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Cataract in babies and childrenCCataract in babies and childrenCataract in babies and childrenEnglishOphthalmologyChild (0-12 years);Teen (13-18 years)EyesNervous systemConditions and diseasesCaregivers Adult (19+)NA2012-12-12T05:00:00Z8.0000000000000065.90000000000002825.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Discover how cataracts develop in children and how they can be treated.</p><h2>What is a cataract?</h2> <p>A cataract is a cloudy area over the lens of the eye. Cataracts can affect one or both eyes. Childhood cataracts are rare: they occur in one to three in 10,000 children.</p><h2>Key points</h2> <ul> <li>A cataract is a cloudy area over the lens of the eye. In children under nine, it stops the eye's vision from developing normally and can cause amblyopia.</li> <li>If the cataract is mild, the doctor may decide to prescribe eye drops to make the pupil bigger or not to treat it at all if the vision is not affected. If the cataract is serious, the only way to treat it is to remove all or some of the lens during surgery.</li> <li>After surgery, your child will need a corrective device such as a contact lens, intra-ocular lens or, in rare situations, eye glasses. Your child will also need to wear a patch to help both eyes develop equally strong vision.</li> <li>Your eye doctor will need to check your child's vision regularly after surgery. It is extremely important that you keep all follow-up appointments.</li> <li>Please call the eye doctor if your child has increased pain, swelling or sensitivity to light after surgery or if their corrective device causes any redness, swelling, discharge, pain or other unusual symptoms.</li> </ul><h2>Causes of cataract</h2> <p>A cataract can be congenital (a person is born with it) or can be acquired or developmental (it appears later in childhood or in adulthood).</p> <p>Common causes include:</p> <ul> <li>heredity (inheriting a cataract from a parent)</li> <li>trauma (injury) to the eye</li> <li>radiation (treatment for cancer)</li> <li>medication (for example steroids)</li> <li>other illnesses or conditions (for example Down syndrome)</li> <li>infection (for example German measles).</li> </ul> <p>In many cases, however, the cause of a cataract is not known.</p><h2>How to tell if your child has a cataract</h2> <p>Have your child's eyes examined by an ophthalmologist (say: op-thal-MOL-o-jist), a medical eye doctor, if:</p> <ul> <li>you notice a white spot on your child's eye(s)</li> <li>a parent or sibling had a cataract as a child (not as an older adult)</li> <li>your child has eye problems or another disease or condition in which cataracts are likely to be present</li> <li>your family doctor or paediatrician recommends an eye exam because of a concern about possible cataracts</li> <li>your child's eyes are crossed</li> <li>there is a concern about your child's vision.</li> </ul> <p>If there is a family history of cataracts in childhood, bring your child to an ophthalmologist before they are two weeks old.</p> <h2>Checking your child's eyes for cataracts</h2> <p>The ophthalmologist will carefully examine your child's eyes. Here is what you can expect during the exam.</p> <ul> <li>Your child will have special eye drops to make their pupils bigger. These drops sting at first but only for about 10 seconds. They may be repeated.</li> <li>Since your child needs to be very still when the eyes are checked, they may be wrapped in a blanket and held down gently, especially if they are very young or too upset to stay still on their own.</li> <li>When the drops start to work, usually after about 30 minutes, the ophthalmologist will shine a bright light into your child's eyes and use different instruments to help check them.</li> </ul> <p>Being held down and having a bright light shone in their eyes will make your child uncomfortable, but they should not feel any pain.</p> <p>After the exam, the eye doctor will explain the condition of your child's eyes. If there is a cataract, the doctor will tell you and talk to you about the best treatment for your child.</p><h2>Treatments for cataracts</h2> <p>Cataracts do not go away by themselves, except in a few rare situations.</p> <h3>Mild cataract</h3> <p>If the cataract is small and does not affect your child's vision, the doctor may decide not to treat it at all or may prescribe special eye drops to dilate (widen) the pupil to allow more light to enter the eye. If your child needs eye drops, make sure you carefully follow the instructions for <a href="/Article?contentid=995&language=English">putting them in</a>.</p> <h3>Serious cataract</h3> <p>If the cataract is more serious, your child will need surgery to remove it. Cataracts cannot be removed with medication or lasers.</p> <h2>Why it is important to have surgery to remove a serious cataract</h2> <p>Surgery is important because it will allow your child's vision to develop as normally as possible. It is especially important for children aged under nine because their vision is still developing.</p> <p>If your child has a cataract and they are aged under nine, there is a risk that they will develop <a href="/Article?contentid=835&language=English">amblyopia</a> if the cataract is not removed. Amblyopia is sometimes called "lazy eye" and can occur when the affected eye does not get enough stimulation from light rays.</p> <p>All children aged under nine should be operated on as soon as possible, whether they are born with a cataract or develop one later. If your child develops a cataract when he is aged nine or over, the timing of the surgery is more flexible because their vision has fully developed.</p> <h2>What happens during cataract surgery</h2> <p>Before the surgery, your child will have special drops to dilate (widen) the pupil of the eye. These drops sting at first but only for about 10 seconds. They may need to be repeated once or twice.</p> <p>The eye drops are usually applied right before the surgery in the hospital. If your child needs them before then, your eye doctor will give you a prescription for the drops and explain when to start putting them in.</p> <p>Your child will have a special "sleep medicine" called a general anaesthetic for the surgery. This will make sure they sleep through the operation and do not feel any pain.