Hello, I am searching for answers. I take my son regularly to his eye surgeon and regular eye Dr. He was born with cataracts and we just recently found out they he has permanent nerve damage in his eyes. His cataracts are dead center and every time he has an eye exam the surgeon says light is getting to the back of his eye. He does wear glasses to help with some of the blurriness. Recently, his therapist and I have noticed an increase in frustration when asked to focus on a task. He seems to be getting bits and pieces of some images but not the full image. He is having trouble working on kindergarten readiness stuff and progressing in his therapies. Something he has to bring the image really close to his face to see it. My question is can this hinder him when he goes to regular school next year and is it a good idea to approach the subject of removal?
Very rarely central cataracts can effect the central 'fine seeing' vision in child. This can be quite difficult to assess but one way is to get a pattern VEP test. If indeed the cataracts ( even though central ) are affecting the child's vision the VEP ( visual evoked potential ) will pick this up. If this is the case then cataract surgery may be needed.
When you say that there is optic nerve damage , it would be good to ascertain whether the speacilist means 'amblyopia' or actual nerve damage. Actual nerve damage does not occur due to cataracts and suggests another process but amblyopia (failure of the brain to develop vision because of the optical hindrance from the cataracts) can be caused by cataracts.
I think it would be useful to clarify these points with your specialist and also to ascertain the actual vision level your child has according tot the specialist .
Ken K Nischal FRCOphth
Scientific Advisory Board
Pediatric Glaucoma and Cataract Family Association
Article ID: 29
Last updated: 28 Aug, 2017