Inborn cataract
Contents:
Description:
Changes of a crystalline lens are one of the main reasons for a slabovideniye and a blindness at children, and can be both inborn, and acquired. It is possible to distinguish change of a form, situation, size, and also a cataract from various types of its pathology – a cataract.
The inborn cataract makes more than a half of all inborn defects of an organ of sight. The disease can be both unilateral, and bilateral, and also to be combined with other pathology.
Symptoms Inborn cataract:
* in the field of a pupil it is possible to see opacification in the form of a point or a disk. The area of a pupil can be diffuzno muddy;
* squint, nystagmus (rhythmic twitching of eyeglobes);
* at the age of two months there is no fixing of a look on faces of relatives and toys, there is no reaction of tracking objects;
* the child by consideration of a toy turns to it always the same eye.
Most often occur among inborn cataracts:
* KAPSULYARNY
The isolated opacification of a front or back bag (capsule) of a crystalline lens. The size and a form of opacifications is various. Extent of decrease in sight depends on the amount of opacification of the capsule. Development of a kapsulyarny cataract can be caused by diseases of mother during pregnancy or pre-natal inflammatory processes.
* POLAR
Defeat extends both to the capsule, and to crystalline lens substance at front or back poles. In most cases the bilateral cataract meets. The sizes and a form considerably vary what its influence on sight depends on.
* LAYERED (zonular)
The most often found form of an inborn cataract. In most cases two-hundred-dropping. Is located in the center, around transparent (or slightly rather turbid) kernels. Sight decreases always, most often is very considerable, to 0,1 and below.
* NUCLEAR
Develops on both eyes, has the expressed heredo-familial character, sight most often decreases to very low level 0,1 below. In cases when opacification is limited to an embryonal kernel, sight can slightly decrease or not fall at all.
* FULL
Disease, as a rule, bilateral. The clinical picture is various and depends on phacoscotasmus degree. At full development of a cataract all crystalline lens muddy. The child grew blind, has only photoperception. Can develop till the birth, or ripen in the first months of life.
The most important feature of a full cataract is its combination to other defects of development of eyes (mikroftalmy, a choroid coloboma, a macula lutea hypoplasia, a nystagmus, squint, etc.). The full cataract can sometimes tend to a rassasyvaniye and then in the field of a pupil there is a film – a filmy cataract.
* COMPLICATED
The galactosemia, diabetes, viral rubella and other serious illness can be the cause of its development. Often is followed by other inborn defects (heart diseases, deafness and др).
Inborn cataract at survey of an eyeground
Reasons Inborn cataract:
Factors of an inborn cataract
* metabolic disturbances;
* a diabetes mellitus at mother;
* infectious diseases of mother in the I trimester of pregnancy (a rubella, herpes, toxoplasmosis and др).
Treatment by the Inborn cataract:
Early diagnosis of an inborn cataract allows to choose individual treatment planning for each child. If localization and the amount of opacification in a crystalline lens do not interfere with the correct development of sight, then such cataract does not demand surgical treatment. It is necessary to watch its state in dynamics. If opacification interferes with the central sight, then it is necessary to remove this obstacle as soon as possible in order that the visual system of the child correctly developed.
It is impossible to cure a cataract medicamentally. In this case surgical intervention is necessary.
The safest and effective is the fakoemulsifikation. By means of the diamond tool the surgeon creates microincision no more than 2,5 mm and makes all further manipulations through it. By means of ultrasound the crystalline lens is turned into an emulsion and brought out of an eye.
If there are no contraindications in the form of the accompanying heavy pathology of an eye, then implantation of a folding intraocular lens at a unilateral cataract is made in one step. Through microincision in the capsule where earlier the muddy crystalline lens was placed, enter a flexible lens in the put state which is independently developed in an eye and is reliably fixed.
After implantation of a lens microincision through which all surgical operations were performed somegermetizirutsya and does not demand suture. Operation is performed on an outpatient basis, without hospitalization therefore in the same day parents will be able to take away the child home.
