Common Eye Surgeries in Children
Although eye surgeries for children are usually last-resort options, the level of urgency is comparatively higher than that of surgeries done on adults.
Children's eye development is at critical during the first decade of life, and a key surgery in this period can prevent a lifetime of untreatable problems.
Thousands of children would benefit from the surgical procedures available today, but wind up with life-long visual troubles because their parents lacked awareness and correct information.
This brings me to some of the eye-surgeries commonly done on children - when to consider one, what to expect, care taking and the estimated costs.
A surgery may be necessary if the child has congenital or birth abnormalities, squints or has suffered a severe injury or trauma.
Squints are by far the most common.
Squint Surgery A squint (crossed eye/s) may be a result of poor vision or poor control over the eye muscles.
In the first, spectacles and ocular therapy usually work well - but the latter (if severe) may need a little 'fixing' in the operation theatre.
A weak eye muscle can 'tacked' into place by a simple procedure and the child is 'good to go' in a couple of days.
One can expect a bit of redness in the first few days, and post-operative complication are quite rare.
However, the squint may not go away after the first surgery and may need a second procedure.
In some rare cases, an infection may develop - this is easily controlled with proper medical care.
Ptosis Correction Surgery A drooping eyelid, technically called 'Ptosis', can interfere with vision and lead to permanent impairment of vision ('amblyopia', also known as 'lazy eye') if it involves part of the whole of the pupil.
An oculoplastic surgeon will tuck the extra folds of the lid out of the way.
The surgery requires stitches and post-operative care until the skin heals completely.
Results are usually good, though minor complications can follow.
One such complication can be incomplete closure of eyes while sleeping - however, this is not a big problem unless the gap is very large.
Dr.
Debraj Shome, an internationally renowned facial plastic surgeon based in Mumbai says, "A ptosis surgery should be performed as soon as possible, especially if the lid obstructs vision, as the initial few months of a child's life are critical for vision development.
If the lower eyelid does not obstruct vision, surgery could be delayed and considered by the school-going age (4 to 6 years) in these children.
If necessary, cosmetic correction can be done by a second surgery when the child attains teenage.
" The fee for this procedure may range between Rs.
15000-20 000.
Corneal Transplant This major procedure becomes necessary when the cornea (the transparent part in the 'black' of the eye) turns opaque due to an infection, injury or a birth anomaly.
A new donor cornea is transplanted in place of the damaged one.
As with all transplants, chances of rejection and infection are high and the eye need close monitoring and medical care for many months.
Glasses or contact lenses may be required after the graft has stabilized.
There is usually a waiting period for a donor cornea and the surgery might cost from Rs.
20,000 upwards Cataract Surgery Most people associate cataracts with old age, but they are quite common in children too.
A juvenile cataract may develop due to an injury, genetic disorder, radiation/lightening/electric shock, steroid intake or an inflammatory reaction.
Surgery usually yields good results, but glasses may be required for distance and near work after surgery.
Says Dr.
Sunil Singh, a leading ophthalmologist from Lucknow, "Children have a better healing and coping mechanism than adults.
Cataract surgery done at an early age usually yields good results.
However, vision improvement needs to be tracked closely after this procedure.
If amblyopia has already set in, some follow-up procedures may be needed.
" The cost of the surgery largely depends on the quality of lens (local or imported) and the surgical approach involved.
It may cost anywhere from Rs.
7000 to 20,000.
Trauma Repair This can be a very complex surgery.
It is usually done if there has been a penetrative injury (with a sharp object).
The outcome primarily depends on how severe the injury and internal damage is.
Recovery can take a while, and there can be complications and failure.
Vitreo-retinal (the most complex) trauma repair procedures can cost anywhere between Rs..
20,000 and Rs.
50,000.
Glaucoma Surgery Congenital glaucoma, or increased pressure in the eye, is not very common in children.
However, surgery is necessary if it is detected because it can lead to juvenile glaucoma.
This is especially true if there has been a history of surgery, trauma, steroid intake or a structural defect in the eye.
Sometimes, the pressure can be controlled by medication, but surgery is necessary in other cases.
Problems after surgery can include excessive lowering of eye pressure, or infections.
Even after surgery, pressure needs to be monitored regularly, and medication may still be required.
According to Dr.
Sunil Singh, "Glaucoma surgeries and corneal transplants should only be done on children if absolutely necessary, and the results are not always very good.
