Marriages between blood relations could lead to cataract

Don't turn a blind eye:

by Shanika Sriyananda

Twenty-year-old Lingeshvari did not know much about the normal functions of a human eye. She did not know that the eyes work like a camera, which has lens that helps to focus the visual image.

This mothers' instincts made her realise that her three-month-old daughter's eyes were not normal. They were not crystal clear as others but were clouded with a white haze.

Unlike other infants she did not respond to her mother but after a while may be due to the natural smell of her mother she started crying or smiling. Unfortunately Lingeshvari discovered her daughter's both eyes were filled with white haze.

Living in Vakarai, which was under the control of the LTTE, Lingeshvari, despite the war, took her daughter to the Batticaloa Teaching Hospital, where the eye specialists recommended cataract surgery. She was asked to find the money to buy two lenses but her 20-year-old husband, being a labourer who is her first cousin, could not fulfil the requirement. Thanks to a foreign INGO, (She cannot remember the name) her daughter was gifted with two lenses to see the world.

After living in a refugee camp until last year they have returned to their homes March this year after the area was liberated by the Sri Lankan military.

Packing her things to go home after a stay of more than a month at the Colombo Eye Hospital, the young mother told the Sunday Observer that her happiest day in her life was when her little daughter got vision back. Now the one and half-year-old Nilushalini looks around with wide open eyes. Still too young to understand, one day she will thank everyone who had helped regain her vision.

Lingeshvari is married to her cousin and according to health experts, marriages between close family members could have been a major cause for childhood cataract.

"We do get children with cataract and in Sri Lankan it is mainly hereditary. The chances for childhood cataract can be seen in marriages between cousins", said Director of the Eye Hospital and Consultant Eye Surgeon Dr. Champa Banagala.

She says that the most important thing is the early identification of the illness. "Because the visual system develops very early in life. This development starts after birth, around 8 weeks and until two and half years. When the child is five years he or she will have a good visual system", she says.

Dr. Banagala says "that if the child have anything that obstructs normal visual system, steps taken to remedy late in life will not give positive results in child's vision, especially when the problem is on one eye.

"Because if you have little reduction in vision in both eyes the brain get equal stimulation. If you have better vision in one eye that eye dominates. Same thing happens when you have a squint in one eye. The eye with squint does not see clearly and the good eye sees clearly. After sometime, the brain forgets that there is another eye. Once it is established whatever you do later to that eye to recover the vision the child will not get that vision back".

She advises that if the parents think that the child does not see clearly they have to consult an eye specialist immediately. She also says that the condition will arise soon after the birth and with poor fixation to mother's face would be an early sign of a problem in the eyes.

"Usually the child see the mother's face after few weeks and if the child does not respond and his eyes are just wandering all over, the child is not seeing properly. Nowadays the mothers are very intelligent and they pick it up. So the most important thing is to consult a doctor as soon as possible when the mother sees these differences.

Not only parents but also the grand parents and maids could see whether the child is normal with the vision.

Dr. Banagala says that earlier rubella was the main cause for the congenital cataract but now due to wide coverage in rubella vaccine programs the number of children who had cataract due to rubella has come down.

According to Dr. Banagala now the most common cause for cataract in very early childhood is mainly due to hereditary and apart from that maternity infections like toxo plasma caused cataract but they are rare causes. She says that there are children with abnormally formed eyes due to other conditions.

However, the little children who are operated for cataract, have vision for lifetime with Intra Oracular Lenses. Worldwide it was found that the main cause for cataract, which has now become one of the known eye problem, is the UV rays which are becoming more deadly at a rapid rate. "It is advisable to wear hats and wear dark glasses when going out", she says.

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Your eyes do some great things for you, so take these steps to protect them

* Wear goggles in classes where debris or chemicals could go flying, such as wood shop, metal shop, science lab, or art.

* Wear eye protection when playing racquet ball, hockey, skiing, or other sports that could injure your eyes.

* Wear sunglasses. Too much light can damage your eyes and cause vision problems, such as cataracts, later in life. If the lens gets cloudy, it's called a cataract. A cataract prevents light from reaching the retina and makes it difficult to see.

The eyes you have will be yours forever. Treat them right and they will never be out of sight!

How can parents, family, friends and teachers make a difference?

There are lots of things that can be done to help children with cataract make the most of their vision.

We use our vision to get around, learn new things and to meet other people and make friends. It is important to consider what your child's particular problems with vision might be now and in the future.

If your child has been prescribed spectacles, contact lenses or a Low Visual Aid (LVA) it is important that they are encouraged to wear and use them. This will help your child see more clearly and ensure the vision parts of the brain grow and develop.

Wearing a hat and tinted glasses can also help reduce symptoms of photophobia (dislike of bright light). If your child has also been prescribed drops they should be used regularly as advised by the nurses and doctors at the eye clinic.

Problems at school may be due to some of the reading books being hard to see. This often means it takes longer and more effort to do the work. If the size of print is increased and letters and words spaced more widely most children will find school work easier.

Good bright lighting and crisp black print on a clean white background will also make things easier. Sometimes placing reading books on a slope, which tilts the print towards the child, will improve reading speed as well.

When reading it can be helpful to read one line at a time through a 'letter box' placed over the page. Placing a piece of blue tack below the line they are reading, at the beginning of the next sentence, can help some children find their way back to the start of the next line more quickly.

It is also worth watching carefully to find out what the smallest toys are that a child can see and play with. Then try to only play with toys that are the same size or bigger.

Placing one toy on a plain background will often help children see it more readily. Placing lots of toys of different size and colour close together on a patterned background can make them more difficult to see.

Recognising facial expressions can often be difficult. It is worth trying to find out at what distance facial expressions can be seen and responded to. Then always try to talk and smile from within this distance. This helps a child to learn what facial expressions mean and to copy them.

Infants and young children need to learn about the world around them. Home visiting teachers, physiotherapists and occupational and speech therapists may all add to the child's care and education. It is important to continue the programmes that they recommend. If the child is involved in family activities vision can improve and new skills can develop.

Even if a child has very poor vision many useful and practical things can be done to improve the ability of the child to get around, interact with other children and learn.

Kidshealth.com