Pediatric cataracts

What are pediatric cataracts?

A cataract is a cloudy patch on the normally clear lens of the eye that may cause blurred vision. Some cataracts are so small they don't impair vision at all, while others can affect the whole lens, causing blindness. Cataracts most often occur in older adults, but children can have them as well. In the United States, about 3 out of 10,000 kids have a cataract.

When light enters the eye, the retina senses it and sends a signal to the brain. If a cataract blocks or distorts the light, the image sent to the brain may be blurry or even completely obstructed. It is important to catch and treat cataracts early before they interfere with the development of a your child's visual system.

Children with cataracts may complain of cloudy or double vision. You may notice your child squinting or that his eyes wander more than usual. Kids with cataracts may also have an extreme sensitivity to light. Newborns and infants should have an eye examination to detect a cataract or other vision problem.

What are the different types of pediatric cataracts?

• Congenital cataracts are usually the result of abnormal lens development in the womb. It may be the result of a mother’s exposure to an infection such as rubella or smallpox during pregnancy. Other congenital cataracts are genetic—for instance, children with Down syndrome are more likely to have a cataract at birth.

• Developmental cataracts show up in older kids. They are most often the result of an eye injury.

What are the signs and symptoms of pediatric cataracts?

Childhood cataracts usually affect one eye, but can be present in both. It can be hard to detect cataracts in babies and younger children. Some cataracts form on the outer edge of the lens (cortical cataracts) and don't impair vision at all. Others may have either moderate or serious impact on a child's vision.

Symptoms of cataracts in children include:

• Cloudy vision

• Double vision

• Wandering eyes

• Squinting

• Sensitivity to light

• Yellowing or fading of images

How are pediatric cataracts diagnosed?

A pediatric ophthalmologist or optometrist can diagnose cataracts in children during a physical exam. The doctor can detect cloudy areas on the lens (sometimes even before it affects your child's vision). Special cameras can measure the density of a cataract.

• Newborns, infants and toddlers - A doctor will perform a “red reflex test” using a device called an ophthalmoscope. It can detect an opacity in the lens, which may be a cataract.

• Older children - Kids preschool-aged and above will receive similar eye tests to the ones adults get. The doctor will cover or patch one eye while your child identifies letters or pictures on a chart from a distance.

Other test may include:

• Contrast sensitivity - Charts with contrasting backgrounds are used to test for contrast sensitivity.

• Glare sensitivity - Your child will read a chart twice, once with bright lights on and once without.

• Ocular motility - Tests on macular function can help determine whether your child is a good candidate for surgery.

What are the causes of pediatric cataracts?

Most childhood cataracts are congenital, meaning they are present at birth. Cataracts may also develop after an eye injury.

How are pediatric cataracts treated?

Cataracts are often mild in children and may not affect a child's vision at all. If your child is having vision problems, or if the cataract is on your infant's lens, surgery to remove the affected lens is the only option. Surgery should be performed as early as possible so that your child's visual system develops normally. Ophthalmologists are the only professionals qualified to perform cataract surgery.

Cataract surgery is an outpatient procedure that usually takes less than an hour.

• In adults, an artificial lens usually replaces the affected one.

• In kids, it is more common for an ophthalmologist to prescribe glasses or contact lenses.

Studies show that infants with a cataract should have surgery between four and six weeks of age.

• Earlier, and your child may be at risk for glaucoma later on.

• Any later, and the development of her visual system may be compromised.

Prognosis

With proper treatment, children with cataracts usually go on to lead normal, healthy lives. Without treatment, kids may develop more serious disorders such as amblyopia (lazy eye), which can lead to blindness later on.