Childhood Cataracts

Patches of cloudy areas in the lens of the eye are called cataracts. Cataracts affect infants, children, and adults.
Congenital cataracts. Present in a newborn infant.
Juvenile cataracts. Present in older babies and children.

They could develop cataracts in unilaterally (one eye) or bilaterally (both eyes). Cataracts in children and babies could be mild and may or may not affect the vision. Nevertheless, they could delay or prevent normal progress of sight in childhood.

Causes

Common cause could include infections and genetic conditions during pregnancy, though in many, the cause cannot be determined.
Genetic causes. Cataracts may be inherited. It could also be caused by abnormalities in the chromosome like Down’s syndrome.
Infections in pregnancy like German measles, cytomegalovirus, chickenpox, and toxoplasmosis.
Cataracts present from birth for conditions like retinopathy of prematurity or aniridia.
Cataracts are also caused by circumstances that influence metabolism like diabetes or galactosaemia.
Injury to the eye.

Diagnosis

It is vital to identify congenital cataracts during the first weeks of a newborn baby in order to prevent vision loss. General appearance and movement of the baby’s eye are observed. If there is cloudiness, it could be cataract. If the baby’s eye is closed, swollen or if the newborn baby is unsettled, irritated, or anxious, it becomes difficult to examine the eye. Despite cataract being there from birth, it is undiagnosed until the child or baby is older.

In case cataract is present, the child or the baby will be referred to an ophthalmologist or paediatric ophthalmologist. He may identify a cataract if he sees it in the lens or an examination shows poor red reflex. Red reflux is a reflection from the rear end of eye.

Blood tests and urine tests can also be done to diagnose the cause of childhood cataracts in the absence of a family history.

Treatment

Cataracts in children and babies can be treated in the following ways:
Replacing a cloudy lens with artificial lens by surgery.
Wear contact lenses.
Wear glasses.

If the cataract is present unilaterally or in one eye, a surgery might be needed. If the cataract is present bilaterally or in both eyes, each eye will be operated upon separately. For a newborn infant, the surgery might be some weeks after their birth. Then, the baby or child may be required to stay in the hospital for a few days.

After surgery, a pad will be put over the eye to cover and protect it. Drops will also be given to help inflammation and avoid infection. They will need to undergo regular follow-ups as outpatients.

Complications

Even if it is a successful surgery, complications that may arise from surgery include
Glaucoma or increased eye pressure.
Strabismus or a squint eye.
Pupil abnormalities.
Cloudy vision (Posterior capsule opacification or visual axis opacification).
Retinal detachment from the wall of the eye.
Infections like endophthalmitis, which is a bacterial infection.
Lazy eye or amblyopia.