A cataract is the clouding of the clear lens of the eye which lies behind the iris and pupil. The purpose of the lens is to focus light onto the retina and to adjust the eyes focus, allowing vision both close up and far away. When an individual has a cataract, he effect is like looking through a dirty or foggy window. There are several causes for cataract formation, including congenital, trauma to the eye, induced by medications such as corticosteroids, and induced by age, which is the most common cause. When cataracts are present in children, they can be present at birth or develop during the first few months of life. Cataracts in older children are often caused by injury or inflammation. Symptoms Symptoms of cataracts include a whitish appearance of the pupil, blurred vision, reduction in visual acuity, photophobia(abnormal sensitivity to light), and halos around light. Symptoms of congenital cataracts may also include nystagmus and squint. If not surgically removed, cataracts will continue to progress, further reducing an individual’s vision. Treatment Surgical removal is the only treatment for cataracts. Congenital cataracts should be removed within the first few months of life if vision is to develop normally. This is not possible in children who have cataracts caused by maternal rubella because the live virus is present in ocular tissues after birth. Surgery in this case is usually not performed until the second year of life, resulting in a less favorable prognosis for good visual acuity. If the cataract is not removed early enough, there is a risk of amblyopia(lazy eye) caused by light deprivation. Surgery for congenital cataracts is done under general anesthesia. Microsurgical techniques are used for the removal. This us usually well tolerated, even in very small children. In older adults who undergo cataract removal, the lens of the eye is often replaced with an intraocular lens implant(IOC). Complications of cataract surgery can include retinal detachment and glaucoma. Following congenital cataract removal, visual rehabilitation is required. The new lens to provide focus for the eye is provided by an IOC, glasses, or contact lenses. Even when an IOC has been utilized, glasses or contacts may be needed. Patching therapy is often needed to help develop vision in the affected eye to prevent amblyopia. Implications -A comprehensive evaluation by an opthamologist, preferably pediatric, will need to be performed, along with regular checkups to evaluate the adequacy of provided correction.
-A functional evaluation by a Teacher of the Visually Impaired to assess the need for low vision devices and services will need to be performed contingent on the degree of vision loss. An evaluation by an Orientation and Mobility specialist may also be needed.
-High contrast materials such as bold black ink on white paper should be used.
-Recommended adaptations may include enlargement of materials such as tests, worksheets, and textbooks. More time may be needed for completion of assignments. Also, low vision devices such as a CCTV may be utilized.
-Lighting that will reduce glare, and adjustable lights for close work. Extra adjustment time may be needed to allow for different lighting situations.
-A “buddy” may need to be assigned to help with travel(class changes, fire drills, etc.), and to help verbalize distance activities.
-Tolerance should be given for unusual head/eye positions because a child is “looking around a cataract” in order to see. References Mayo Foundation for Medical Education and Research. (2010, May 20).
Cataracts. Retrieved July 2, 2010 from http://www.mayoclinic.com/health/cataracts/DS00050/METHOD=all
Cataracts. (n.d.). Retrieved July 2, 2010 from
National Eye Institute. (n.d.) Cataracts: Causes and Risk Factors.