Pediatric Refraction Case Study: Improvement of Vision With Glasses and Contact Lenses in Congenital Cataract Surgeries

AIM: To observe the visual prognosis in post congenital cataract children’s between the ages 5-12 years and observe the visual improvement in follow up.


METHODOLOGY:  An observational case study was performed including 6 patients (11 eyes) aging from 5- 12 years (mean age: 2.95±0.36 years). All patients underwent complete ophthalmic examination including detailed history, vision, retinoscopy (undilated and dilated), slit lamp biomicroscopy, fundus examination. Three children underwent B-scan examination as fundus view was very hazy (in case of matured cataract). Three patients had history of marriage cansanguity.  After post cataract surgeries, patients underwent refraction. Proper retionoscopy was done on the day of refraction. In case of two patients, vision improvement was done by using contact lenses.  Four patients were assessed by spectacle.  Hand held keratometer was used to assess corneal curvature values for proper contact lens fitting.  Improvement in vision and overall prognosis was observed in next follow up.


RESULT: Both contact lens and spectacle users shows visual improvement. Distance vision was more improved in case of contact lens patients than spectacle. Glasses were prescribed to patients (mean: 23.06±1.57 D). Contact lenses were prescribed to two patients (mean: 16.5±0.70 D). Near glasses was given to three children depending on their acceptance and comfort ability (mean: 2.58±0.11 D). It was also found that stereopsis was better in children later manifesting cataracts, in the absence of strabismus and in cases with a good postoperative VA as it was the most important factor affecting the outcome of stereopsis in children with unilateral pseudophakia.


CONCLUSION:  Both spectacle and contact lens wearer were happy and improved confidence in follow ups. So it is very important to prescribe full aphakic correction for post cataract children.


Keywords: Refraction, spectacle, contact lenses

Posted by: Neelam A Kothawale, B.Optom (M.optom), Lotus College of Optometry, India (30-May-2012)
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