</p> <p>The surgeon takes out the cataract by removing the lens of the affected eye(s). Your eye doctor will tell you before the surgery if it is best to remove the whole lens or only part of it.</p> <p>The surgeon will use special stitches to repair the eye wound. These stitches are absorbable, meaning that that they do not need to be taken out. They will dissolve on their own over the first six to eight weeks after surgery.</p> <p>In young children with cataracts in both eyes, surgery is often done on the second eye as soon as possible after the first eye. This is to make sure that the vision in both eyes develops evenly.</p> <p>At times, surgery may be done on both eyes on the same day. Your eye doctor will explain exactly when your child will have surgery and, if it applies, when each eye will be done.</p> <p>The operation is usually done as a day surgery if your child is over 12 weeks old. If your child was born prematurely or if the surgery is within the first 12 weeks of life, they will usually stay in the hospital overnight.</p> <h2>What to expect after the surgery</h2> <h3>Eye patch and shield</h3> <p>Immediately after surgery, an eye patch will be placed over the operated eye. The eye patch is covered with a plastic or metal shield for protection. Your child's patch will be removed the next day by the ophthalmologist when they return to the eye clinic. If the patch comes off at home, you can leave it off, but make sure you put the eye shield back on.</p> <p>Your child will continue to wear the shield over the operated eye to protect it while they are sleeping. Your doctor will tell you when your child can stop wearing the shield.</p> <h3>Pain or discomfort</h3> <p>Your child may experience some pain or discomfort in the operated eye. Please ask your doctor what medication you can give your child at home to relieve the discomfort or pain.</p> <p>The nurses in the recovery room will watch your child for signs of pain or discomfort and will be able to give medication if your child needs it.</p> <p>Before your child is discharged from hospital, please ask the nurse when your child last had any pain relief medication. This way, you can monitor your child's pain and give medication safely as needed.</p> <h3>Redness, swelling, and discharge</h3> <p>The operated eye will be red and slightly swollen after the surgery. It will also produce a clear discharge. These should decrease over the next few days.</p> <h3>Blurred vision</h3> <p>Without the lens, your child's eye is no longer able to focus clearly, but be assured that your child will not be blind. Objects will be very blurry at first until your child receives a corrective device to improve their vision. You can read more about corrective devices below.</p><h2>When to call your doctor</h2> <p>Call your doctor immediately if:</p> <ul> <li>your child feels more pain or sensitivity to light</li> <li>your child's eyelid becomes redder or more swollen from day to day</li> <li>your child complains of or shows any signs of decreased vision</li> <li>there is any yellowish or greenish discharge from the eyes</li> <li>your child shows any other changes that concern you</li> </ul> <h2>Follow-up appointments after cataract surgery</h2> <p>Follow-up appointments are as important as the surgery itself. These appointments are usually scheduled:</p> <ul> <li>one day after surgery</li> <li>one week after surgery</li> <li>four weeks after surgery</li> </ul> <p>Every time the eye doctor sees your child, they will tell you when to come back again.</p> <p>It is very important to keep these appointments.</p> <p>Write the date and time of the first appointment here: ______________________</p> <h2>Corrective devices after cataract surgery</h2> <p>A corrective device is something that your child wears to repair their vision. Before the surgery, your child's ophthalmologist will discuss the best device for your child. The main options are:</p> <ul> <li>contact lens</li> <li>intra-ocular lens</li> <li>eye glasses.</li> </ul> <p>Your child's eye may also need to be patched. Patching is described in the next section.</p> <h3>Contact lens</h3> <p>A contact lens is an artificial lens made of special material, which can be either soft or hard. It is placed on the child's eyeball.</p> <p>Once your child's eye has healed enough, they will be fitted for a lens, usually in the eye clinic. Sometimes a child will need to be sedated (calmed with medicine) for the fitting or may even need a general anaesthetic.</p> <p>The eye doctor will start the fitting by putting an anaesthetic drop in the operated eye.</p> <p>The doctor will then place a sample contact lens on the eyeball and measure the child's contact lens prescription for strength and fit. Your doctor will explain the strength of contact lens your child is prescribed and the reason for it.</p> <p>The eye doctor or your optician or optometrist (where you buy the contact lens), will teach you how to insert and take out the contact lens as well as how to clean and store it. Make sure you understand these instructions.</p> <p>Your child's vision will need to be checked regularly (by an ophthalmologist) with the contact lens on. Because your child's eyes are still growing, they will get a new prescription to adjust the contact lens strength and fit.</p> <p>Younger children may be prescribed glasses to wear as a back-up when not using the contact lens. Older children may need glasses or bifocals in addition to their contact lenses.</p> <p>Although it might seem like a major change, babies and children adjust to contact lenses more quickly than adults do.</p> <h3>Intra-ocular lens</h3> <p>An intra-ocular lens is an artificial lens placed in the eye. Most times this is done during the surgery to remove the lens, but it can sometimes be done later. If your child needs this type of lens, the doctor will tell you when it will be fitted.</p> <p>Unlike the normal lens in the eye, an intra-ocular lens does not change its focusing power. Your ophthalmologist will decide what power of intra-ocular lens your child needs.</p> <p>Your child may also need bifocal eye glasses. Your doctor will discuss this with you. </p> <h3>Eye glasses</h3> <p>Eye glasses are prescribed only if no other device is suitable. This because the lenses are thick and would distort, or interfere with, your child's vision and the glasses feel heavy to wear. However, the vision will develop with glasses just as well as with another corrective device.