Transcript Document

Developmental cataract
• Present at birth or after birth
• 25% have a hereditary
predisposition
• Causes : intrauterine infections
[TORCHES]
: prematurity,
: inborn errors of metabolism
: trauma e.g forceps delivery
Developmental cataract
• Types of cataract
• Punctate
• Anterior polar
Posterior polar
Central nuclear
Zonular
Sutural
Clinical presentation
• Nystagmus
• Squint
• Leucokoria [cat’s eye
reflex ]
• Squeezing their eyes to
get a pinhole effect.
• Mother notices child is
not focusing
Management
• INVESTIGATIONS
• Ocular examination• Assess density of cataractophthalmoscopy
• Morphology of cataract
• Associated ocular pathology- corneal
clouding, microphthalmos
• Special tests- prefrential looking
Lab investigations
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Serological tests- TORCH
Urinalysis for reducing substance
Urine chromatography of amino acids
Blood sugar levels
Serum calcium and phosphorus
Galactokinase levels
Chromosome analysis
Treatment
• Small cataract and not impairing
vision – just observe
• Significant cataract and impairing
vision surgical treatment
• Timing of the surgery is crucial –
early the surgery better the
prognosis because of amblyopia
Surgery
• Lens aspiration[ lensectomy] with
posterior capsulotomy with posterior
chamber intra ocular lens under G.A.
• Child more than 3 yrs-- IOL
• Child is less than 3 yrs – lensectomy with
contact lens or spectacles
• Unilateral aphakia, spectacles should not
be given ,because of diplopia
Post operative complications
 The same as in adults except the
postoperative inflammation is more
severe
 In all cases a posterior capsulotomy
and an anterior vitrectomy is
performed to prevent posterior
capsule opacification
 amblyopia
Questions
• SIGNS AND SYMPTOMS OF
CONGENITAL/DEVELOPMENTAL
CATARACT
• MANAGEMENT OF
DEVELOPMENTAL CATARACT