Case Stories

Bright Beginnings - A 3-month-old child’s journey to visual restoration
- Dr. JENIL SHETH

HealEYE

Health Insights

Dr. JENIL SHETH

Faculty
Pediatric Ophthalmology, Strabismus and Neuro-Ophthalmology

Bright Beginnings - A 3-month-old child’s journey to visual restoration

A Case of Pediatric Cataract

Case History

A 3-month-old girl from suburban Mumbai was referred to the Shantilal Shanghvi Eye Institute for a second opinion. The family had noted white pupillary reflex. Systemically, she had multiple problems which included an obstructed hydrocephalus, a congenital heart defect, and a large umbilical hernia. The baby had delayed milestones, and instead of looking at her mother's face or smiling, she could only respond to sounds. At SSEI, she was noted to infrequently move her face to a bright light source and ocular examination showed cataract and nystagmus.

Treatment

Due to the presence of multiple systemic congenital abnormalities, the baby was at high risk of general anaesthesia. Fortunately, this risk was mitigated by a collaborative effort from expert anaesthetists and pediatricians. A rare decision of bilateral cataract surgery at the same sitting was made. Stringent precautions were taken, treating each eye as an individual case, to prevent any possible or repetitive complication. The surgeries were successful and there was a smooth recovery from general anaesthesia.

Result

Following the surgery, the child underwent a series of post-operative assessments at day one, one week, and one month. Glasses were prescribed. Simple visual rehabilitation exercises were explained to the parents for home practice and thus to continuously stimulate the vision. At the one-month follow-up, the baby exhibited remarkable improvement. It was a sight to see the baby engaging playfully, following bright objects, and following the light with her gaze. The mother was overjoyed that her baby was now able to see her and smile back! This wonderful progress brought smiles to everyone in the family, showing a big change in the way any child interacts since birth and how the gift of sight made her fill their hearts with immeasurable joy.

Pediatric cataracts are lens opacities present at birth or developing during infancy. These are caused by genetic factors, infections, or metabolic disorders and these clouded lenses hinder normal vision and its development in affected infants. Timely diagnosis and surgical intervention are crucial to prevent permanent visual impairment. Early detection allows for better outcomes, as the vision pathways are still amenable to change at a young age. Pediatric ophthalmologists play a vital role in managing Pediatric cataracts, and we emphasize the importance of regular screening of infants at risk.