</p> <p>If a baby needs eye glasses, the prescription will be for near vision, as they spend their waking hours focusing on things up close (for example food, toys or a parent's or caregiver's face).</p> <p>When the baby gets older and needs distant vision, they will get a prescription for bifocals (lenses that allow the eyes to focus on things that are close and far away).</p> <h3>Remember to have regular check-ups</h3> <p>Whatever corrective lens is prescribed, your child will still require regular check-ups with the ophthalmologist. Please call your eye doctor between appointments if your child develops:</p> <ul> <li>any discomfort or pain</li> <li>discharge, redness or swelling of the eye</li> <li>decrease in vision</li> <li>any unusual signs or symptoms.</li> </ul> <h2>Eye patching</h2> <p>When a child has cataract(s), the vision in the affected eye does not develop properly, which can lead to amblyopia.</p> <p>If there is any difference in vision between the eyes, even if both eyes were operated on, the doctor will order an <a href="/Article?contentid=57&language=English">eye patch</a>. Blocking the vision of your child's stronger eye with a patch will help to strengthen the weaker eye.</p> <p>If your child's eye needs patching, your eye doctor will explain:</p> <ul> <li>which eye needs to be patched</li> <li>how long and how often your child should wear the patch</li> <li>when a follow-up appointment is needed to check your child's vision.</li> </ul><h2>At SickKids</h2> <p>If the eye doctor who operated on your child's eye(s) is not available, call 416-813-7500 and ask for the eye doctor on call.</p>
CataracteCCataracteCataractFrenchOphthalmologyChild (0-12 years);Teen (13-18 years)EyesNervous systemConditions and diseasesCaregivers Adult (19+)NA2012-12-12T05:00:00Z8.0000000000000066.00000000000002783.00000000000Health (A-Z) - ConditionsHealth A-Z<p> Apprenez comment les cataractes se forment et peuvent être traitées chez les enfants.</p><h2>En quoi consiste la cataracte?</h2> <p>Une cataracte est une opacification (diminution de la transparence) du cristallin. Elle peut apparaître dans un seul œil ou dans les deux yeux. Les cataractes infantiles sont rares : leurs incidences varient entre 1 sur 4 000 et 1 sur 10 000 enfants.</p><h2>À retenir</h2> <ul><li>Une cataracte est une opacification (diminution de la transparence) du cristallin. Chez les enfants âgés de moins de 9 ans, la cataracte nuit au développement de la vue et peut entraîner une amblyopie.</li> <li>Pour un cas de cataracte léger, l’ophtalmologue peut décider de prescrire des gouttes spéciales qui dilatent (agrandissent) la pupille ou de ne pas la traiter si elle ne gêne pas la vue. La seule façon de traiter un cas de cataracte grave est d’extraire entièrement ou partiellement le cristallin par chirurgie.</li> <li>Après la chirurgie, l’ophtalmologue prescrira le port d’un verre de contact, l’implantation d’une lentille intraoculaire ou, bien que rarement, le port de lunettes. L’utilisation d’un cache-œil est aussi nécessaire pour permettre le renforcement uniforme de la vue dans les deux yeux.</li> <li>Votre enfant devra passer des examens réguliers chez l’ophtalmologue. Il est extrêmement important de respecter tous ces rendez-vous de suivi.</li> <li>Communiquez avec l’ophtalmologue si, après la chirurgie, les douleurs, l’enflure ou la sensibilité à la lumière augmentent ou si le verre de contact, les lunettes ou la lentille intraoculaire entraînent une rougeur, une enflure, des sécrétions, des douleurs ou toute autre séquelle inhabituelle.</li></ul><h2>Causes des cataractes</h2> <p>Une cataracte peut être congénitale (qui est présente à la naissance) ou acquise (qui se forme pendant l’enfance ou à l’âge adulte).</p> <p>Ses causes courantes sont :</p> <ul><li>l’hérédité (transmission par un parent),</li> <li>un traumatisme (lésion) à l’œil,</li> <li>l’irradiation (traitement du cancer),</li> <li>certains médicaments (par exemple, les stéroïdes),</li> <li>d’autres maladies (par exemple, le syndrome de Down),</li> <li>une infection (par exemple, la rubéole).</li></ul> <p>Dans bon nombre de cas, la cause des cataractes est inconnue.</p><h2>Comment déterminer si votre enfant est atteint d’une cataracte</h2> <p>Un examen des yeux par un ophtalmologue (médecin spécialisé dans les yeux) s’impose si:</p> <ul><li>vous observez une tache blanche dans un œil ou les deux yeux de votre enfant,</li> <li>une cataracte s’est formée chez un parent ou une sœur ou un frère durant l’enfance (et non pas à un âge adulte avancé),</li> <li>votre enfant présente des problèmes oculaires ou un autre trouble ou maladie susceptibles d’être accompagnés de cataractes,</li> <li>votre médecin de famille ou votre pédiatre recommande que votre enfant passe un examen de la vue en raison de la présence possible de cataractes,</li> <li>votre enfant est atteint de strabisme (il louche),</li> <li>la vue de votre enfant est préoccupante.</li></ul> <p><strong>​S’il y a des antécédents de cataractes infantiles dans la famille, faites examiner les yeux de votre enfant par un ophtalmologue avant l’âge de deux semaines.​</strong></p> <h2>Examen de dépistage des cataractes</h2> <p>L’ophtalmologue examinera minutieusement les yeux de votre enfant. Voici comment se déroulera l’examen.</p> <ul><li>L’ophtalmologue mettra des gouttes spéciales dans les yeux de votre enfant pour dilater (agrandir) ses pupilles. Les gouttes provoqueront d’abord une sensation de brûlure, mais cela ne durera que 10 secondes environ. L’administration des gouttes peut être répétée.</li> <li>Puisque votre enfant devra rester tout à fait immobile pendant l’examen, on pourrait l’envelopper dans une couverture et le tenir en place doucement, surtout s’il est très jeune ou trop inquiet pour ne pas bouger.</li> <li>Quand les gouttes commenceront à agir, ce qui se produit habituellement au bout d’une trentaine de minutes, l’ophtalmologue projettera une lumière vive dans les yeux de votre enfant et fera l’examen à l’aide de divers instruments.</li></ul> <p>Votre enfant peut trouver difficile d’être maintenu en place et d’avoir une lumière vive projetée dans les yeux, mais il ne devrait éprouver aucune douleur.