Case Study: Congenital Cataracts

Case Study Congenital Cataract

Surgery to Remove Cataract

Other Forms of Cataract

Early History
Congenital Cataract removed at 3 months
Contact lens correction to manage high refractive error
Family history: grandmother and mother have different manifestations of disease

Contact Lens Placement

EUA(exam under anesthesia) at 1.5 years
Corneal Diameter OD 12.25mm
OS 9.75mm
IOP OD 29mmHg
OS 20mmHg
C/D OD 100 %
OS 50%
Refractive error +24.00
Goniotomy
Medical therapy

Increased Cupping of the Optic Nerve Increased cupping Normal fundus

Increased cupping of the optic nerve

Cloudy Corneas

Increased Corneal Diameter

EUA at 2.5 years
Corneal Diameter OD 12.25mm
OS 10.0mm
IOP OD 32mmHg
OS 32mmHg
C/D OD 100%
OS 60%
Refractive Error +20.00

Exam at Age 6 years
VA OD NLP
OS 20/125 ETDRS
Refractive Error +20.00/+3.00
IOP OD 21mmHg
OS 14mmHg
Learning Braille
Large Print (using 48pt)
Black marker/Bold lined paper for writing
Aide in the classroom

Exam at Age 7 years
VA cc OD LP
cc OS 10/100
cc OU 10/100(20/200) Feinbloom
Near VA 0.4/3M (20/150) Lighthouse
Fundus Exam:
OD complete cupping
OS 80% cupping with good rim
Current Meds: Timoptic, pilocarpine and diamox

Low Vision Recommendations at Age 7 years
Spectacle Prescription
OD +20.00/+3.00 add
OS +20.00/+3.00 add
1.8X bright field magnifier (20/40)
3X illuminated magnifier with battery plug–in-handle (20/40)
4.2X12 telescope (10/25)

Stand Magnifiers

Illuminated Stand Magnifiers

Telescopic Devices

External light source at work area
Services of TVI
Services of O + M (caning)
Braille /hypotonia and poor touch sensitivity are an issue
CCTV introduced
Bold-lined paper/ black felt tipped pen

Braille

Closed Circuit Television

Lap Desk,Bold-lined Paper and Marker

Vision Concerns at age 9 years
Difficulty reading standard print without use of CCTV
Cannot see blackboard
Teacher using overhead projector
Hand devices prescribed last time seem insufficient to enhance vision

Exam Findings at Age 9 Years
VA cc OD LP
cc OS 10/120
cc OU 10/120 Feinbloom
Near VA cc 0.4/3M (20/150)
Lighthouse
Visual Field restriction

Progression of Visual Field Loss Age 9 years Age 11 years

Spectacles
CCTV/only mag device effective
Hard copies of overhead projections at his desk
Telescope is of limited benefit because of reduction in visual field and contrast sensitivity
Intense Braille studies

Exam Findings Age 11 years
VA cc OD LP
cc OS 10/200 Feinbloom
Near VA cc 0.4/5M (20/250)
Visual Field Restriction
continued decline

Low Vision Recommendations Age 11 years
Braille – can type well but reading Braille is slow due to poor touch sensitivity
Kurzweil reader for longterm reading
Talking calculator for math
Audiotapes in class and books on tape

Low Vision Recommendations Age 11 years
Jaws (screen reading program for word processing/ Internet)
Notebook computer with Jaws and Zoomtext
CCTV still effective (prefers 72 point)

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Case Study: Congenital Cataracts

by eadvisor on Jan 31, 2007

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Case Study: Congenital Cataracts — Presentation Transcript