Cataracts

A cataract is a clouding of the eye’s lens. Cataracts occur most commonly in the senior population, but they can happen in children as well.

In order for a child to develop good vision, the child has to have clear light focused on the retina so the brain receives a clear image. If the cataract blurs the light, it may limit the child’s visual development and result in amblyopia.

The effect of a cataract in a child’s eye can be devastating. Immediate treatment may be needed to prevent permanent vision loss. This is in contrast to adults, whose vision loss can be reversed because the cataracts have developed long after normal vision development.

Early detection is essential for all cataracts during childhood. 

Pediatric cataracts may occur spontaneously without a known cause. They can also occur due to:

• Abnormal lens development during pregnancy.
• A genetic abnormality.
• Other medical problems, such as infections or metabolic syndromes.
• Blunt or penetrating injuries to the eye, causing damage to the lens. The cataract can form shortly after the trauma, or months to years after the injury.

Some cataracts are small or off center in the lens. These cataracts do not need to be removed because vision can develop normally. Some of these cataracts can grow or may develop during childhood, and they should be monitored by a pediatric ophthalmologist.

Cataracts that interfere with vision should be removed as soon as is safely possible. Pediatric cataract surgery is technically challenging and should be performed by a pediatric ophthalmologist familiar with the procedure as well as the visual rehabilitation after the surgery. 

Cataract surgery performed by an experienced surgeon is generally very safe. The risks of pediatric cataract surgery include infection, inflammation, retinal detachment, development of glaucoma, displacement of the intraocular lens, development of capsular cloudiness and development of vitreous cloudiness. The cataract surgery is just the first step in restoring vision in a child with cataracts. Visual rehabilitation after the surgery may include contact lenses, glasses and patching of the fellow eye to strengthen the connection between the brain and the eye with the cataract.