Cataracts are cloudy patches in the lens of the eye that cause blurry vision. Although they typically occur in older adults, some children are born with cataracts or develop them early in life.
Cataracts are often associated with older adults, but children can have them, too. Every year, 20,000–40,000 children worldwide have congenital or childhood cataracts.
While many children with cataracts may have no symptoms or only mild ones, for some children, untreated cataracts can cause permanent changes in their vision.
It’s important for children to attend all well-baby and well-child checkups so they can undergo regular tests, including vision tests.
Childhood cataracts are also sometimes known as congenital cataracts if they’re diagnosed at birth. Other names for them include developmental, infantile, or juvenile cataracts. They can be present in one or both eyes.
Cataracts blur the normally transparent cornea of the eye. The cornea is a part of the eye found on the front and responsible for focusing and reflecting images onto the retina in the back.
Children with untreated cataracts can develop vision problems like lazy eye (amblyopia), a type of reduced vision that happens when the brain ignores the signal coming from a significantly weaker eye. In rare cases, blindness is also possible.
The cause of childhood cataracts is not always known. In some cases, it may be due to:
Signs of childhood cataracts can include:
- noticeably poor vision (a young child may have difficulty recognizing people or tracking items)
- white or gray pupils
- eyes that point in different directions
- rapid, uncontrolled eye movements
Your child’s doctor will look for evidence of cataracts during their newborn exam or a routine physical.
They’ll test for a red reflex to determine eye health and look for cataracts. Shining a bright light into the pupil, they’ll look to see whether the retina reflects back a red glow and measure the glow’s brightness, color, and symmetry. If they see no red reflex or a weak red reflex, this may mean that the lens is not fully transparent, possibly indicating cataracts.
When signs of cataracts are present, your doctor will typically refer you to an ophthalmologist, where dilation and further eye testing will occur.
Some cataracts are very mild and do not affect a child’s vision. However, if they do, surgery to remove the affected lens or lenses may be necessary.
During the surgery, an artificial lens can be applied to replace the affected lens so the eye can still focus. Children may also use contact lenses or glasses after surgery to compensate for changes in vision due to the lens removal.
If cataracts are present in both eyes, your child’s doctor may choose to do two separate operations to reduce the risk that both eyes will be affected by any surgery complications.
If one eye is stronger than another, a lazy eye may develop even after surgery. Patching the strong eye for several hours a day may be necessary to strengthen the weaker eye.
That said, potential complications of cataract surgery include:
- posterior capsule opacification (PCO) or a clouding of the new artificial lens
- pupil abnormalities
- eyes looking in different directions
- retinal detachment
- fluid building up between layers of the retina
Additional surgeries or medications may be necessary to correct these complications.
Risk factors for childhood cataracts include:
How quickly childhood cataracts are diagnosed can make a significant difference in their long-term effects. When promptly and properly treated, children with cataracts can develop nearly normal vision.
Left untreated, childhood cataracts may cause severe vision problems, including blindness.
A common treatment is cataract surgery; however, not all children with congenital cataracts need to be treated with surgery. Because the risk for glaucoma is so high after cataract surgery in children, some children are simply monitored to see whether lazy eye develops.
It’s important that children continue to have regular eye exams to ensure that no other complications develop that might negatively affect their vision.
Can childhood cataracts be prevented?
Many cases of childhood cataracts can’t be prevented. However, in some cases, vaccinations and other measures to prevent infectious diseases during pregnancy may help.
What are some of the infections most likely to lead to childhood cataracts?
Some of the major infections that can lead to childhood cataracts include:
When should you seek medical help after a cataract removal surgery?
It’s important to let your doctor know if your child has any of the following symptoms following cataract removal surgery:
- significant stickiness and redness
- sudden change in vision
- fever or other signs of infection
Cataracts are a clouding of the eye’s lens that leads to blurry vision. Although cataracts are more common in older people, they can be present from birth or develop shortly thereafter. Surgery is required in many cases to treat this condition.
While it can be hard to determine how well a young child is seeing, it’s important to see an eye doctor if you believe that your child has symptoms of cataracts. Left untreated, serious vision problems may develop.