After his pediatrician found an abnormal red reflex in his eyes, baby Kash Kennamer was referred to an ophthalmologist who diagnosed the infant with aphakia. Then at four months old, Kash underwent cataract surgery. Following a referral from Callahan Eye Hospital, one week later, his parents brought Kash to UAB Eye Care’s new Pediatric Aphakia Clinic started by Natalie West, OD.
“My husband Tate and I drive from Huntsville so Kash can receive care,” his mother Hannah said. “We wanted to ensure that he would receive the best care possible and we knew that he could at UAB. I feel confident in the doctor’s knowledge and ability to take the best care of our son.”
Aphakia is the lack of natural focusing lenses in the eye due to bilateral congenital cataracts, which Kash had removed. West explained that, unlike most adults who undergo cataract surgery, most infants do not receive implants to replace the natural lens of the eye. The continual changes in eye growth over the first 12-18 months of life and the potential need for more surgeries make implants impossible.
“This leaves the infant with a very high prescription that needs to be corrected in order to provide good visual input to the brain,” she said. “Contact lenses are a great option compared to glasses for some of these patients. Contact lenses offer better visual optics for patients compared to glasses, due to the thickness in the glasses prescription needed for these patients. Contact lenses also allow a better chance of continual wear of the prescription because babies cannot take them out, compared to the babies’ ability to pull at and remove glasses from their face.”
Contact lenses proved to be Kash’s best option. West fitted Kash for hard contact lenses in both eyes to correct his high prescription.
Hannah said, “This experience has not been the easiest but seeing how big his smile is and interactive he is once his contacts are in makes it all worth it. We have learned so much about our son and his condition through all of his doctor visits and his daily eye care routine. We feel all the doctors have been very transparent with us and it has allowed us to trust them in taking care of our son.”
Although the experience has been challenging so far, Kash’s prognosis is great. In 2019, the Infant Aphakia Treatment Study (IATS) reported that for a group of 96 children who underwent cataract surgery between the ages of one to seven months old, the median visual acuity at age five years old was 20/45.
While the clinic is new, providing care for aphakic infants isn’t new to UAB Eye Care’s pediatrics department. Kathy Weise, OD, MBA, pediatric service director, has been providing care for aphakic infants since 2015. West began working with her and these patients in 2019 during her residency training and has continued since joining the faculty in 2020.
When asked about her goal as leader of the new Pediatric Aphakia Clinic, West said, “Many of our current patients and families in this clinic drive several hours to see us. My goal is to train future optometrists in this area to increase access to quality eye care for this specialized patient population.”