Pediatric Cataract 

You always associated cataract with old age. Did you know, cataract can occur in babies too?

Clouding of lens is called as 'Cataract'.

Cataracts  occurring in children are called pediatric cataract. They may be Congenital or Developmental.

Pediatric cataracts occur due to some insult to the lens fibers. The lens fibers lose their transparency and become opaque. According to the timing of the insult, specific group of lens fibers may be affected, giving rise to different types of cataracts.

How do I know my baby has a cataract?

The child appears to have a 'white pupil' (Leukocoria). A squint may develop. The baby may cry if you keep a hand over his 'good eye'. He may not be able to respond to toys held away from him.

Causes -

Genetic -  due to abnormality in the genes. Congenital cataracts run in families.

Infections occurring in the womb like due to Herpes virus, CMV, Rubella, Syphilis etc.

Metabolic diseases due to abnormal metabolism like that of the mucopolysaccharides as in Hurler's disease.

Traumatic- due to mechanical injury

In association with developmental abnormalities like PHPV

In association with tumors like Retinoblastoma.

Idiopathic- cause not known.

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Management

The cataract blocks the light from reaching the retina either wholly or partly. This interferes with the development of vision, in the child. The first few years are extremely vital for development of vision. During this time if the eye  and the brain are not trained, they never will see again. Therefore early cataract surgery is highly crucial for the child.

Children require to be anaesthetized fully for detail examination. This is called EUA- Examination Under Anaesthesia.

Cataract surgery in children is more difficult. It has to done under General Anaesthesia, which has its own risks, in small babies. 

In children, complications are more common. 

Putting eyedrops itself is very difficult! 

Another problem is whether intraocular lens (IOL)  should be inserted, or not and what power of lens should be used.

If IOL is not inserted, the child becomes aphakic. (Aphakic means 'without lens'. His vision will be only about 2 feet) He requires aphakic glasses or contact lenses for normal vision. The aphakic glasses or contact lenses are obviously difficult to use in a child. But it is miraculous to see how well the child adapts to them, once he is convinced of its benefits.

Type of glasses for a child -

If parents fail to take those extra pains for their child, his vision may never develop later.

If there is cataract in both eyes can both eyes be operated at the same time?

Both eyes are almost never operated at the same time.

When there is cataract in both eyes, the second eye is usually operated 3-6 weeks after the first.

The child needs a prolonged follow up to check the visual development.

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Congenital means "Present Since Birth".