- Coats' disease involves leakage of the blood vessels in the retina.
- It is a non-hereditary condition so your other children are not at risk of acquiring the disease and the affected child is not at risk of passing on the disease to the next generation.
- No identifiable cause has been found for Coats’ disease.
- It is usually a unilateral condition.
- Coats disease can occur at any age, but the majority of patients are diagnosed in the first or second decades of life.
- Vision in one eye is usually noticeably impaired.
Complication of Coats' Disease
- Total retinal detachment – fluid under the retina
- Secondary glaucoma – increased intraocular pressure that can cause redness, pain, nausea and vomiting.
- Scarring in the centre of the eye causing low vision.
- These complications may sometimes require the eye to be removed. If enucleation is necessary then a prosthetic eye is placed and the cosmesis is usually good with the prosthesis.
Treament
- The leaking blood vessels can be treated with laser surgery or cryotherapy (freezing). On an average three to four sessions of treatment are required to control the disease process. The treatments are done under general anesthesia with the child asleep. After these treatments the eye can be red and swollen for few days, this is painless and subsides on its own.
- In rare cases, a vitrectomy to replace the vitreous (the clear gel-like substance inside the eye) with a gas bubble may be necessary to settle the detached retina.
- In some cases injections are given to decrease the edema (swelling) in the retina. This could be either a steroid injection or VEGF inhibitors (like avastin). These injections are also given at the time of general anesthesia.
Follow up
- Till the disease is under control follow up visits have to be every 3-4 months. After that the visits can be every 6 months.
- The child will have to be on a twice yearly follow up by an ophthalmologist life long.
Precautions
- Wear polycarbonate glasses at all times for protection.
- Wear goggles while playing sports.
- Report to ophthalmologist if eye is red or painful.
- No dietary restriction.