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Chapter-13 Tips and Pearls for Achieving the Optical Results when Managing Cataract in a Child

BOOK TITLE: Surgical Techniques in Ophthalmology (Pediatric Ophthalmic Surgery)

Author
1. Pajic Bojan
2. Müller Jörg
3. Pajic-Eggspuehler Brigitte
4. Ljubic Jasna
ISBN
9789350251485
DOI
10.5005/jp/books/11282_13
Edition
1/e
Publishing Year
2011
Pages
4
Author Affiliations
1. Vision Care, Klinik Pallas, Louis Giroud Str. 20, 4600 Olten, Switzerland, Klinik Pallas, Louis Giroud-Str. 20, 4600 Olten, Switzerland, Swiss Eye Research Foundation, Eye Clinic Orasis Titlisstrasse 44, 5734 Reinach AG Switzerland, Eye Clinic Orasis; Swiss Eye Research Foundation, Titlisstrasse 44, 5734, Reinach, AG Switzerland, Klinik Pallas,Louis Giroud Str, Olten, Switzerland, Swiss Eye Research Foundation, Eye Clinic Orasis, Titlisstrasse, Reinach, Switzerland, Chief of the Cornea and Refractive, Klinik Pallas, Louis Giroud-Str. 20, 4600 Olten, Switzerland, Klinik Pallas, LouisGiroud Str 20, 4600 Olten Switzerland, Klinik Pallas Louis Giroud-Str.20 4600, Olten, Switzerland, Swiss Eye Research Foundation, Eye Clinic ORASIS, Titlisstrasse 44, 5734, Reinach, Switzerland, Klinik Pallas, Louis Giroud Str. 20, 4600 Olten, Switzerland, Klinik Pallas, Louis Giroud-Str. 20, 4600 Olten (Switzerland), Vedis, Klinik Pallas, Olten, Switzerland, Vedis, Klinik Pallas, 4600 Olten, Switzerland
2. Klinik Pallas, Louis Giroud-Str. 20, 4600 Olten, Switzerland, Swiss Eye Research Foundation, Eye Clinic Orasis Titlisstrasse 44, 5734, Reinach, Switzerland, Nova Optik, Hauptplatz6, 6431 Schwyz, Switzerland, Nova Optik, Hauptplatz 6, 6431 Schwyz, Switzerland, Klinik Pallas, Louis Giroud-Str. 20 4600 Olten, Switzerland, Klinik Pallas, Louis Giroud-Str 20, 4600 Olten, Switzerland, Klinik Pallas, Louis Giroud-Str. 20, 4600 Olten (Switzerland)
3. Swiss Eye Research Foundation, Eye Clinic ORASIS, Titlisstrasse 44, 5734, Reinach, Switzerland, Augen Zentrum Pajic (AZP), Research Institute, Titlisstrasse, Reinach, Switzerland, Swiss Eye Research Foundation, Eye Clinic Orasis, Titlisstrasse, Reinach, Switzerland, Swiss Eye Research Foundation, Eye Clinic Orasis Titlisstrasse 44, 5734, Reinach, Switzerland
4. Swiss Eye Research Foundation, Eye Clinic ORASIS, Titlisstrasse 44, 5734, Reinach, Switzerland, General Hospital, Leskovac, Serbia, Swiss Eye Research Foundation, Eye Clinic Orasis, Titlisstrasse, Reinach, Switzerland, General Hospital 16000, Leskovac Serbia
Chapter keywords

Abstract

The management of cataract surgery in children is a more complex process than in adult patients. Diagnosis of cataract in children is difficult as they can never express the symptoms, so it relies basically on the ophthalmologist’s skills. Cataract can also be inherited. Cataracts may be classified by laterality, age of onset, extent, size-density, and by progression. Associated defects should be investigated as these defects will modify the procedure and instrumentation that will be used. Not all pediatric cataracts require surgical treatment. Cataracts that are small and partial and have areas where clear undistorted retinoscopy is performed may require observation only. A visual acuity of 0.32 or less would suggest that cataract surgery is indicated. The decrease may be due to the cataract, amblyopia or a combination of both. The onset of strabismus or nystagmus related to visual deprivation is another indication for surgery. Children with a complete monocular congenital cataract should receive surgery before the 3rd month. After the surgery the next goal is optical rehabilitation, it differs for monocular and binocular contract. Following cataract surgery and optical rehabilitation with either contact lenses or implants, amblyopia must be addressed. In following up care after cataract surgery in children is common to require more than ten visits over a year, to monitor the clarity of the visual axis, and then the frequency of the follow-up lessens gradually.

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