(See also Cataract Cataract A cataract is a clouding (opacity) of the lens of the eye that causes a progressive, painless loss of vision. Vision may be blurred, contrast may be lost, and halos may be visible around lights... read more in adults.)
Congenital cataracts have many causes. They may be inherited (multiple genetic or chromosomal disorders Overview of Chromosome and Gene Disorders Chromosomes are structures within cells that contain a person's genes. A gene is a segment of deoxyribonucleic acid ( DNA) and contains the code for a specific protein that functions in one... read more ), related to disorders of metabolism (such as galactosemia Galactosemia Galactosemia (a high blood level of galactose) is a carbohydrate metabolism disorder that is caused by a lack of one of the enzymes necessary for metabolizing galactose, a sugar that is part... read more ), or caused by infections contracted while in the womb (such as rubella Rubella Rubella is a contagious viral infection that typically causes in children mild symptoms, such as joint pain and a rash. Rubella can cause death of a fetus or severe birth defects if the mother... read more ) or by another disease of the mother during pregnancy.
Congenital cataracts may affect only one or both eyes. As with other cataracts, the clouding of the lens sometimes blocks vision.
Some cataracts cover only part of the lens (partial cataracts), and cloudiness begins during the first 10 years of life. Vision is better in eyes that have partial cataracts.
Diagnosis of Congenital Cataract
Doctors look for cataracts during the routine eye examinations that are done at birth and again at routine well-child visits. If cataracts are suspected, children should be evaluated by a medical doctor who specializes in the evaluation and treatment of all types of eye disorders (ophthalmologist). The ophthalmologist's examination must be done right away because a cataract should be treated within 4 to 6 weeks after birth. The ophthalmologist does an eye examination and possibly ultrasonography of the eye to confirm the diagnosis of a cataract and to look for any problems with the retina.
Treatment of Congenital Cataract
Surgical removal of cataracts
Sometimes implanting an artificial lens
Treatment of amblyopia if present
If necessary, ophthalmologists remove the whole lens containing the cataract through a small incision in the eye. Sometimes, like in adult cataract surgery, doctors implant a plastic or silicone lens (intraocular lens) at the same time. However, in many children, doctors implant the lens after the child is 6 months of age. Until then, the child wears a hard contact lens Contact Lenses Refractive errors can be corrected with glass or plastic lenses mounted in a frame (eyeglasses) or with a small lens made of plastic floating or resting on the cornea (contact lens). Good vision... read more to correct vision.
With a cataract in one eye, the quality of the image in the affected eye is poorer than that of the other eye (assuming the other eye is normal). Because the better eye is preferred, the brain suppresses the poorer-quality image, and children may develop amblyopia Amblyopia Amblyopia, a common cause of vision loss in children, is a decrease in vision that occurs because the brain ignores the image received from an eye. Vision loss may be permanent if the disorder... read more (decrease in vision that occurs because the brain ignores the image received from an eye). Thus, even after cataract removal, doctors often force the child to use the treated eye by putting a patch over the better eye (patching) or using eye drops to blur the vision in the better eye. Patching or using eye drops in the better eye helps the treated eye develop normal sight.
After cataracts are removed from both eyes, children who had image quality that was similar in both eyes more frequently develop equal vision in both eyes.
The following is an English-language resource that may be useful. Please note that THE MANUAL is not responsible for the content of this resource.
Children's Eye Foundation of AAPOS: Practical information about prevention, detection, research, and education to protect the vision of children