Now that Christmas is over we are going to get down to business on this blog and have a serious conversation about infant cataracts. Why? Because Penny apparently has one.
Short Story:
After being referred to an ophthalmologist by the pediatrician, we now know that Penny has a cataract in her left eye. The doctor does not think that it is surgical right now (it is out of her line of vision and her vision testing in general is fine), and he also doesn't think it's a symptom of another disease. He would like us to see a pediatric ophthalmologist, however, to get a second opinion.
Long (LONG) Story:
About a month ago, I noticed a weird coloring in Penny's pupil... it looked like there was a pie slice of grayish bluish in her pupil, but it could only be seen in certain light and when there wasn't too much reflection. It stumped the nurse on the phone, so we went into the pediatrician. The pediatrician did a fairly quick exam, and determined that it was some kind of opacity of the lens, which I guess is a cataract, but he never said the word "cataract." He said that he didn't think it was anything serious or affecting her vision, but referred us to an ophthalmologist in town, who we saw about a month later since it takes time to see a specialist. The ophthalmologist did a more thorough exam, including dilating her eye, and confirmed that it is indeed a cataract. He said that sometimes cataracts can be indicative of metabolic disorders or other genetic conditions, but since it is only in one eye, he doesn't think that is the case with Penny. He kept asking if the OB used forceps when Penny was born, as infant cataracts can often be a sign of trauma, but she was C-section. And there hasn't been any trauma since - I PROMISE (pinky swear!) you we have not dropped her... He also doesn't think she would need it to be removed surgically since it looks like it's out of her field of vision (wouldn't it be nice if we could ask her???), but that she will probably need cataract surgery earlier in life than most people. But, since this is such a rare thing with no clear cause, he wants us to see a pediatric ophthalmologist, which is an hour away. We are still waiting to find out when that appointment is since the office was closed Friday for the holiday.
And then I consulted Dr. Google. Dr. Google can be a cruel bastard sometimes, but in this case I thought it might be a good idea to come armed with some information so I can ask the right questions when we see the really special specialist. I found out some interesting things:
First, infant cataracts are extremely rare - like, 3 out of 10,000. First I tried to look up some general things about infant cataracts. I discovered that they can sometimes be detected with the use of the camera that doesn't have red eye correction. When taking a photograph, red eye is a GOOD thing because it means there aren't any cataracts. If there is no red eye, a cataract could be blocking the reflection from the retina. With today's cameras having such good red eye correction, however, this is almost useless. What's interesting though is that I took a picture of Penny shortly after we got home from the ophthalmologist.
You can see that her right eye has the red eye and her left does not (where the cataract is). Normally, my camera would erase the red eye, but I'm guessing that since her eyes were still dilated, it didn't detect it. Or maybe it's because it was only in one eye, who knows. The point is that I feel good about this, because it basically confirms there is no cataract in the right eye, which could indicate a more severe condition.
Naturally, I Googled these conditions to make sure Penny didn't have other symptoms. It was dangerous territory... I am not one who needs anything else to be paranoid about with my kid, but again, I wanted to be informed. Luckily I couldn't find anything that Penny could remotely have. Rubella? Nope. Lowe's Syndrome? Highly unlikely with her good muscle strength and the fact she's female. And on and on... This isn't to say that I didn't miss something, but I do feel better about it.
I wish they could tell me definitively that the one cataract is the end of the issue and that she won't have anymore problems related to it, but I know they can't. I just have to hope and pray that it is an isolated thing that we can overcome, even if we have a few vision issues along the road. Luckily her development seems to be right on track and is otherwise pretty happy and healthy - all good signs.
In the meantime I was beside myself trying to figure out if she could have had this since birth. After all - she's had a couple eye exams at well baby visits and her vision was checked at birth. How could they miss it if I could see it with the naked eye? Luckily Andrew's dad has been taking pictures along the way, and he has a very sophisticated camera. We blew up a picture we believe was taken 19 days after birth, and we can ever so slightly see the cataract pie slice even then. The ophthalmologist said that it would be easy to miss at her exams since it is at the top of the pupil, and therefore behind the iris when her eyes are not dilated in brighter light (or something to that effect). Plus, she doesn't exactly sit still.
So, I wish I could say I wasn't worried anymore, but I am and always will be. I guess it's part of the gig about being a mother.
