Cataracts in infancy and childhood

What is a cataract?

A cataract is a clouding of the clear lens in the eye and is one of the leading causes of vision impairment. While cataracts most commonly occur in those who are older, they can develop in younger people as well. Some people are born with a cataract.

These images give an impression of what someone with cataracts may see compared to someone with normal vision.

Cataract simulation
Normal vision simulation

What causes cataracts in children?

Sometimes no single cause for cataracts can be identified. There may be a family history of cataract. The other main causes are due to infection of the unborn baby in the womb, genetic conditions and some metabolic genetic conditions. The cataract can occur in only one eye or may be present in both.

When is surgery necessary for removal of the cataracts?

Congenital cataracts (present at birth) and developmental cataracts are the most common cause of surgically treatable blindness in infancy and childhood. The size of the cloudy area of the lens, the degree of density of the cataract and the position of the opacity in the lens will all be a factor in the determination of whether the child needs to have surgical removal of the cataract and how soon after birth the cataract should be removed.

Some cataracts are slow to progress and do not cause an interruption to normal patterns of visual development. These cataracts will be monitored carefully by an eye doctor and removed only if they are causing a significant visual impairment.

If the child is born with dense cataracts interfering with vision they will be removed within a few days of birth.

Why is early surgery necessary?

The first few days and weeks after birth are critical for the development of normal vision. The brain needs to have a clear image from the back of the eye to enable normal development. If the brain does not receive a clear picture from the eyes in the first few weeks of life the vision will not develop normally. This condition is known as amblyopia or ‘lazy eye’.

What happens when the cataracts are removed?

Surgery to remove the cataract is usually undertaken as soon as practical once it is decided that the cataracts are interfering with normal visual development. The normal lens inside the eye may be replaced by a plastic lens or the child may wear contact lenses to enable clear vision.

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