of Eye Cataract If They Have The Following:

Down Syndrome-
Genetic Problems Such As Down Syndrome Can Cause Eye Cataracts In Children. If Thissyndrome Runs In Your Family, Then Be Prepared To Take Your Child To An Eye Doctor Early In His Life Even If You Don’t See Any Symptoms.
Illness-
If Your Child Is Suffering From Rheumatoid Arthritis Or Diabetes, Then The Risk Of Eye Cataractsis Higher.

Diagnosis

If Your Child Has Any Symptoms Of Cataract, Then You Should Get Him Diagnosed By A Healthcare Expert.

Health History of Child-
The Healthcare Expert Will Ask For The History Of The Health Of The Child. If Your Little One’s Health Has Not Been Good In The Past, Then It Is Somehow Related To Cataract. It Will Give A Better Understanding Of The Condition And Causes Of Cataract In Child.
Pupil Dilation-
The Eye Doctor May Also Check For Any Other Problems In The Eye Or Any Sign Of Eye Damage By Closely Examining The Eyes. There Will Be A Close-Up View Check-Up Of The Optic Nerve, Retina, And Lens Of The Eyes By Dilating The Pupils. Thismakes The Pupil Wider For Close Observation.
Visual Acuity Test-
The Eye Doctor Can Test The Ability Of The Child’s Vision By Asking Him To Read From A Distant Eye Chart. In This Eye Chart, There Will Be Numbers And Alphabet In Different Sizes.

Treatment

If Your Child Has Eye Cataract, The Treatment Depends On Multiple Factors Such As The Child’s Health, Age, Symptoms, And Severity Of The Condition.An Eye Doctor Can Treat The Condition Based On The Type Of Cataract Your Child Is Having. Sometimes, The Treatment Can Be Done By Using Contact Lenses Or Eyeglasses, Which Will Help Him To See Better. Children Who Are More Than 1 Year Old Are Treated By Removing Cataracts Through Cataract Eye Surgery. After That, New Lenses Are Inserted Into The Eyes.

Young Children Can Get The Eye Cataract Removed Surgically. The Doctor Will Give Anaesthesiato The Child While Conducting The Surgery. If Thecataractis Small And Does Not Affect The Vision, Then It Need Not Be Removed. But If It Is Affecting The Child’s Vision, Then It Needs To Be Removed Immediately As It Can Affect The Long-Term Vision Of The Child.

Eye Cataracts Cannot Be Prevented In Most Children. Adults Can Also Develop This Condition If They Are Over-Exposed To Sunlight. Save Your Children From Getting Exposed To Sunlight Too Much. You Can Use Sunglasses To Avoid UV Rays.

The Unilateral Corneal Blindness Cases In India Were Estimated To Be Around 10.6 Million In The Year 2020. And The Cases Are Only Going To Go Up In The Future. A Corneal Transplant Is Quite Effective In Restoring Vision In The Majority Of Cases. However, To Achieve Maximum Treatments Being Done At The Correct Time, Awareness About Corneal Transplant Plays A Huge Role. Additionally, The Best Cornea Specialist In India Cost Must Be Within The Means Of A Large Section Of The Population. Let’s Discuss All The Aspects Of A Cornea Transplant In This Article.

What Is A Cornea?

Before Diving Into The Details Of A Cornea Transplant, Let’s Discuss Cornea In Brief. The Cornea Is A Dome-Shaped Outermost Layer Of The Eye That Acts As A Protective Barrier Against Germs, Dust Particles And Hazardous UV Light. It Helps In Clear Vision By Refracting Light Correctly Onto The Lens. Almost 75% Of The Eye’s Optical Power Is Based On The Cornea. It Is Made Up Of Three Primary Layers Of Tissue, With Two Thin Membrane Layers Between Them.

What Is A Cornea Transplant?

A Cornea Transplant Is A Surgical Procedure To Replace All Or Part Of The Cornea With Healthy Corneal Tissue. The Surgeon Removes The Damaged Part Of The Clear, Outermost Layer Of The Eye. After Which, The Healthy Corneal Tissue Of A Donor Is Put In The Place Of The Damaged Cornea. A Corneal Transplant Helps In Restoring Vision And Reducing Any Pain In Patients. It Is Also Known As Keratoplasty And Has A High Success Rate With Minimal Risk Of Complications.

Who Needs A Cornea Transplant?

A Cornea Transplant Is Recommended For Patients With A Damaged Cornea That Causes Blurred And Cloudy Vision With Eye Pain. It Can Also Relieve Other Symptoms Of Corneal Diseases. Here Are A Few Conditions That Can Be Successfully Treated Through Keratoplasty:

● A Hereditary Eye Condition, Known As Fuch’s Dystrophy
● Corneal Thinning And Tearing
● Keratoconus, A Condition That Causes The Cornea To Bulge Outwards
● Scars On Cornea Caused By Infection Or Injury
● Corneal Swelling
● Corneal Ulcers That Are Not Receptive To Medical Treatments
● Any Complications That Have Arisen Due To A Previous Eye Surgery

How To Prepare For A Cornea Transplant?

