FEATURE | Posted May 20, 2015

Five generations of congenital cataracts

Pediatric patient had vision-saving surgery as newborn

Teddy has an exam from Dr. O'Hara © UC Regents
Teddy Reynolds was born with congenital cataracts in both eyes. They were removed when he was a newborn and he now has normal vision.

Cataracts and cataract surgery are often thought to be a concern of an aging adult, not a newborn baby. But when Theodore “Teddy” Reynolds was born, it was the first thing his parents, Steven and Lana, asked that he be screened for.

Congenital cataracts run in Teddy’s family. Because of this, Steven and Lana knew that each of their children had a 50/50 chance of being born with cataracts. During his newborn screening, doctors discovered cataracts in both of Teddy’s eyes.

When he was one week old, Teddy saw Mary O’Hara, director of pediatric ophthalmology at UC Davis Eye Center. At one month, he had cataract removal surgery in one eye. In another month, his eye was fully healed and he had the same surgery in the second eye.

“If we didn’t remove his cataracts that early, the eye-brain connection would never develop and he would have poor vision his whole life,” O’Hara said. “He would have been legally blind, with the ability to differentiate between shadows and lights, but wouldn’t have been able to see definition. His life would be completely different.”

Cataracts in the family

“It’s really a success in three generations to change this from a blinding disease to a treatable disease.”
— Mary O’Hara

The first known record of cataracts in Steven Reynolds’ family was in his great grandmother. Steven, his sister, mother and grandfather all had them as well. Teddy is the fifth generation born with congenital cataracts.

All of Steven’s relatives with cataracts were legally blind. Steven was 2 years old when he had his cataracts removed and, because of his young age, doctors were able to preserve some of his vision.

About 1 in 10,000 children will have some form of cataracts. However, not all of them have to be removed. Some can be compensated with glasses or other devices. Teddy’s particular type of cataracts were visually significant and had to be removed as an infant.

Congenital cataract surgery in babies is very similar to adult cataract surgery. In adult surgery, the cataracts are removed and replaced with an artificial lens. But since Teddy had smaller, growing eyes, the lenses were replaced with contact lenses, which can be changed as he grows.

The natural lens is flexible, and Teddy’s contact lenses, acting as artificial lenses, can only focus at one level. In addition to his contact lenses, which help for distance, Teddy wears glasses which give him the ability to focus while reading.

“Newborn screening is extremely important. If cataracts are found in a newborn and if they are dense, visually significant cataracts, time is of the essence. If they are not removed within the first couple of months, they won’t have the same visual outcome.”

Teddy and Dr. O'hara © UC Regents
Teddy Reynolds visits pediatric ophthalmologist Mary O'Hara every six months.

Normal vision

Teddy is now 9 years old and, because of his early surgery, has normal visual acuity. Since children with cataracts can develop other vision impairments, he visits O’Hara every six months to make sure his eyes are healthy.

“Teddy’s done fabulously,” said Lana Reynolds. “If we didn’t have the option of the contact lenses and the support that we’ve had, his vision wouldn’t be as good as it is now. It’s been great to have such a supportive doctor. And it puts me at ease knowing there’s an entire team behind Teddy’s treatment.”

“It’s really a success in three generations to change this from a blinding disease to a treatable disease,” O’Hara said.