They are a necessary evil, because postponing them can lead to bigger problems".
Children's eye development is at critical during the first decade of life, and a key surgery in this period can prevent a lifetime of untreatable problems.
Thousands of children would benefit from the surgical procedures available today, but wind up with life-long visual troubles because their parents lacked awareness and correct information.
This brings me to some of the eye-surgeries commonly done on children - when to consider one, what to expect, care taking and the estimated costs.
A surgery may be necessary if the child has congenital or birth abnormalities, squints or has suffered a severe injury or trauma.
Squints are by far the most common.
Squint Surgery A squint (crossed eye/s) may be a result of poor vision or poor control over the eye muscles.
In the first, spectacles and ocular therapy usually work well - but the latter (if severe) may need a little 'fixing' in the operation theatre.
A weak eye muscle can 'tacked' into place by a simple procedure and the child is 'good to go' in a couple of days.
One can expect a bit of redness in the first few days, and post-operative complication are quite rare.
However, the squint may not go away after the first surgery and may need a second procedure.
In some rare cases, an infection may develop - this is easily controlled with proper medical care.
Ptosis Correction Surgery A drooping eyelid, technically called 'Ptosis', can interfere with vision and lead to permanent impairment of vision ('amblyopia', also known as 'lazy eye') if it involves part of the whole of the pupil.
An oculoplastic surgeon will tuck the extra folds of the lid out of the way.
The surgery requires stitches and post-operative care until the skin heals completely.
Results are usually good, though minor complications can follow.
One such complication can be incomplete closure of eyes while sleeping - however, this is not a big problem unless the gap is very large.
Dr.
Debraj Shome, an internationally renowned facial plastic surgeon based in Mumbai says, "A ptosis surgery should be performed as soon as possible, especially if the lid obstructs vision, as the initial few months of a child's life are critical for vision development.
If the lower eyelid does not obstruct vision, surgery could be delayed and considered by the school-going age (4 to 6 years) in these children.
If necessary, cosmetic correction can be done by a second surgery when the child attains teenage.
" The fee for this procedure may range between Rs.
15000-20 000.
Corneal Transplant This major procedure becomes necessary when the cornea (the transparent part in the 'black' of the eye) turns opaque due to an infection, injury or a birth anomaly.
A new donor cornea is transplanted in place of the damaged one.
As with all transplants, chances of rejection and infection are high and the eye need close monitoring and medical care for many months.
Glasses or contact lenses may be required after the graft has stabilized.
There is usually a waiting period for a donor cornea and the surgery might cost from Rs.
20,000 upwards Cataract Surgery Most people associate cataracts with old age, but they are quite common in children too.
A juvenile cataract may develop due to an injury, genetic disorder, radiation/lightening/electric shock, steroid intake or an inflammatory reaction.
Surgery usually yields good results, but glasses may be required for distance and near work after surgery.
Says Dr.
Sunil Singh, a leading ophthalmologist from Lucknow, "Children have a better healing and coping mechanism than adults.
Cataract surgery done at an early age usually yields good results.
However, vision improvement needs to be tracked closely after this procedure.
If amblyopia has already set in, some follow-up procedures may be needed.
" The cost of the surgery largely depends on the quality of lens (local or imported) and the surgical approach involved.
It may cost anywhere from Rs.
7000 to 20,000.
Trauma Repair This can be a very complex surgery.
It is usually done if there has been a penetrative injury (with a sharp object).
The outcome primarily depends on how severe the injury and internal damage is.
Recovery can take a while, and there can be complications and failure.
Vitreo-retinal (the most complex) trauma repair procedures can cost anywhere between Rs..
20,000 and Rs.
50,000.
Glaucoma Surgery Congenital glaucoma, or increased pressure in the eye, is not very common in children.
However, surgery is necessary if it is detected because it can lead to juvenile glaucoma.
This is especially true if there has been a history of surgery, trauma, steroid intake or a structural defect in the eye.
Sometimes, the pressure can be controlled by medication, but surgery is necessary in other cases.
Problems after surgery can include excessive lowering of eye pressure, or infections.
Even after surgery, pressure needs to be monitored regularly, and medication may still be required.
According to Dr.
Sunil Singh, "Glaucoma surgeries and corneal transplants should only be done on children if absolutely necessary, and the results are not always very good.
They are a necessary evil, because postponing them can lead to bigger problems".
