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Child had congenital cataract surgery done. Advised for eye patching. What should I do?

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Posted on Fri, 1 Mar 2013
Question: My son is 2 years 1 month old. He had congenital cataract surgery when he was 5 months old. Till now he is wearing thick glasses eveyday and every day for 2 hrs we are putting patch on his left eye since the vision on right eye is lesser than the left. Every 3
months we are going for eye checkup. Today the doctor said that she wants to put the intraocular lens inside his eyes in the month of may.
She also said that even after putting intraocular lens, he has to use the glasses while studying and also said that patching has to be continued for another 4 to 5 years. That is when my son becomes 6 to 7 years old. So I just wanted to have a second opinion. I want to
know is there any alternative for patching? Is patching necessary even after inserting intraocular lens? Is there any surgery to equalize the vison of both right and left eyes? Please suggest me.
doctor
Answered by Dr. N. K. Misra (9 hours later)
Dear XXXXXXX,
thanks for sending your query to us.
The approach being followed looks to be correct.In your case a two stage surgery was planned.We at times prefer a single stage surgery to avoid two anesthesia
Usually the need of patching is not there after putting in the IOL.As patching is done to improve the vision of eye with lesser vision,and by putting in the iol the vision is equal in both the eyes.
The advise of continued patching for few years may be due to the fact that the vision in that eye is less and that is the reason that the doctor has fore warned you of the patching to be continued for some time after the surgery.
These are trying times for parents but these small children become very co operative and it is not that much of a ordeal later on.
Your doctor seems to be following a correct line of treatment.
Please do get back to me in case of any further query in this regard
.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. N. K. Misra (14 hours later)
Hello Doctor,

Thanks for your opinion. Yesterday I forgot to mention my son's eye power.

Here it is : Sph Cyl Axis

Right Eye: +18.00 -01.50 10

Left Eye : +17.00 -01.00 170

So, I have a question doctor. Is because of this difference in right and left eyes, our doctor is advicing us for continuing patching even after surgery for another 4 to 6 years?

Please let me know.

Thanks in advance,
XXXXXXX
doctor
Answered by Dr. N. K. Misra (1 hour later)
Dear XXXXXXX,
Thanks for getting back to us.
it is not due to the difference in the power but a lot of power per se that is giving rise to some difficulty in maintaining the binocular vision as well as the visual acuity post operatively.
The difficulty will be once the iol is put in and the power of eye is say near normal then the disparity in power of two eyes will be too much.
That apparently is the reason you have been asked to be prepared for occlusion.
Please do get back to me in case of any further query in this regard.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. N. K. Misra

Ophthalmologist

Practicing since :1977

Answered : 1281 Questions

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Child had congenital cataract surgery done. Advised for eye patching. What should I do?

Dear XXXXXXX,
thanks for sending your query to us.
The approach being followed looks to be correct.In your case a two stage surgery was planned.We at times prefer a single stage surgery to avoid two anesthesia
Usually the need of patching is not there after putting in the IOL.As patching is done to improve the vision of eye with lesser vision,and by putting in the iol the vision is equal in both the eyes.
The advise of continued patching for few years may be due to the fact that the vision in that eye is less and that is the reason that the doctor has fore warned you of the patching to be continued for some time after the surgery.
These are trying times for parents but these small children become very co operative and it is not that much of a ordeal later on.
Your doctor seems to be following a correct line of treatment.
Please do get back to me in case of any further query in this regard
.