A two week old child presents with unilateral cataract Which of the following statements is the best management advice? Q (AIIMS May 2012)
|A||The best age to operate to get the best visual results is four weeks|
|B||The best age to operate to get the best visual results is four months|
|C||The best age to operate to get the best visual results is four year|
|D||The eye already lost, only cosmetic correction is required|
Congenital cataract - two thirds of cases are bilateral
1. Autosomal dominantQ -Most Common
2. **The critical period for developing the fixation reflex between 2 and 4 months Q of age Any cataract dense enough to impair vision must be dealt with before this age and the earliest possible time is preferred.
3. **The results of surgery in unilateral cataract in children are universally poor, unless the operation is carried out as early as possible, within the first 6 weeks Q of birth.
4. Dense cataract present at birth is an indication for urgent operative management to prevent amblyopia
5. Phacoemulsification or simple aspiration with centroposterior capsulotomy and limited anterior vitrectomy is recommended for congenital cataract.
6. The current trend is to place an intraocular lens. The Power of lens is adjusted according to the age
a. ≤ 2 yrs -80% of the calculated power
b. 2 yrs to 8 yrs – 90% of the calculated power
c. >8 yrs – Calculated IOL power