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Eye Care Archive (Expert Forum)
Posterior Subcapsular Cataract in a 6 year old
Our Ask A Doctor Ophthalmology Forum is where you can post your question and receive a personal answer from physicians affiliated with the American Academy of Ophthalmology.
Posterior Subcapsular Cataract in a 6 year old
by Paulinr, Dec 04, 2006 12:00AM
My 6 year old has just been diagnosed with a congenital posterior subcapsular cataract and amblyopia. The specialist who saw her said that basically the problem is more neurological rather than with the physical eye as it has been present for some time. He recommended no treatment but simply review in 6 months. My husband and I are not satisfied with this as he seemed to believe that she has lived with it this long living with it the rest of her life should pose no problem. Thats great exept for the fact that she can see out of it can use it well and can read just fine with it. I don't know if it will deteriorate what vision she has now what to expect etc plus all the reading I have done on the internet says that the brain sets itself somewhere in the first decade of life (exactly when is still being argued) so with this how can it be too late for her as he was suggesting??? Also if it has been present from birth if this is so why was it never picked up? Could it be possible that it caused only a partial blockage or was not yet quite formed yet so enough light was getting in to allow the eye to function normally so that critical period of brain eye function was not affected? Only recently as her work load at school increased and perhaps the blockage became more apparent has it become a problem?? I just want someone to give me a straight anwser unfortunately that seems almost impossible!
Doctor's Answer
by Forum-OD-MP, Dec 04, 2006 12:00AM
IMO the critical period ends about 8. multiple studies show this. so she has some time (2-ish years?) to try and regain vision in that eye.
why it was never picked up is an easy answer...b/c the pediatrician's office doesnt know jack about eyes, to be blunt. you would have had to seen an eye doc to diagnose that.
the reason you cant find a "straight" answer is b/c there are as many opinions on who needs surgery/treatment for this kind of disorder and who does not as there are doctors out there. there is no rule that says "X amount of amblyopia at Y age should be treated, but K amount of amblyopia at P age should not".
here's how i would treat it: if she can see better than about 20/100 at any distance with any lens, then IMO it might be worth trying to save the vision in that eye with surgery, progressive add glasses (or multifocal implant) and patching. if its worse than 20/400 at all distances, IMO its probably not worth it...she doesnt have enough time to make up the difference. 20/200-ish would be a grey area. it would depend on my perceived parental motivation.
why it was never picked up is an easy answer...b/c the pediatrician's office doesnt know jack about eyes, to be blunt. you would have had to seen an eye doc to diagnose that.
the reason you cant find a "straight" answer is b/c there are as many opinions on who needs surgery/treatment for this kind of disorder and who does not as there are doctors out there. there is no rule that says "X amount of amblyopia at Y age should be treated, but K amount of amblyopia at P age should not".
here's how i would treat it: if she can see better than about 20/100 at any distance with any lens, then IMO it might be worth trying to save the vision in that eye with surgery, progressive add glasses (or multifocal implant) and patching. if its worse than 20/400 at all distances, IMO its probably not worth it...she doesnt have enough time to make up the difference. 20/200-ish would be a grey area. it would depend on my perceived parental motivation.
Member Comments
by Paulinr, Dec 05, 2006 12:00AM
thankyou very much for your response. She will be seeing another specialist in 2 weeks. (hopefully more of a proffessional in this field) Thankyou for being the only person since I found out to even come close to making it understandable and giving an honest opinion. I hope you are right in your opinion and she still has a chance to receive treatment. Thanks again. I wish doctor's would understand that parents doen't want things sugar coated and most of all that a majority of us just want a decent diagnosis we are not looking toe sue anyone for being honest - even if that means they admit that they don't know everything.
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