Cataract is a growing risk…for your kids

MUMBAI: Unlike his five-year-old friends, Aviraj Mohapatra didn’t enjoy late night drives or dinners in brightly lit hotels.

It hurt, he would complain, holding his hands over his eyes. He avoided walking in harsh sunlight and got startled if someone suddenly switched on the lights at home. “I know it sounds incredible, but Aviraj had cataract in both eyes. We thought his eyesight was still developing and ignored it,” says Sandesh Mohapatra, Aviraj’s father.

It was during a PTA meeting at Aviraj’s school that his parents first got worried. “His teacher casually mentioned how Aviraj would rush to the front seat to take notes and hated his seat being changed,” recollects Mohapatra, who then thought Aviraj needed glasses. A check-up by an ophthalmologist revealed that Aviraj was blinded by cataract in his right eye. His left eye, too, was fast developing one.

Unfortunately, Aviraj is not alone. “We are seeing an alarming number of 2-6 year-olds with cataract. Five years ago, a dozen children with it would come to me in a month — but now I see at least 40,” says Dr TP Lahane, ophthalmologist at JJ Hospital.

“Awareness is low and neglect is rampant,” says Dr Nagendra Shah, consultant eye surgeon at Bombay Hospital. “Bad diet and ante-natal care is worsening the situation.”
Last year, when Dr Lahane examined 7,00,000 children across 1,508 schools in Mumbai under the Sarva Shiksha Abhyan scheme, 10,000 were diagnosed with problems and 1,000 had cataract.

“I had never been so shocked — wasn’t cataract a condition that struck seniors? I had never heard of it in my circle of friends,” says Mohapatra, who subsequently stayed up nights and downloaded everything on cataract in children. “It is unbelievable that so many children around the world are suffering from it.”  

Dr Ashwin Sainani, paediatric ophthalmologist at PD Hinduja Hospital, adds that developing countries have a higher incidence of paediatric cataract, because of a diet deficient in protein, infectious diseases, and a rise in diabetes. “Though cataract is congenital and hereditary in many cases, a rubella infection and diabetes in the pregnant mother or child are major causes too.”

Dr Shah says poor antenatal care is another major contributor. “Many pregnant women ignore the nutritional needs of their unborn children. Vitamins A and D, iron and proteins are lacking in most diets and a number of mothers continue to smoke and drink throughout their pregnancy. What do you expect with such a casual attitude?”

Nutritional deficiencies decrease the blood supply to the child’s eye and increase the chances of developing paediatric cataract. Poor lactation and improper weaning practices after birth can also contribute to it.

Shubha Narang swears she is guilty of no such neglect during her pregnancy seven years ago. The 34-year-old mother went for regular check-ups to the obstetrician who announced that she was doing all it took to ensure a healthy child.

“But it didn’t help, did it?” asks Narang bitterly. At the age of six, Narang’s daughter, Anshika, was detected with cataract in her right eye. Doctors later concluded that the steroids in eye-drops Narang often used to cure the redness and itching in Anshika’s eye did it.

Anshika had surgery and now wears glasses to support her vision. “I had read about over-the counter medicines so often, but I never thought I would have to pay so dearly for using eye-drops,” says Narang, who is now wary of any allergy medication that contains steroids.

Another little-known fact is that injuries with cricket balls, toy guns, water balloons or something as trivial as a jab in the eye with a pencil are contributing to the rise in cataract.

Though surgery remains the only way out, many of its aspects remain shrouded in myths - the foremost being the right age for surgery. Experts unanimously rubbish the idea that five - or even two - is too young an age for a cataract removal operation. In fact, they insist that the longer you wait, greater are the chances of blindness.

“Parents must also know that children with cataract are more prone to conditions like the Lazy Eye  syndrome, retinal damage, glaucoma and myopia - and these are irreversible after the age of nine,” says Dr Gul Nankani, consultant ophthalmologist at Lilavati Hospital.

Surgery involves removal of the cataract, inserting a lens in the eye and then supplementing the vision with glasses. But a child has to be at least two years old.
Aviraj, now six, underwent surgery last year and now awaits another, scheduled later this month.

“Though the ordeal unnerved us, Aviraj was surprisingly calm throughout and is coping excellently. The only regret remains that we didn’t detect it earlier,” says his father.

It’s true that the earlier the cataract is detected, the less damaging will be its effects. And the only way to detect it early is a regular eye check-up. “A parent should make sure that their paediatrician checks the child’s eyes thoroughly - even a minuscule white spot in the eye may spell trouble,” says Dr Nankani.
g_kareena@dnaindia.net