</p> <p>Une fois l’examen terminé, l’ophtalmologue vous décrira l’état des yeux de votre enfant. S’il y a observé une cataracte, il vous expliquera le meilleur traitement pour votre enfant.</p><h2>Traitements des cataractes</h2> <p>Les cataractes ne disparaissent pas d’elles-mêmes, sauf dans quelques rares situations.</p> <h3>Cas de cataractes légers</h3> <p>Si la cataracte est petite et ne nuit pas à la vue de votre enfant, le médecin peut décider de ne pas la traiter ou de prescrire des gouttes spéciales qui dilatent (agrandissent) la pupille afin que plus de lumière puisse pénétrer dans l’œil. Si votre enfant a besoin de ces gouttes, assurez-vous de bien suivre les directives pour <a href="/Article?contentid=995&language=French">les mettre dans l’œil</a>.</p> <h3>​Cas de cataractes graves</h3> <p>Si la cataracte est plus grave, une chirurgie sera nécessaire. Les cataractes ne peuvent pas être éliminées au laser ou à l’aide de médicaments.</p> <h2>​Importance de la chirurgie dans un cas de cataracte grave</h2> <p>La chirurgie est alors importante parce qu’elle permettra d’assurer le plus possible le développement normal de la vue de votre enfant. Elle est particulièrement cruciale chez les enfants âgés de moins de 9 ans étant donné que leur vue est en plein développement.</p> <p>Sans intervention chirurgicale, votre enfant risque d’être atteint d’<a href="/Article?contentid=835&language=French">amblyopie​</a> s’il est âgé de moins de 9 ans. L’amblyopie, qui est parfois appelée « œil paresseux », peut survenir quand l’œil comportant une cataracte ne peut pas être assez stimulé par les rayons lumineux.</p> <p>Tous les enfants âgés de moins de 9 ans, présentant une cataracte, qu’elle soit congénitale ou acquise, devraient subir une chirurgie dès que possible. À compter de l’âge de neuf ans, la chirurgie est moins urgente étant donné que la vue est alors entièrement développée.</p> <h2>​Déroulement de la chirurgie de la cataracte</h2> <p>Avant l’intervention, on mettra des gouttes spéciales qui dilatent (agrandissent) la pupille dans l’œil atteint de votre enfant. Les gouttes entraîneront d’abord une sensation de brûlure, mais cela ne durera que 10 secondes environ. L’administration des gouttes pourra être répétée une ou deux fois.</p> <p>L’administration des gouttes se fait habituellement à l’hôpital même, immédiatement avant la chirurgie. Mais, si votre enfant a besoin de gouttes auparavant, votre ophtalmologue vous remettra l’ordonnance nécessaire et vous dira quand en commencer l’administration. Votre enfant recevra ensuite un mélange de médicaments (anesthésie générale) pour qu’il dorme pendant toute l’intervention et ne ressente aucune douleur.</p> <p>Pour supprimer la cataracte, le chirurgien retirera le cristallin de l’œil. Votre ophtalmologue vous précisera avant la chirurgie s’il est préférable d’effectuer une extraction complète ou partielle du cristallin.</p> <p>Pour fermer la plaie, le chirurgien utilisera des points de suture fondants, ce qui signifie qu’ils n’auront pas à être retirés. Les points se résorberont au cours des six à huit semaines suivant la chirurgie.</p> <p>Chez les jeunes enfants aux prises avec des cataractes dans les deux yeux, la deuxième intervention suit souvent dès que possible la première afin d’assurer le développement uniforme de la vue dans les deux yeux.</p> <p>Parfois, les chirurgies des deux yeux sont réalisées le même jour. Votre ophtalmologue vous donnera la date exacte de la chirurgie. S’il effectue les deux interventions le même jour, il vous précisera aussi l’heure de chacune.</p> <p>Les enfants de plus de 12 semaines peuvent normalement rentrer à la maison le jour même de l’intervention. Les enfants prématurés ou de moins de 12 semaines sont habituellement hospitalisés jusqu’au lendemain.</p> <h2>​À quoi vous attendre après la chirurgie</h2> <h3>Cache-œil et protecteur</h3> <p>Un cache-œil sera placé sur l’œil immédiatement après la chirurgie de la cataracte.</p> <p>Le cache-œil sera recouvert d’un protecteur en matière plastique ou en métal pour plus de sûreté. Le lendemain, vous retournerez au centre de soins des yeux pour que l’ophtalmologue retire le cache-œil. Si celui-ci se détache de l’œil à domicile, vous n’aurez pas à le remettre en place pourvu que vous replaciez le protecteur.</p> <p>Votre enfant devra continuer de porter le protecteur pour dormir. L’ophtalmologue vous dira quand le protecteur ne sera plus nécessaire.</p> <h3>Douleurs ou malaises</h3> <p>Votre enfant pourrait éprouver des douleurs ou des malaises à l’œil ayant subi l’intervention. Demandez à votre médecin quel médicament vous pourrez lui donner à domicile pour le soulager.</p> <p>Dans la salle de réveil, les infirmiers surveilleront votre enfant pour déceler tout signe de douleurs ou de malaises et lui administreront des médicaments au besoin.</p> <p>Avant que votre enfant reçoive son congé de l’hôpital, assurez-vous de demander à l’infirmier qui l’a pris en charge à quelle heure les derniers antidouleurs lui ont été administrés. Vous pourrez de cette manière surveiller votre enfant et, au besoin, lui donner des médicaments sans danger.</p> <h3>​Rougeur, enflure et sécrétions</h3> <p>L’œil sera rouge et légèrement enflé après la chirurgie. De plus, des sécrétions claires s’en écouleront. L’écoulement devrait toutefois cesser au bout de quelques jours.</p> <h3>​Vision floue</h3> <p>Votre enfant ne verra plus clairement de l’œil ayant subi l’extraction du cristallin. Soyez assuré qu’il ne sera pas aveugle de cet œil. Toutefois, sa vue sera brouillée jusqu’à ce qu’une correction optique (verre de contact, lentille intraoculaire ou lunettes) lui soit prescrite afin de l’améliorer. La correction optique est présentée ci-dessous.</p><h2>​Quand communiquer avec l’ophtalmologue</h2> <p>Communiquez immédiatement avec votre ophtalmologue si :</p> <ul><li>l’œil de votre enfant est plus sensible à la lumière ou plus douloureux quand il y est exposé,</li> <li>la rougeur ou l’enflure de la paupière de l’œil de votre enfant s’intensifie de jour en jour,</li> <li>votre enfant se plaint de moins bien voir ou vous observez chez lui tout signe de baisse de l’acuité visuelle,</li> <li>des sécrétions jaunâtres ou verdâtres s’écoulent de l’œil de votre enfant,</li> <li>vous observez chez votre enfant tout autre changement qui vous préoccupe.