Cataracts in children

Although cataracts are mainly seen in older people, they may also occur in babies and children. A cataract is a clouding of the lens inside the eye. The eyes lens sits behind the coloured iris and helps to focus the light rays that enter the eye. If the lens is cloudy due to a cataract, the vision is reduced because light cannot reach the back of the eye as it should. It is essential that cataracts be detected and treated when a child is young, before amblyopia develops in the affected eye.

What are the signs of that a child has a cataract?

Some signs of a cataract in a child may be; white or grey pupil, poor vision, nystagmus or strabismus in the eye with the cataract.

What causes cataract in children?

Some children are born with cataracts. A child may also develop a cataract as a result of an eye injury (traumatic cataract) or due to problems with his or her general health. Cataracts are sometimes passed onto the child through heredity factors from a parent who has had cataracts. In many cases however, the cause is unknown.

How are cataracts in children treated?

The treatment of cataracts varies depending on how cloudy the lens is. Sometimes vision loss is only slight and no treatment is necessary. However usually the cloudy lens must be removed before the vision can improve.

Children undergoing cataract surgery are given a general anaesthetic. The abnormal lens is then removed through a small incision in the eye. Generally the child feels little or no pain after the operation, and is able to go home a few hours later. He or she will need to be examined by the ophthalmologist the next day and several times over the following days and weeks. A protective eye shield is worn for a while and eye drops are given several times a day.

Are there any risks involved in cataract surgery?

Cataract surgery is very safe but complications that may decrease vision or affect the health of the eye are possible. The back capsule of the lens is not removed during surgery and in some cases this can become cloudy and need treatment with a laser procedure. (YAG capsulotomy)

What ongoing treatment will be necessary?

Children who have had cataract surgery need to wear glasses or contact lenses to compensate for the loss of the eye's natural lens. Without glasses or contact lenses the child's vision would be poor, and the maximum benefit from the surgery would not be obtained. In children over the age of 2 - 2 1/2 years an intra ocular lens can be inserted.

Some children may develop amblyopia, especially if they have only had a cataract in one eye. The treatment for amblyopia is to patch the "good eye" to encourage the development of better vision in the eye which has had the cataract.