Many adults are squeamish at the thought of inserting contact lenses into their own eyes. After surgery to remove congenital cataracts in both eyes, Luke and Krystal Simon of Springfield had to learn how to insert contacts into the eyes of their then-infant daughter, Olivia.

Fortunately, they received a lot of help and instruction from pediatric ophthalmologist Scott Atkinson, M.D., and his staff at St. John’s Clinic-Eye Specialists. He and his staff treat one to two new patients each year with congenital cataracts.

“We were really nervous about putting them in, but once they were in, there was a noticeable difference. She started tracking us across the room and her development has remained on target ever since,” Luke says.

Cataracts are a condition where the normally clear lens inside the eye is cloudy and obscures vision, and are a major cause of vision loss throughout the world. Usually age is a factor with most people over 60 having some degree of cataract formation, but congenital cataracts can occur in newborns with devastating consequences. Congenital cataracts are sometimes associated with an infection during the mother’s pregnancy or genetic syndromes, but as in Olivia’s case, the majority are sporadic. Olivia’s 10-month-old sister Sophie has normal vision.

Dr. Atkinson says it’s imperative that cataracts in newborns are discovered sooner rather than later.
“A baby’s brain requires a good-quality visual image to be presented to it right from the start,” he says. “If babies have cataracts blocking their vision, there’s no way for the visual sense to develop. And unless those cataracts are discovered within the first few weeks after birth, there may be irreversible loss of vision.”

Fortunately, physicians are on the lookout for newborn cataracts within the first few days of an infant’s life.

“During the baby’s newborn screenings, the pediatrician looks for red reflexes when shining a light into the pupil of the eye,” Dr. Atkinson says. “If red light is reflected back, it tells you that light is getting into the eye and getting back out. If the red reflex is normal, then there are no cataracts. If cataracts are discovered, treatment is initiated immediately.  Surgery is required if the cataract is complete.”

The only way to correct cataracts is to surgically remove them. Cataract surgery on babies can be difficult, but untreated cataracts prevent the developing brain from learning to see. Standard treatment for adult cataracts, a lens implant after surgery, is avoided in such young children because inflammation and implant difficulties are common and repeat surgeries may be necessary as the child’s eyes grow and his or her prescription changes.

Permanent lenses are usually implanted later in childhood or adolescence, when the eyes have reached maturity. Until then, glasses or optimally contact lenses are worn.

After Olivia’s surgery, she wore glasses for about three weeks before being fitted for the contact lenses.

“The glasses were big and heavy and rubbed blisters on her little face, so we were happy to be rid of them,” Krystal says. “Dr. Atkinson and his staff went above and beyond to help us learn how to insert the contacts and make sure her development was on track. With his encouragement, we enrolled her in First Steps so they could do skills therapies with her.”
Dr. Atkinson emphasizes the importance of the partnership he has with his patients’ parents.

“It’s easy for me to show them how to put the lenses in, but they are the ones who have to do it,” he says. “It’s very important for the child’s development to have parents willing to adhere to the schedule of care,” Dr. Atkinson says.

Olivia is now almost 3 and has the language and motor skills of a 4-year-old. She enjoys swimming with goggles and going to story hour at the library.

Her parents clean and change her lenses about every 30 days. She knows that she needs the lenses
to see and is cooperative when it’s time to change them.

Chocolate helps, her mom says.
“She gets M&Ms afterward,” Krystal says, smiling.

Olivia sees Dr. Atkinson every three months, and once a year undergoes glaucoma testing. Those born with congenital cataracts have a higher risk for glaucoma.

“With her contacts in, she is very close to having perfect vision. At her last check-up, Dr. Atkinson was amazed at how well she was seeing,” Krystal says.