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Cloudiness of the Cornea


Question

At my child’s annual eye exam, her doctor found what he thought was a cut that healed as a scar on her right cornea. Her cornea is cloudy. Could this actually be a cataract instead?

Answer of our experts

  1. Cloudiness of the cornea (clear dome shaped covering over the eye) can look very much like a cataract (cloudiness in the lens of the eye, which is located behind the pupil) to the lay observer. Sometimes the special equipment of the eye doctor is required to tell the difference. 2. Cloudiness of the cornea can occur for several reasons in CdLS. a. The most common cause would be due to blepharitis, slow flow in the 20-30 glands normally present in each eyelid. This can result either in drying out of the surface of the eye or an immune reaction (in which natural chemicals in the body attack something they don't like) to excess growth of germs (called staph or staphylococcus) on the margins of the eyelids that is allowed because the flow is not there to wash them away. Both events can lead to corneal cloudiness or scars, especially in the lower half of the cornea. b. Self injury. Some children with CdLS injure themselves as part of their behavior profile. c. Very, very rarely, we see a baby with CdLS who also has congenital glaucoma. This occurs in infancy and the whole cornea is cloudy, with a bigger eyeball, aversion to bright lights, and tearing. d. Children with severe ptosis (droopy eyelids) may not close their eyes all the way when they sleep. This can result in drying out of the bottom half of the cornea with a white scar. AL /TK 7-13-10
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Recommendation(s)

The eyes and the visual system

R36
Surgical correction of ptosis should be considered if vision is significantly affected or if the individual is lifting their chin in attempt to see more clearly and it is affecting the individual’s ability to move around.
R37
Blepharitis in individuals with CdLS should be treated conservatively with lid hygiene. Nasolacrimal duct obstruction (blocked tear ducts) should be suspected if symptoms are not improved with lid hygiene.
R38
Vision should be regularly evaluated in all individuals with CdLS, especially in infancy and childhood. Problems with vision should be corrected early to prevent amblyopia (lazy eye), although children may have difficulty tolerating glasses or contact lenses.

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Please take note that the Ask the Expert service is comprised of volunteer professionals in various areas of focus. Answers are not considered a medical, behavioral, or educational consultation. Ask the Expert is not a substitute for the care and attention your child’s personal physician, psychologist, educational consultant, or social worker can deliver.

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