Aa
congenitl cataracts removed - one eye dialates 1-2 mm more then the other
Just some background...I hope I have all the terms correct, if not plz correct me!!!! :)
My son was born with cataracts, complete, I think it's called nuclear? anyhow we had them removed when he was 4wks+6 d/o and 5wks +3d/o, he was fitted with contact lenses (hard) when he was 61/2 wks. (+27 in each eye) The surgery went fine.
Over the last few months one of his eyes seems to dilate more then the other between 1-2mm. Under the last EUA there was previous concern that the vitreous fluid had been leaking thru the lens cavity into the pupil but it seems not to have come in contact with the cornea which I'm told is a good thing. We didn't need to have a vitrectomy done.
The ophthalmologist I'm seeing is brilliant but he says that he has no idea why the difference in dilation. I'm wondering whether it has something to do with the removal of the cataracts when he made the cavity quite big so he didn't have to go in and operate just in case it closed. Some discrepancy there, or perhaps something to do with the vitreous fluid??
Any possible theories? I'm very much into being a little researcher and if someone could point me in the right direction I'm happy to go read and learn too!
Any help is most welcome lovely people! Thank you for reading this!
- Harmony
My son was born with cataracts, complete, I think it's called nuclear? anyhow we had them removed when he was 4wks+6 d/o and 5wks +3d/o, he was fitted with contact lenses (hard) when he was 61/2 wks. (+27 in each eye) The surgery went fine.
Over the last few months one of his eyes seems to dilate more then the other between 1-2mm. Under the last EUA there was previous concern that the vitreous fluid had been leaking thru the lens cavity into the pupil but it seems not to have come in contact with the cornea which I'm told is a good thing. We didn't need to have a vitrectomy done.
The ophthalmologist I'm seeing is brilliant but he says that he has no idea why the difference in dilation. I'm wondering whether it has something to do with the removal of the cataracts when he made the cavity quite big so he didn't have to go in and operate just in case it closed. Some discrepancy there, or perhaps something to do with the vitreous fluid??
Any possible theories? I'm very much into being a little researcher and if someone could point me in the right direction I'm happy to go read and learn too!
Any help is most welcome lovely people! Thank you for reading this!
- Harmony
MEDICAL PROFESSIONAL
1. Only if the pupil is extremely large and doesn't constrict properly.
2. Not a problem in a young person. For a middle age person bordering on needing reading glasses or bifocals it could interfer enough to be a problem with reading and near tasks. These first two answer. HOWEVER your child had cataract removal and an implant was not inserted in the eye (I can tell that by the power of the contact lens) so the eye can't focus. All focusing will have to be done with contact lens, cataract glasses or bifocal glasses worn over the contacts.
3. Pupils are compared with the pupil of the other eye, normally (90%) they're same size. Some people have huge pupils (5 mm or >) and it's normal for them.
JCH III MD
2. Not a problem in a young person. For a middle age person bordering on needing reading glasses or bifocals it could interfer enough to be a problem with reading and near tasks. These first two answer. HOWEVER your child had cataract removal and an implant was not inserted in the eye (I can tell that by the power of the contact lens) so the eye can't focus. All focusing will have to be done with contact lens, cataract glasses or bifocal glasses worn over the contacts.
3. Pupils are compared with the pupil of the other eye, normally (90%) they're same size. Some people have huge pupils (5 mm or >) and it's normal for them.
JCH III MD
Thank you for posting, I did search the archives for complications after cataract surgery but could find nothing referring to changes in pupil size. Lots to ponder!
A few more qu's
Pupils help let the light in right, so will the more dilated one be more sensitive to light? Does it affect the focusing ability to the eye?
How far can the pupil dilate before it becomes abnormal? Comparative to the other eye?
:)
A few more qu's
Pupils help let the light in right, so will the more dilated one be more sensitive to light? Does it affect the focusing ability to the eye?
How far can the pupil dilate before it becomes abnormal? Comparative to the other eye?
:)
MEDICAL PROFESSIONAL
Hello StormAngel If you will use the search feature on this page for "dilated pupils" as well as review the archives you will see it's a common reason for posting. To start with up to 10% of people are born with one pupil larger than the other, it's called "physiological aneisocoria".
Once someone has had cataract surgery the pupils are no longer totally reliable to reflect their intrinsic innervation. As you suspected during any cataract operation the pupil can be stretched, injured or intentionally stretched, even cut. A small pupil makes cataract surgery difficult and more complication prone. Drops are used to widely dilate the pupil. These don't always work or during the surgery the "pupils may come down". When this happens a variety of maneuvers or instruments ("mechanical pupil dilators") are used to make it big again. This may unbalance the size of the pupils. Lastly during the healing phase the pupil may adhere to the cornea, an implant if one is used and become scarred into place so that segments do not work right and also a hole (iridotomy) is often cut in the iris that also may affect the pupil size.
Odds are you child's pupils were influenced by one of the above mechanisms during surgery.
JCH III MD Ophthalmologist = Eye MD
Once someone has had cataract surgery the pupils are no longer totally reliable to reflect their intrinsic innervation. As you suspected during any cataract operation the pupil can be stretched, injured or intentionally stretched, even cut. A small pupil makes cataract surgery difficult and more complication prone. Drops are used to widely dilate the pupil. These don't always work or during the surgery the "pupils may come down". When this happens a variety of maneuvers or instruments ("mechanical pupil dilators") are used to make it big again. This may unbalance the size of the pupils. Lastly during the healing phase the pupil may adhere to the cornea, an implant if one is used and become scarred into place so that segments do not work right and also a hole (iridotomy) is often cut in the iris that also may affect the pupil size.
Odds are you child's pupils were influenced by one of the above mechanisms during surgery.
JCH III MD Ophthalmologist = Eye MD
I can post pics if you like and any extra history if you need! I also found out that it is hereditary once he was born as I have it myself and must have some autosomal dominant genes that somehow got mutated apparently in there somewhere, I don't have the same problem with dilation issues though. My son seems to see quite well if that helps and has no nastigma (wobbly eye thingy)
You are reading content posted in the Eye Care Forum
Find out how beta-blocker eye drops show promising results for acute migraine relief.
Eye whitening, iris color change, and eyeball "bling." Eye expert Dr. John Hagan warns of the dangers from these unnecessary surgeries.
Eye expert John Hagan, MD, FACS, FAAO discusses factors to consider and discuss with your eye care team before embarking on cataract surgery.
Is treating glaucoma with marijuana all hype, or can hemp actually help?
Protect against the leading cause of blindness in older adults
Got dry eyes? Eye drops aren't the only option! Ophthalmologist John C. Hagan III, MD explains other possible treatments.