</li></ul> <h2>​Rendez-vous de suivi après la chirurgie</h2> <p>Les rendez-vous de suivi sont aussi importants que la chirurgie même. Ces rendez-vous ont habituellement lieu :</p> <ul><li>le lendemain de la chirurgie,</li> <li>1 semaine après la chirurgie,</li> <li>4 semaines après la chirurgie.</li></ul> <p>À chaque examen, l’ophtalmologue vous précisera la date du prochain rendez-vous.</p> <p><strong>Il est très important de respecter chacun des rendez-vous de suivi.</strong></p> <p>Consignez ici la date du premier rendez-vous : ______________________</p> <h2>Correction optique supplémentaire suivant la chirurgie</h2> <p>Après la chirurgie, une correction optique supplémentaire sera essentielle pour votre enfant. L’ophtalmologue discutera avec vous avant la chirurgie de la meilleure option, dont voici les principales :</p> <ul><li>verres de contact (aussi appelés lentilles de contact),</li> <li>lentilles intraoculaires,</li> <li>lunettes.</li></ul> <p>Votre enfant aura peut-être aussi besoin d’un cache-œil. Le port et l’utilité du cache-œil sont expliqués dans la prochaine section.</p> <h2>​Verres de contact</h2> <p>Un verre de contact est un cristallin artificiel fait d’un matériau spécial qui peut être souple ou dur. Il sera placé sur le globe oculaire (c’est-à-dire directement sur l’œil) de votre enfant.</p> <p>Quand l’œil de votre enfant se sera suffisamment rétabli, il sera examiné pour déterminer la force et la taille du verre de contact dont il aura besoin. Cet examen a généralement lieu au centre de soins des yeux. Les enfants peuvent parfois avoir besoin d’un sédatif (médicament qui calme) ou même d’une anesthésie générale pour l’examen. L’ophtalmologue mettra d’abord des gouttes anesthésiques dans l’œil dont le cristallin a été extrait.</p> <p>Il placera ensuite un échantillon de verre de contact sur le globe oculaire et déterminera la force et la grandeur qui doivent être prescrites. Il vous expliquera aussi la force nécessaire du verre de contact et pourquoi elle est prescrite.</p> <p>L’ophtalmologue ou votre opticien ou optométriste (du point de vente où vous achèterez le verre de contact), vous montrera comment mettre et retirer le verre de contact ainsi que comment le laver et le ranger. Assurez-vous de bien comprendre les directives transmises.</p> <p>Votre enfant devra passer des examens ophtalmologiques réguliers en conservant son verre de contact. Puisque les yeux de votre enfant sont en pleine croissance, l’ophtalmologue vous remettra une nouvelle ordonnance afin d’ajuster la force et la taille du verre.</p> <p>Les enfants en bas âge peuvent avoir à mettre des lunettes quand ils ne portent pas leur verre de contact. Les enfants plus âgés peuvent devoir porter des lunettes bifocales (à double foyer) en plus de leur verre de contact. </p> <p>Même si le port d’un verre de contact vous semble constituer un changement majeur, rassurez-vous, car les bébés et les enfants s’y adaptent plus rapidement que les adultes.</p> <h3>​Lentilles intraoculaires</h3> <p>Une lentille intraoculaire est un cristallin artificiel implanté dans l’œil. En règle générale, l’implantation est effectuée au même moment que l’extraction chirurgicale du cristallin, quoiqu’elle puisse parfois être réalisée ultérieurement. Si votre enfant a besoin d’une lentille intraoculaire, l’ophtalmologue vous précisera quand elle sera implantée.</p> <p>Contrairement à la capacité de mise au point du cristallin, celle de la lentille intraoculaire est fixe. L’ophtalmologue déterminera la force nécessaire de la lentille intraoculaire.</p> <p>Votre enfant pourrait aussi avoir à porter des lunettes bifocales (à double foyer). L’ophtalmologue abordera cette question avec vous.</p> <p>Des lunettes ne sont prescrites que lorsque les autres options ne conviennent pas. Cela s’explique par le fait que des lunettes seraient non seulement lourdes, mais que ses verres seraient épais et perturberaient la vue de votre enfant par un effet déformant ou autre. Cependant, si votre enfant doit porter des lunettes, sa vue s’améliorera aussi bien qu’avec un verre de contact ou une lentille intraoculaire.</p> <p>Des lunettes pour voir de près sont prescrites aux bébés étant donné que lorsqu’ils sont éveillés, ils passent tout leur temps à regarder des objets ou des personnes proches d’eux (par exemple, leur nourriture, leurs jouets ou le visage d’un parent ou d’un fournisseur de soins).</p> <p>Quand les bébés atteignent l’âge où ils ont besoin d’une correction pour voir de loin, des lunettes bifocales (qui permettent de bien voir à la fois les objets de près et de loin) leur sont prescrites.</p> <h3>​Assurez-vous que votre enfant passe des examens de la vue réguliers</h3> <p>Peu importe si votre enfant a besoin d’un verre de contact, d’une lentille intraoculaire ou de lunettes, il devra passer des examens réguliers chez son ophtalmologue. Assurez-vous de communiquer avec ce dernier si, entre les rendez-vous, votre enfant présente :</p> <ul><li>un malaise ou des douleurs,</li> <li>des sécrétions, une rougeur ou une enflure à l’œil, </li> <li>une baisse d’acuité visuelle,</li> <li>des signes ou des symptômes inhabituels.</li></ul> <h2>​Port d’un cache-œil</h2> <p>Chez les enfants atteints d’une cataracte, la vue dans l’œil touché ne se développe pas correctement, ce qui peut y causer une amblyopie.</p> <p>Si l’acuité visuelle n’est pas identique dans les deux yeux (même si le chirurgien a extrait le cristallin dans les deux), l’ophtalmologue prescrira le port d’un cache-œil. Le fait de bloquer l’œil offrant la meilleure acuité visuelle à l’aide d’un cache-œil permettra de renforcer celui qui est plus faible.</p> <p>Si c’est le cas de votre enfant, l’ophtalmologue vous précisera :</p> <ul><li>sur quel œil placer le cache-œil,</li> <li>pendant combien de temps et à quelle fréquence le cache-œil doit être utilisé,</li> <li>la date à laquelle un examen de la vue sera fixé.</li></ul><h2>À SickKids</h2><p>Si l’ophtalmologue qui a pratiqué la chirurgie de la cataracte sur votre enfant n’est pas disponible, composez le 416 813-7500 et demandez de parler à l’ophtalmologue de garde.</p><br>

 

 

 

 

