Childhood Cataracts

An Overview

Cataracts are an eye condition where the lens of the eye becomes cloudy. The lens normally allows light to pass through the eye. When the lens becomes cloudy, light can pass through. So, vision becomes blurred. This can happen in one eye or both eyes. Cataracts are most common in adults. However, they can also affect babies and young kids. Because the eyes are still developing, cataract should be treated right away. Delaying the treatment can increase the risk of lazy eye

Cataracts occur when changes in the lens of the eye cause it to become less transparent (clear). This results in cloudy or misty vision. The lens is the transparent structure located just behind the pupil (the black circle in the centre of the eye). It allows light to pass through to the light-sensitive layer of tissue at the back of the eye (retina).
Cataracts most commonly affect older adults (age-related cataracts), but some babies are born with cataracts.
Children can also develop them at a young age. These are known as childhood cataracts.

At any age, cataracts are a clouding of the eye’s lens. An eye’s lens must be clear to focus the images it sees onto the retina, which then sends the images to the brain. A cataract can prevent light from reaching the retina. It can also cause light rays to scatter as they pass through the cloudiness. This distorts the image and can cause blurry vision or blindness. In adults, cataracts happen after the eyes and vision develop. Most adults have good vision again after they have their cataracts removed. Children’s eyes and brains are still developing until they’re 8 or 10 years old. That’s why untreated cataracts can have serious, permanent effects on their vision.

Causes of Childhood cataracts

In many cases, the exact cause is unknown. The main causes of congenital cataracts are genetic disorders (like Down’s Syndrome) and infections during pregnancy (like measles and rubella).
Juvenile cataracts are acquired later in life. They may be due to diabetes, eye trauma, infection by a parasite, or galactosaemia (a condition where the sugar in milk cannot be broken down by the body).
If you have a family history of childhood cataracts, your child may be at a greater risk.

• Injury to eyes, especially after birth
• Diabetes
• Use of steroids
• Exposure to poison
• Rheumatoid arthritis
• Eye diseases like glaucoma
• Metabolic disorders like enzyme deficiencies
• Genetic conditions like Down Syndrome
• Eye injury
• Eye diseases, such as glaucoma
• Metabolic disorders, such as enzyme deficiencies
• Genetic conditions, such as Down syndrome or genetic faults passed on from parents
• Infections caught by mother during pregnancy like chickenpox, rubella
• Most cataracts that children develop generally occur with any other eye or health complication.

Symptoms
Cloudy patches in the lens can sometimes get bigger and more can develop, resulting in the child’s vision becoming increasingly affected.
As well as poor vision, cataracts can also cause “wobbling eyes” and asquint, where the eyes point in different directions.
When your child is very young, it can be difficult to spot signs of cataracts.
But your baby’s eyes will be routinely examined at their newborn physical screening examination within 72 hours of birth, and again when they’re 6 to 8 weeks old.
• A condition called nystagmus cannot control rhythmic eye movements – the eyes go back and forth, up and down, all around and mixed.
• Blurry and clouded vision
• Difficulty seeing
• Lights that look very bright or have a glare
• Seeing a halo or a circle of light around an object

Types of Childhood Cataracts:

There are two types: congenital and juvenile. Congenital cataracts are found in newborn babies, while juvenile cataracts develop in toddlers or young children.
1. Congenital Cataracts
Some babies tend to be born with cataracts or develop them in childhood. Congenital cataracts develop in both eyes. This kind of cataract does not generally affect the child’s vision and does not need to be removed.
2. Secondary Cataracts
This type generally develops because of another illness. Diabetes or any other eye illness can be the cause of secondary cataracts. Steroids can also cause this type of cataract.

Diagnosis of Cataracts In Child

Your healthcare provider or pediatrician will check and know about your child’s health history. Your child will then be recommended an eye examination. They will suggest the following tests:
• Visual Acuity Test: This is an eye chart test and tests your child’s ability to see from a distance.
• Pupil Dilation: Your child will be given an eye drop that will dilate the pupil. This will help the doctor to examine the eye lens, retina, and optic nerve. It will also help the doctor look for any signs of damage or other eye-related problems.

Prevention

It’s not usually possible to prevent cataracts, particularly those that are inherited (run in the family).
But following the advice of your midwife or a GP to avoid infections during pregnancy (including making sure all your vaccinations are up to date before getting pregnant) may reduce the chances of your child being born with cataracts.

Treatment of Cataracts In Child

Treatment of cataracts depends on the severity of the contract and other symptoms, age, and general health of the child. The pediatric ophthalmologist may monitor small cataracts that do not affect vision. However, if the cataract significantly hinders vision, surgical removal or insertion of an artificial lens may be needed to restore normal vision.
Depending on the child’s age, an artificial plastic lens is placed in the eye during the initial cataract surgery. In children less than a year of age, no intraocular lens is placed, and when the child has grown, a lens is implanted. Post-surgery, they may need short-term treatment with anti-inflammatory and antibiotic eye drops.

The most common cataract surgery risks include:
• glaucoma,
• detached retina,
• infection, and
• the need for more surgery
For most children, surgery is just the first step to fix the eyes. Ongoing treatment must help repair eye-brain connections. This involves having the proper refractive correction to focus clear images on the retina.

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