Before A Cornea Transplant, The Patient Undergoes A Thorough Eye Examination To Ascertain And Rule Out Any Conditions That Can Cause Risk After The Transplant. Additionally, The Ophthalmologist Will Review The Patient’s Medical History And Current Dosage Of Medicines Or Supplements. If Any Existing Eye Infection Can Affect The Cornea Transplant’s Efficacy, It Will Be Treated Beforehand. The Doctor Will Also Measure The Patient’s Eye For Finding The Right Size Of A Donor Cornea.

What Are The Types Of Cornea Transplant Available In India?

Before Starting The Procedure, The Patient Will Be Given General Anaesthesia, And The Doctor Will Apply A Numbing Cream To The Affected Eye. After Which The Surgeon Will Hold The Eye In Place And Choose One Of The Three Cornea Transplant Options:

Penetrating Keratoplasty

It Is Also Known As Full-Thickness Cornea Transplantation That Was Developed More Than 100 Years Ago. The Advanced Version Of Penetrating Keratoplasty Still Remains The Most Common Cornea Transplant. In This Procedure, A Small Circular Blade Is Used To Manually Extract The Entire Layer Of The Damaged Cornea. A Healthy Donor Cornea Of The Same Size Is Then Put In Place. It Is Usually Recommended To Patients With Severe Corneal Damage, Bulging Or Scarring.

Deep Anterior Lamellar Keratoplasty

This Type Of Cornea Transplant Is Suggested When The Innermost Corneal Layer Is Healthy, But The Outer And Middle Layers Are Damaged. It Is Also Known As A Partial-Thickness Cornea Transplant. To Separate The Healthy Inner Layer, The Surgeon Injects Air That Lifts The Outer And Middle Layers. These Damaged Layers Are Then Replaced With Healthy Corneal Tissue From A Donor. It Has A Relatively Shorter Healing Time And Less Risk Of Infection As The Innermost Layer Remains Untouched.

Endothelial Keratoplasty

Endothelial Keratoplasty Is Advised When The Innermost Layer Of Cornea Known As Endothelium Is Damaged. The Innermost Endothelial Layer Is Made Up Of Thin Tissue Known As Descemet’s Membrane. Surgeons Perform Two Types Of Endothelial Keratoplasty As Follows:

● Descemet Stripping Automated Endothelial Keratoplasty (DSAEK): In This, One-Third Of The Cornea Is Replaced By Donor Tissue.

● Descemet Membrane Endothelial Keratoplasty (DMEK): In This, A Relatively Thinner Layer Of Donor Tissue Is Used.

However, In Both Procedures, The Damaged Cells Are Removed From The Descemet’s Membrane.

What Should The Patient Expect After A Cornea Transplant?

For A Few Days Post-Surgery, The Eye Will Remain Red, Sensitive To Light And Irritated. The Surgeon Will Prescribe Over-The-Counter Medicines For Relieving Pain. Moreover, The Eye Is Covered With A Patch That Must Be Worn By The Patient, Especially While Sleeping And Showering. Activities That Directly Affect The Eye Should Be Avoided Till Recovery. Within 24-48 Hours Of The Procedure, A Follow-Up Is To Be Done With The Doctor To Remove The Eye Patch And Check The Healing Status. The Doctor Will Prescribe Eye Drops And Ointments For Faster Recovery. A Few Extra Measures Such As Wearing Glasses, Avoiding Rubbing Your Eyes Will Be Briefed By The Surgeon.

What Is The Cost Of A Cornea Transplant In India?

The Average Cost Of A Cornea Transplant In India Is Around Rs. 1,30,000 I.E. $2000. It Is Inclusive Of The Entire Treatment Process, Starting From Clinic Visits To Post-Surgery Care. India Offers Affordable Healthcare With Utmost Quality Treatment In Comparison To Other Countries. The Corneal Transplant In India Is Cheaper For International Patients As The Cost Is Slashed Down By A Whopping 50%-70%. However, Several Factors Such As The Hospital’s Location, Surgeon’s Experience, Accreditation Of The Medical Facility, Hospital Stay Etc., Can Affect The Cost.

A Cornea Transplant Is A Safer And Effective Treatment Option For Restoring Vision Due To Corneal Damage. The Cost Of A Cornea Transplant In India Is Largely Economical For International Patients. However, People From Lower Strata Of Society May Struggle To Bear The Expenses. In All, India Is A Healthcare Hub That Offers Top-Notch Treatment At A Comparably Lower Cost.

Author: Dr. Bhupesh Singh

Cataracts in Children: Everything You Need to Know