Cataract in babies and children837.000000000000Cataract in babies and childrenCataract in babies and childrenCEnglishOphthalmologyChild (0-12 years);Teen (13-18 years)EyesNervous systemConditions and diseasesCaregivers Adult (19+)NA2012-12-12T05:00:00Z8.0000000000000065.90000000000002825.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Discover how cataracts develop in children and how they can be treated.</p><h2>What is a cataract?</h2> <p>A cataract is a cloudy area over the lens of the eye. Cataracts can affect one or both eyes. Childhood cataracts are rare: they occur in one to three in 10,000 children.</p><h2>A healthy eye</h2><p>The eye is like a camera. It records pictures of what it sees. But to see clearly, all parts of the eye must work properly.</p><ul><li>The cornea is a clear outer covering at the front of the eye. It covers the iris and pupil.</li><li>The sclera, or white part of the eye, is the continuation of the cornea around into the back the eye.</li><li>The iris is the coloured part of the eye and controls how much light enters through the pupil.</li><li>The pupil is the window in the centre of the iris.</li><li>The lens is behind the pupil. It is designed to focus the rays of light onto the retina, just like a camera lens focuses an image onto a film.</li><li>The retina is the innermost covering of the eye. It converts the rays of light into an electrical signal and sends the signal to the brain.</li></ul> <figure class="asset-c-80"> <span class="asset-image-title">Eye cross-section</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Cataracts_normal_eye_MED_ILL_EN.jpg" alt="The optic nerve, retina, lens, sclera, cornea, pupil and iris receiving an image of a balloon" /> </figure> <h2>What happens when your child has cataract(s)</h2><p>When your child has a cataract, the lens cannot focus the rays of light onto the retina normally. Instead, the lens produces blurry images, which reduce the child's vision.</p><p>Your child's vision might be mildly or seriously affected by a cataract, depending on how big it is and where it covers the lens. A cataract will not affect your child's vision if it is very small or away from the centre of the lens.</p> <figure class="asset-c-80"> <span class="asset-image-title">Cataracts</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Cataract_V2_MED_ILL_EN.png" alt="Pupil and iris of a normal eye seeing a clear image of balloons and eye with cataract over the pupil seeing a blurry image" /> <figcaption class="asset-image-caption">A normal clear lens focuses the image on the retina. A lens clouded by a cataract results in a blurry image.</figcaption> </figure><h2>Key points</h2> <ul> <li>A cataract is a cloudy area over the lens of the eye. In children under nine, it stops the eye's vision from developing normally and can cause amblyopia.</li> <li>If the cataract is mild, the doctor may decide to prescribe eye drops to make the pupil bigger or not to treat it at all if the vision is not affected. If the cataract is serious, the only way to treat it is to remove all or some of the lens during surgery.</li> <li>After surgery, your child will need a corrective device such as a contact lens, intra-ocular lens or, in rare situations, eye glasses. Your child will also need to wear a patch to help both eyes develop equally strong vision.</li> <li>Your eye doctor will need to check your child's vision regularly after surgery. It is extremely important that you keep all follow-up appointments.</li> <li>Please call the eye doctor if your child has increased pain, swelling or sensitivity to light after surgery or if their corrective device causes any redness, swelling, discharge, pain or other unusual symptoms.</li> </ul><h2>Causes of cataract</h2> <p>A cataract can be congenital (a person is born with it) or can be acquired or developmental (it appears later in childhood or in adulthood).</p> <p>Common causes include:</p> <ul> <li>heredity (inheriting a cataract from a parent)</li> <li>trauma (injury) to the eye</li> <li>radiation (treatment for cancer)</li> <li>medication (for example steroids)</li> <li>other illnesses or conditions (for example Down syndrome)</li> <li>infection (for example German measles).</li> </ul> <p>In many cases, however, the cause of a cataract is not known.</p><h2>How to tell if your child has a cataract</h2> <p>Have your child's eyes examined by an ophthalmologist (say: op-thal-MOL-o-jist), a medical eye doctor, if:</p> <ul> <li>you notice a white spot on your child's eye(s)</li> <li>a parent or sibling had a cataract as a child (not as an older adult)</li> <li>your child has eye problems or another disease or condition in which cataracts are likely to be present</li> <li>your family doctor or paediatrician recommends an eye exam because of a concern about possible cataracts</li> <li>your child's eyes are crossed</li> <li>there is a concern about your child's vision.</li> </ul> <p>If there is a family history of cataracts in childhood, bring your child to an ophthalmologist before they are two weeks old.</p> <h2>Checking your child's eyes for cataracts</h2> <p>The ophthalmologist will carefully examine your child's eyes. Here is what you can expect during the exam.</p> <ul> <li>Your child will have special eye drops to make their pupils bigger. These drops sting at first but only for about 10 seconds. They may be repeated.</li> <li>Since your child needs to be very still when the eyes are checked, they may be wrapped in a blanket and held down gently, especially if they are very young or too upset to stay still on their own.</li> <li>When the drops start to work, usually after about 30 minutes, the ophthalmologist will shine a bright light into your child's eyes and use different instruments to help check them.</li> </ul> <p>Being held down and having a bright light shone in their eyes will make your child uncomfortable, but they should not feel any pain.</p> <p>After the exam, the eye doctor will explain the condition of your child's eyes. If there is a cataract, the doctor will tell you and talk to you about the best treatment for your child.</p><h2>Treatments for cataracts</h2> <p>Cataracts do not go away by themselves, except in a few rare situations.</p> <h3>Mild cataract</h3> <p>If the cataract is small and does not affect your child's vision, the doctor may decide not to treat it at all or may prescribe special eye drops to dilate (widen) the pupil to allow more light to enter the eye. If your child needs eye drops, make sure you carefully follow the instructions for <a href="/Article?contentid=995&language=English">putting them in</a>.