Ophthalmology & Optometry/Congenital cataracts


QUESTION: I took my 7 year old daughter for an eye exam and knew she needed glasses.  While we were there the dr. Said she had congenital cataracts but they didn't effect her vision.  He said it was like three spots sorta in a triangle formation?  I asked if I needed to do anything he said no.  It just happens sometimes.

Is this true?  I keep reading how rare it is and all these stories of surgery.

Though usually 'congenital catarat' is though of as bad and have a bad prognosis, very, very often we see tiny 'specs' inside the otherwise normal lens.  They are more 'interesting' than significant. the question is 'how is her vision with any needed glasses?'  if the vision is good, then thats's that.  it would have to be poor to consider doing any surgery.  It sounds like the insignificant interesting spec type opacities that are common, not a truly significant congenital cataract. Call the doctor and ask how big or bad they are and what her 'corrected vision' is.
Hope that helps,
Mitch Axelrod, OD

---------- FOLLOW-UP ----------

QUESTION: This is where I
get confused.  I took my daughter to a pedi ophthalmologist last April when she
did poorly on school eye test.  The dr. said she was borderline for glasses,
come back in a year.  In september 2014, she did poorly at school on the eye
test again.  We went back to same ophthalmologist and she said again, still
borderline, she could probably wait until summer but if she has trouble seeing
the board at school etc. I could come back.

So my daughter was starting to
have trouble at school, very slightly.  The problem was that my insurance
changed and now really only covered optometrists.  I figured that was probably
ok, because she had seen a medical eye dr. TWICE in the last year, and this was
a simple eye exam for glasses.  So when we went, HE the optometrist is the one
who mentioned the congenital cataracts.  He stated twice, these do not effect
her vision.  I was very upset at the time though.  

He drew a picture of a
circle with 3 oblong ovals surrounding the center and said that is about what it
looks like.  

I just don't know what to do at this point.  My husband called
the office of the pedi ophthalmologist and there was nothing on her charts
stating anything about cataracts.  

Is this something I need to follow up on
with opthalmologist?  can they get worse over time?  My husband thinks I am over

any advice would be helpful.

I made a very crude drawing of
what he showed me. It is attached."

Hi again,
Any congenital cataracts worth doing something about are like a dense, cloudy ice cube, not an otherwise clear lens with a few marks in it. the ophthalmologist either didn't notice it or didn't care to notate it or both. It certainly doesn't sound significant like you need a pediatric ophthalmologist.  also, don't assume the optometrist is a poorer diagnostician than the MD. Actually, the MDs work with and notice the train wrecks and don't care much about the more minor things. so relax, and get glasses when they will help. let the optometrist manage the glasses and general exams. Sometimes we don't know whether or not to tell patients unimportant things.  If we don't and someone else does, the patient thinks we missed something.  Or we run the risk of unnecessarily alarming a patient. I usually tell patients things and simultaneously tell them to forget it except when another eye doctor may mention it.
Mitch Axelrod, OD

Ophthalmology & Optometry

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Mitchell Axelrod


I'm happy to answer questions about eye exam findings and procedures, glasses and contact lens types/prescriptions/problems. I can also answer questions about general eye conditions/diseases. I do not answer questions concerning surgical techniques/procedures. Please state your age or within a small range when asking questions, as it is often important.


Optometrist 19 yrs.

Doctor of Optometry, cum laude; Residency in Ocular Disease

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