Paediatric Cataract
What is a paediatric cataract?
A paediatric cataract is a clouding of the natural lens of the eye present at birth or developing during childhood. The cloudy lens prevents light from reaching the retina properly and can interfere with normal visual development.
Why is early treatment important?
A child’s vision develops rapidly during the first few years of life. If a cataract blocks vision during this period, the brain may not learn to see properly, resulting in amblyopia (lazy eye) and permanent visual impairment.
Symptoms
- White reflex in the pupil (white spot in the eye)
- Poor fixation or following of objects/poor vision
- Delayed visual milestones
- Nystagmus (abnormal eye movements)
- Squint (strabismus)
- Photophobia (light sensitivity)
Causes
- Congenital (present at birth)
- Intrauterine infections
- Metabolic disorders
- Developmental
- Hereditary/familial
- Trauma
- Steroid use
- Associated systemic syndromes
Treatment
- Surgery
Surgery is the main treatment for visually significant cataracts.
- Removal of the cloudy lens
- Implantation of an intraocular lens (IOL) in selected children
- Optical correction with spectacles or contact lenses when necessary
Lens implantation (IOL)
Depending on the child’s:
- Age
- Eye size
- Cataract type
- Associated ocular conditions
An artificial lens implantation may be deferred at the time of initial surgery, and a second surgery at an appropriate age is done to implant a lens for better results.
Important points
- The eye continues to grow after surgery.
- Spectacle number can change with age.
- Additional glasses may still be required even after IOL implantation.
Importance of amblyopia therapy
Surgery alone does not guarantee good vision.
Many children require:
- Patching of the better eye
- Glasses
- Contact lenses
- Vision therapy
- Regular follow-up
Parental cooperation is essential for visual rehabilitation.
Risks of delaying surgery
- Permanent amblyopia (lazy eye)
- Poor visual development
- Nystagmus
- Squint
- Reduced binocular vision
- Irreversible visual loss