</p> <h3>Serious cataract</h3> <p>If the cataract is more serious, your child will need surgery to remove it. Cataracts cannot be removed with medication or lasers.</p> <h2>Why it is important to have surgery to remove a serious cataract</h2> <p>Surgery is important because it will allow your child's vision to develop as normally as possible. It is especially important for children aged under nine because their vision is still developing.</p> <p>If your child has a cataract and they are aged under nine, there is a risk that they will develop <a href="/Article?contentid=835&language=English">amblyopia</a> if the cataract is not removed. Amblyopia is sometimes called "lazy eye" and can occur when the affected eye does not get enough stimulation from light rays.</p> <p>All children aged under nine should be operated on as soon as possible, whether they are born with a cataract or develop one later. If your child develops a cataract when he is aged nine or over, the timing of the surgery is more flexible because their vision has fully developed.</p> <h2>What happens during cataract surgery</h2> <p>Before the surgery, your child will have special drops to dilate (widen) the pupil of the eye. These drops sting at first but only for about 10 seconds. They may need to be repeated once or twice.</p> <p>The eye drops are usually applied right before the surgery in the hospital. If your child needs them before then, your eye doctor will give you a prescription for the drops and explain when to start putting them in.</p> <p>Your child will have a special "sleep medicine" called a general anaesthetic for the surgery. This will make sure they sleep through the operation and do not feel any pain.</p> <p>The surgeon takes out the cataract by removing the lens of the affected eye(s). Your eye doctor will tell you before the surgery if it is best to remove the whole lens or only part of it.</p> <p>The surgeon will use special stitches to repair the eye wound. These stitches are absorbable, meaning that that they do not need to be taken out. They will dissolve on their own over the first six to eight weeks after surgery.</p> <p>In young children with cataracts in both eyes, surgery is often done on the second eye as soon as possible after the first eye. This is to make sure that the vision in both eyes develops evenly.</p> <p>At times, surgery may be done on both eyes on the same day. Your eye doctor will explain exactly when your child will have surgery and, if it applies, when each eye will be done.</p> <p>The operation is usually done as a day surgery if your child is over 12 weeks old. If your child was born prematurely or if the surgery is within the first 12 weeks of life, they will usually stay in the hospital overnight.</p> <h2>What to expect after the surgery</h2> <h3>Eye patch and shield</h3> <p>Immediately after surgery, an eye patch will be placed over the operated eye. The eye patch is covered with a plastic or metal shield for protection. Your child's patch will be removed the next day by the ophthalmologist when they return to the eye clinic. If the patch comes off at home, you can leave it off, but make sure you put the eye shield back on.</p> <p>Your child will continue to wear the shield over the operated eye to protect it while they are sleeping. Your doctor will tell you when your child can stop wearing the shield.</p> <h3>Pain or discomfort</h3> <p>Your child may experience some pain or discomfort in the operated eye. Please ask your doctor what medication you can give your child at home to relieve the discomfort or pain.</p> <p>The nurses in the recovery room will watch your child for signs of pain or discomfort and will be able to give medication if your child needs it.</p> <p>Before your child is discharged from hospital, please ask the nurse when your child last had any pain relief medication. This way, you can monitor your child's pain and give medication safely as needed.</p> <h3>Redness, swelling, and discharge</h3> <p>The operated eye will be red and slightly swollen after the surgery. It will also produce a clear discharge. These should decrease over the next few days.</p> <h3>Blurred vision</h3> <p>Without the lens, your child's eye is no longer able to focus clearly, but be assured that your child will not be blind. Objects will be very blurry at first until your child receives a corrective device to improve their vision. You can read more about corrective devices below.</p><h2>How to care for your child after cataract surgery</h2> <h3>Antibiotic and cortisone drops</h3> <p>Sometimes the doctor will order antibiotic drops or a combination of antibiotic and steroid drops for the operated eye(s). Your child may also need to have eye drops or ointment to keep their pupil dilated. If your child needs eye drops, your child's doctor will let you know. Please follow any instructions for <a href="/Article?contentid=996&language=English">applying the ointment</a> or <a href="/Article?contentid=995&language=English">putting in the eye drops</a> correctly.</p> <h3>Day-to-day activities</h3> <p>The surgeon who operated on your child will give you instructions about how else to care for your child after surgery. You will need to know, for example, how soon your child can return to normal activities, whether they can have a bath or a shower and when they can return to school or day care.</p> <p>Use this section to write down the instructions from the surgeon.</p> <p>Allowed activities:</p> <p>____________________________________________________________________</p> <p>Swimming:</p> <p>____________________________________________________________________</p> <p>Bath or shower instructions:</p> <p>____________________________________________________________________</p> <p>When your child can return to school or day care:</p> <p>____________________________________________________________________</p> <p>Other questions you want to ask:</p> <p>____________________________________________________________________</p><h2>When to call your doctor</h2> <p>Call your doctor immediately if:</p> <ul> <li>your child feels more pain or sensitivity to light</li> <li>your child's eyelid becomes redder or more swollen from day to day</li> <li>your child complains of or shows any signs of decreased vision</li> <li>there is any yellowish or greenish discharge from the eyes</li> <li>your child shows any other changes that concern you</li> </ul> <h2>Follow-up appointments after cataract surgery</h2> <p>Follow-up appointments are as important as the surgery itself. These appointments are usually scheduled:</p> <ul> <li>one day after surgery</li> <li>one week after surgery</li> <li>four weeks after surgery</li> </ul> <p>Every time the eye doctor sees your child, they will tell you when to come back again.