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Q. Can you tell me if a unilateral posterior polar cataract has congenital onset?

Answered by
Dr. Rahul Vaswani
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jul 06, 2018

Hi doctor,

Can you please tell me if a unilateral posterior polar cataract has a congenital onset or develops after birth? I am desperately seeking answers as my daughter who is 5 years old has been diagnosed for the first time with a congenital polar cataract. The doctor who originally diagnosed her stated with confidence that it has been there since she was born. My daughter has been diagnosed with 20/300 vision and deprivation amblyopia. I took her to another doctor to get a second opinion and he stated there is really no way to tell if it has been there since birth but stated it could have been. How was the first doctor able to make this diagnosis with such confidence when another doctor stated there is really not a way to tell? From what I have researched online, posterior polar cataract is very rare and has a congenital onset, is this true?

The second doctor has started her on a patching regimen for half of her waking day. Her vision has not improved since she has started wearing her eyeglasses and I am wondering how much or if at all it will improve, with such a late diagnosis. Also, I, unfortunately, contracted HSV type 1 during my third trimester while I was pregnant with her and I have also read that this could be a cause, is this a potential cause? If it is a cause in your professional opinion, would you recommend that a newborn born to a mother with HSV 1 developed during late pregnancy with an ophthalmological issue due to the risk? Any input you can offer will be greatly appreciated. Thank you in advance.

#

Hello,

Welcome to icliniq.com.

Since you had an HSV (herpes simplex virus) infection, there are increased chances that this polar cataract is congenital (since birth). Now, during initial years, if there is a hindrance in vision, then due to cataract deprivation, amblyopia sets in.

Your ophthalmologist has correctly started patching therapy but my question here is why has he not thought about surgery because then we can remove the cause of amblyopia, get a clear visual axis, and start patching again. In my opinion, that would yield a much better result.

Please consult a pediatric ophthalmologist who does pediatric cataract surgeries and discuss the case there because I think removing the cataract and implanting a lens is a very good choice and it will help in amblyopia therapy very much.

For more information consult an eye care ophthalmologist online --> https://www.icliniq.com/ask-a-doctor-online/eye-care-ophthalmologist

Thank you doctor,

The second diagnosis was by a pediatric ophthalmologist and he stated that surgery would probably do more harm than good and it is not in the visual axis and he would just watch it to see if it progresses.

#

Hello,

Welcome back to icliniq.com.

If it is not obscuring the visual axis and he is sure, then follow his lead.

Follow amblyopia therapy strictly. That is the only option to bring back vision.

For more information consult an eye care ophthalmologist online --> https://www.icliniq.com/ask-a-doctor-online/eye-care-ophthalmologist


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