</p> <p>It is very important to keep these appointments.</p> <p>Write the date and time of the first appointment here: ______________________</p> <h2>Corrective devices after cataract surgery</h2> <p>A corrective device is something that your child wears to repair their vision. Before the surgery, your child's ophthalmologist will discuss the best device for your child. The main options are:</p> <ul> <li>contact lens</li> <li>intra-ocular lens</li> <li>eye glasses.</li> </ul> <p>Your child's eye may also need to be patched. Patching is described in the next section.</p> <h3>Contact lens</h3> <p>A contact lens is an artificial lens made of special material, which can be either soft or hard. It is placed on the child's eyeball.</p> <p>Once your child's eye has healed enough, they will be fitted for a lens, usually in the eye clinic. Sometimes a child will need to be sedated (calmed with medicine) for the fitting or may even need a general anaesthetic.</p> <p>The eye doctor will start the fitting by putting an anaesthetic drop in the operated eye.</p> <p>The doctor will then place a sample contact lens on the eyeball and measure the child's contact lens prescription for strength and fit. Your doctor will explain the strength of contact lens your child is prescribed and the reason for it.</p> <p>The eye doctor or your optician or optometrist (where you buy the contact lens), will teach you how to insert and take out the contact lens as well as how to clean and store it. Make sure you understand these instructions.</p> <p>Your child's vision will need to be checked regularly (by an ophthalmologist) with the contact lens on. Because your child's eyes are still growing, they will get a new prescription to adjust the contact lens strength and fit.</p> <p>Younger children may be prescribed glasses to wear as a back-up when not using the contact lens. Older children may need glasses or bifocals in addition to their contact lenses.</p> <p>Although it might seem like a major change, babies and children adjust to contact lenses more quickly than adults do.</p> <h3>Intra-ocular lens</h3> <p>An intra-ocular lens is an artificial lens placed in the eye. Most times this is done during the surgery to remove the lens, but it can sometimes be done later. If your child needs this type of lens, the doctor will tell you when it will be fitted.</p> <p>Unlike the normal lens in the eye, an intra-ocular lens does not change its focusing power. Your ophthalmologist will decide what power of intra-ocular lens your child needs.</p> <p>Your child may also need bifocal eye glasses. Your doctor will discuss this with you. </p> <h3>Eye glasses</h3> <p>Eye glasses are prescribed only if no other device is suitable. This because the lenses are thick and would distort, or interfere with, your child's vision and the glasses feel heavy to wear. However, the vision will develop with glasses just as well as with another corrective device.</p> <p>If a baby needs eye glasses, the prescription will be for near vision, as they spend their waking hours focusing on things up close (for example food, toys or a parent's or caregiver's face).</p> <p>When the baby gets older and needs distant vision, they will get a prescription for bifocals (lenses that allow the eyes to focus on things that are close and far away).</p> <h3>Remember to have regular check-ups</h3> <p>Whatever corrective lens is prescribed, your child will still require regular check-ups with the ophthalmologist. Please call your eye doctor between appointments if your child develops:</p> <ul> <li>any discomfort or pain</li> <li>discharge, redness or swelling of the eye</li> <li>decrease in vision</li> <li>any unusual signs or symptoms.</li> </ul> <h2>Eye patching</h2> <p>When a child has cataract(s), the vision in the affected eye does not develop properly, which can lead to amblyopia.</p> <p>If there is any difference in vision between the eyes, even if both eyes were operated on, the doctor will order an <a href="/Article?contentid=57&language=English">eye patch</a>. Blocking the vision of your child's stronger eye with a patch will help to strengthen the weaker eye.</p> <p>If your child's eye needs patching, your eye doctor will explain:</p> <ul> <li>which eye needs to be patched</li> <li>how long and how often your child should wear the patch</li> <li>when a follow-up appointment is needed to check your child's vision.</li> </ul><h2>Long-term effects of cataract surgery</h2><h3>Scar tissue or slight cloudiness</h3><p>Cataracts do not re-appear after surgery, but sometimes the lens capsule may develop scar tissue or slight cloudiness. If this happens, your eye doctor will explain how it will be treated.</p><h3>Other eye conditions</h3><p>Even after patching, and being fitted with a corrective device, your child may develop other eye conditions after surgery. These include <a href="/Article?contentid=836&language=English">strabismus</a>, inflammation (irritation or swelling), glaucoma and retinal detachment.</p><p>You will need to take your child for regular check-ups to let the eye doctor monitor your child's vision closely and check for any of these conditions as early as possible. It is important to keep all your follow-up appointments.</p><p>If you have any questions or concerns, please call your child's eye surgeon. Please write the surgeon's name and phone number here.</p><p><strong>Doctor:</strong> ________________________ <strong>Phone:</strong> _________________________</p><h2>At SickKids</h2> <p>If the eye doctor who operated on your child's eye(s) is not available, call 416-813-7500 and ask for the eye doctor on call.</p>https://assets.aboutkidshealth.ca/akhassets/Cataracts_normal_eye_MED_ILL_EN.jpgCataract in babies and childrenFalse

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